Scientific letter
Factors associated with longer breastfeeding duration in Mexican working mothers
Factores asociados con mayor duración de la lactancia materna en madres trabajadoras mexicanas
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Experience of an urban Primary Care team" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2157 "Ancho" => 2925 "Tamanyo" => 286504 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Distribución de los enfermos en los distintos dispositivos sanitarios.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria Antònia Pou, Raquel Gayarre, Sílvia Ferrer-Moret, María Isabel Fernández-San-Martín, María Victoria Feijoo, Cesar Diaz-Torne" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Maria Antònia" "apellidos" => "Pou" ] 1 => array:2 [ "nombre" => "Raquel" "apellidos" => "Gayarre" ] 2 => array:2 [ "nombre" => "Sílvia" "apellidos" => "Ferrer-Moret" ] 3 => array:2 [ "nombre" => "María Isabel" "apellidos" => "Fernández-San-Martín" ] 4 => array:2 [ "nombre" => "María Victoria" "apellidos" => "Feijoo" ] 5 => array:2 [ "nombre" => "Cesar" "apellidos" => "Diaz-Torne" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0212656721001165?idApp=UINPBA00004N" "url" => "/02126567/0000005300000007/v1_202107210700/S0212656721001165/v1_202107210700/es/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Factors associated with longer breastfeeding duration in Mexican working mothers" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Anel Ibarra-Ortega, Edgar M. Vásquez-Garibay, Alfredo Larrosa-Haro, Barbara Vizmanos-Lamotte, Jorge Castro-Albarrán" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Anel" "apellidos" => "Ibarra-Ortega" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Edgar M." "apellidos" => "Vásquez-Garibay" "email" => array:1 [ 0 => "vasquez.garibay@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Alfredo" "apellidos" => "Larrosa-Haro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Barbara" "apellidos" => "Vizmanos-Lamotte" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Jorge" "apellidos" => "Castro-Albarrán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro Universitario de la Costa Sur, Universidad de Guadalajara, Guadalajara, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Factores asociados con mayor duración de la lactancia materna en madres trabajadoras mexicanas" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Mothers who work outside the home, represent a risk group associated with early weaning.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> When they return early to work after birth, they have higher probability of giving up breastfeeding prematurely.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Even when such mothers wish to continue breastfeeding, they face work-related obstacles that hinder exclusive breastfeeding for the first six months, as well as supplementary breastfeeding later.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Opportunities for breastfeeding can be limited by the type of position held,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> the availability of lactation rooms,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> the right of a 1-h breaktime to express milk,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> and perceived lack of support from managers and coworkers.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> Therefore, the objective of the study was to identify factors associated with breastfeeding duration in Mexican working mothers.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">An analytical cross-sectional study was carried out in 2018 in mothers who worked in Guadalajara, Mexico. The Research, Research Ethics, and Biosafety Committees of the University of Guadalajara (CI-05918) approved the study. We selected institutions of three predominant economic activities in the city with<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>250 employees: governmental; manufacturing industry; and health and social assistance service. The human resources departments, of those companies which agreed to participate, helped us to contact mothers from 6 to 35 months postpartum. The inclusion criteria were: to work in the same institution since delivery, single full-term pregnancy, and apparent good health. Mothers with impediments to proper breastfeeding were excluded. We asked them to sign the written informed consent form if they agreed to participate; mothers who did not breastfeed were also included.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Statistical analysis</span><p id="par0015" class="elsevierStylePara elsevierViewall">We performed a binomial logistic regression on those variables that were significantly associated with breastfeeding duration (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), following the forward method to identify the most important variables in the prediction model.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Ethical considerations</span><p id="par0020" class="elsevierStylePara elsevierViewall">The study adhered to the guidelines of the Declaration of Helsinki in its last correction, which was made during the 64th Annual Assembly of the World Medical Association (2013). The Research, Research Ethics, and Biosafety Committees of the Health Sciences University Center of the University of Guadalajara (CI-05918) approved the study.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="par0025" class="elsevierStylePara elsevierViewall">One hundred fifty-eight mothers from 25 institutions participated. The mean maternal age was 33.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.8 years, while the median age of the infants was 18 months (25th–75th percentiles: 12–26 months). The median breastfeeding duration was 6 months (25th–75th percentiles: 3–11 months). Ninety-two women (58.2%) provided<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>6 months of breastfeeding. Low milk production and workload were the most frequently mentioned reasons for breastfeeding cessation.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Fifty-two variables were analyzed, of which 21 had a significant association with breastfeeding duration: 18 were associated with a breastfeeding duration of ≥6 months, and three with a duration less than 6 months. Most of the variables associated with a breastfeeding duration of ≥6 months involved work-related factors or support from the social environment. The perception of low milk production, a flat or inverted nipple shape, and a favorable attitude towards human milk substitutes were significantly associated with a shorter breastfeeding duration. Four variables were significant in the logistic regression, this model explained 65.4% of the probability of a breastfeeding duration ≥6 months (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">This study revealed the current breastfeeding behavior of mothers employed in institutions that by law must follow measures to protect this practice during the workday (the right to breastfeeding hour and installing lactation rooms where mothers can express milk and/or breastfeed). Moreover, we included variables that have previously shown a significant association with breastfeeding duration.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,6</span></a> In conclusion, breastfeeding is influenced by various factors. The increase in the number of women in the workforce makes it difficult for women to stay with their children during breastfeeding and encourages them to give up prematurely. When mothers have a lactation room in their workplace, they often express milk one or more times during their workday; they tend not to perceive low milk production, and they plan to breastfeed for more than six months predicts 65.4% of the probability of breastfeeding for six months or more.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflict of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical analysis" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Ethical considerations" ] ] ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interest" ] 5 => array:2 [ "identificador" => "xack546637" "titulo" => "Acknowledgements" ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Factors included in the prediction model \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Responses \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CI 95% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Frequency of extraction at work (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>158) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥1 times a day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.75–81.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perception of low milk production (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>158) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.88–22.46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Planned time span of lactation in the prenatal stage (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>153) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>6 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.41–27.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.016 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mothers had a lactation room at work (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>158) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.42–15.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.011 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2660446.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Logistic regression model for predicting the probability of occurrence of duration of breastfeeding for more than six months in working mothers (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>132).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Juggling work and breastfeeding: effects of maternity leave and occupational characteristics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Guendelman" 1 => "J.L. Kosa" 2 => "M. Pearl" 3 => "S. Graham" 4 => "J. Goodman" 5 => "M. Kharrazi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2008-2244" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2009" "volumen" => "123" "paginaInicial" => "e38" "paginaFinal" => "e46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19117845" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Factors associated with short duration of breast-feeding in Mexican working women" "tituloTraducido" => "Factores que influyen en el abandono temprano de la lactancia por mujeres trabajadoras" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Navarro-Estrella" 1 => "M.X. Duque-López" 2 => "J.A. Trejo y Pérez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Salud Publica Mex" "fecha" => "2003" "volumen" => "45" "paginaInicial" => "276" "paginaFinal" => "284" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14506770" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "On-the-job moms: work and breastfeeding initiation and duration for a sample of low-income women" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.T. Kimbro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10995-005-0058-7" "Revista" => array:6 [ "tituloSerie" => "Matern Child Health J" "fecha" => "2006" "volumen" => "10" "paginaInicial" => "19" "paginaFinal" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16521055" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of a breastfeeding-friendly workplace on an employed mother's intention to continue breastfeeding after returning to work" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.Y. Tsai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/bfm.2012.0119" "Revista" => array:6 [ "tituloSerie" => "Breastfeed Med" "fecha" => "2013" "volumen" => "8" "paginaInicial" => "210" "paginaFinal" => "216" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23390987" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breastfeeding policy: a globally comparative analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Heymann" 1 => "A. Raub" 2 => "A. Earle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2471/BLT.12.109363" "Revista" => array:5 [ "tituloSerie" => "Bull World Health Organ" "fecha" => "2013" "volumen" => "91" "paginaInicial" => "398" "paginaFinal" => "406" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Variables associated with breastfeeding duration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Thulier" 1 => "J. Mercer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1552-6909.2009.01021.x" "Revista" => array:6 [ "tituloSerie" => "J Obstet Gynecol Neonatal Nurs" "fecha" => "2009" "volumen" => "38" "paginaInicial" => "259" "paginaFinal" => "268" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19538614" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack546637" "titulo" => "Acknowledgements" "texto" => "<p id="par0045" class="elsevierStylePara elsevierViewall">We thank the institutions that collaborated with the study and the participating mothers; Jocelyn González, Jesúa Villanueva, and Perla Garcia for data collection, and Lic. Alejandro Gaytán and Dr. Ana Sandoval for their support, advice, and critical review of the work.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/02126567/0000005300000007/v1_202107210700/S0212656721001311/v1_202107210700/en/main.assets" "Apartado" => array:4 [ "identificador" => "83076" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas científicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02126567/0000005300000007/v1_202107210700/S0212656721001311/v1_202107210700/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0212656721001311?idApp=UINPBA00004N" ]
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