The Impact Of Breastfeeding On Children’s Nutrition And Development

Background and Importance of Study

According to Krause, Lovelady, and Østbye (2011), breast feeding plays a significant role in a child’s nutrition and development. Breast milk is the preferred food for infants due to its health benefits for both the child and the mother. Moreover, Jing et al. (2014) and World Health Organization agrees that children should absolutely feed on breast milk for the first six months and if possible carry on up to at best, the first year of their life.

Notably, many women fail to feed their children exclusively on breast milk for the first six months because of commitments. Studies conducted by World Health Organization on breast feeding reveal that it helps prevent atopic diseases (Yan et al, 2014). However, the some studies conducted previously just highlight that lack of adequate breast feeding causes obesity and overweight but fails to show the actual degree of the problem. Furthermore, Vafa et al. (2012), acknowledge that childhood obesity is increasing globally at a worrying rate. This has prompted world organizations such as WHO to declare it an epidemic. In the same line of argument, Jing et al. (2014) reports chat most Chinese children are overweight because of the feeding practices their parents exposed them to while young.

Additionally, Grube et al. (2015) assert that the duration of feeding infants on breast milk has an impact in their lives later. Although, Krause, Lovelady, and Østbye (2011) attribute lack of proper breast feeding to the body weight of their parents, most parents are getting more concerned with their career at the expense of their children. Nevertheless, the overweight BMI is between 85 and 95th percentile and that of obese is over 95th percentile (American Cancer Society 2018). This research therefore wants to find the statistical significance between breast feeding and overweight on child development and nutrition. It wants to determine the extent by which lack of feeding children on breast milk up to one year exposes them to obesity and overweight.

Parental responsibilities is limiting the time mothers breast feed their children. In fact, education, employment, and other commitments reduce the time for mother-child relationship. As such, these parents resort to introducing solid foods to their children way below the recommendation the World Health Organization. Intrinsically, they deny infants the precious breast milk and thus affect their nutrition and development. Despite some parents acknowledging that failure to feed children exclusively on breast milk up to six months and continuously up to one year has health implication, they just ignore this truth and thus expose their children to future complications

Research Objectives and Hypotheses

The broad objective of this research is to find out the impact of breast feeding on children nutrition and development.  

1. Besides, the specific objective is to find whether statistical significance exist between breast feeding and overweight among children.
2. Another objective is to find out the extent by which lack of breast feeding causes overweight among children.

Is there a difference in the mean of Body Mass Index (BMI) of children who do not feed exclusively on breast milk and the standardized overweight BMI of over 90th centile?

H0: 90 centile = µBMI  (“the average BMI of the children is equal to 85-95th percentile”)

H1: 90 centile ≠ µBMI  (“the average BMI of the children is not equal to 85-95th percentile”)

This study is important as it contributes to the understanding of the impact of breast feeding on child’s child development and nutrition. It shall help parents understand that different degree of breast feeding affect the lives of their children later on. 

This research will not only highlight the impact of not feeding children on breast milk exclusively but also show the statistical relationship between the two. Again, the study will reveal the extent of damage brought by not breast feeding children by examining the p-value of the one way ANOVA and one sample t-test statistical test.

Consistent with McCrory and Layte (2012), breast feeding development concerning child’s obesity and overweight is not conclusive. The duo allege that the number of research and meta-analyses conducted on the subject is not conclusive even though many studies indicate that breast feeding reduces chances of children becoming overweight. In the spirit of McCrory and Layte (2012), this research aims to fill the gap on examining the extent how breast feeding influences overweight. According to Bryhn and Dimberg (2011), when carrying out a statistical significance test, the p-value should be below the conventional threshold of 0.05. As such, with this research, we shall reject the null hypothesis which assert that the mean BMI of the participants is not equal to 85-95th percentile. Carrying out this research will help know the strength of the relationship by observing the value of p.

Studies conducted by Harder Whaley et al. (2017) reveal that obesity and overweight is on the increase globally. Moreover, research conducted focus on how to alleviate overweight and obesity. Interestingly, these studies does not show different aspect of strengths of statistical significance which this study aims to fulfill. In ideal situation, breast feeding combined with formula feeding can help alleviate the dreaded risk of overweight (Whaley et al. 2017). Despite such revelations, such studies does not reveal the statistical significance on different durations of the study.

Literature Review

In other studies, researchers have observed a positive impact on breast feeding on lowering overweight and other infectious diseases within the first two years of a child’s life (Horta and Victora 2013). The duo further observe that feeding children on breast milk help alleviate other non-communicable diseases later in life which include overweight and obesity. However, the study fails to examine what extent of breast feeding help to minimize chances of overweight in children which is study is out to examine.

Uwaezuoke, Eneh, and Ndu (2017) acknowledge that there is a strong link between breast feeding and weight and length gain in the first years of children development. The relationship is not clear whether continuous breast feeding leads reduced BMI, height, and weight during childhood as well as lowering them later in life. This research therefore comes in handy to find out the statistical significance between breast feeding and overweight. The revelation will help understand the extent by which breast feeding influences overweight in children.

This research will combine both descriptive and quantitative research design. However, a qualitative design will be the most prominent because there is need to find out how parents fed their children between birth up to one year. As such, a qualitative approach is the best to collect information from parents. In essence, qualitative research involves collecting data from population sample by asking questions and interviews in a controlled manner. Worth mentioning, Saunders, Lewis, and Thornhill (2016) recently found out that qualitative approach enables researchers to get detailed and comprehensive data without the participants holding back significant information. Besides, quantitative approach will help in obtaining secondary data on BMI.

Research strategy refers to the path that researchers follow when identifying the sample population from which to collect data (Saunders, Lewis, & Thornhill, 2016). Intrinsically, Sekaran and Bougie (2016) identified surveys, case studies, and ethnography as the main research strategies. In the same line of argument, Saunders, Lewis, and Thornhill (2016) argue that surveys are the most appropriate strategy to obtain information from people on what they have been doing overtime. Based on their recommendation, this study adopted survey of six learning institutions due to limited time and financial resources.

The population of concern is learning institutions. According to Sekaran and Bougie (2016), data from different settings concerning the same subject allows comparisons. The target population comprise of kindergarten and lower primary school going children. From these institutions, the researcher will access the children to measure their height and weight for calculating their respective BMI. This will not only boost external validity but also facilitate the formation of tentative conclusions.

Research Design and Sampling Strategy

Owing to a large number of schools around, this study will adopt random sampling technique to choose participating institutions. Etikan, Musa, and Alkassim, (2016) observe that random sampling is preferable where the sample population is too big and similar. Therefore, the researcher will write the names of the schools, put them in a jar and select six institutions. From the institutions, the researcher will use purposive sampling technique to choose 50 children between ages 5 and 7 years. This will bring the number of children under study to 300 due to time and budget constraints. Moreover, Sekaran and Bougie (2016) acknowledge that sampling help obtains information that represents the entire population from the chosen sample.

The data for this research will be collected using questionnaires, observations, and measurements. Questionnaires will help collect data about feeding practices from parents and their respective ages. Measurements will help collect data on height and weight of each participating child while observation will help to easily identify participating children based on their persanl recordss. Additionally, secondary data on the standard BMI will also be very crucial for this study.

The collected data will be analyzed using Statistical Package for Social Sciences (SPSS).  Ozgur, Kleckner and Li (2015); Wagner III (2016) recommends SPSS as it can help explore relationships between responses to variety of questions. It can also help generate routine descriptive statistical data to question responses which are important in reporting, presentation, and publication. In isolation, the research will use one sample t-test and one way ANOVA testing.

According to Frankfort-Nachmias and Leon-Guerrero (2018), one sample t test help to find out whether the population meant which is being investigated is statistically different from the already identified population mean. Therefore, one sample t test gives us the opportunity to compare the standard BMI mean and those calculated from children. Moreover, the one way ANOVA will help compare the means of those children who were exclusively fed on breast milk and those whose parents introduced solid food in their diet. Such will help determine if there is a statistical relationship between the associated population mean (Frankfort-Nachmias and Leon-Guerrero 2018). Therefore, the researcher will be able to ascertain whether the number of months of breast feeding children has an impact of children being overweight or not based on the level of significance achieved. The analyzed data will be presented in tables, charts, graphs to accomplish the objectives of the study.

Data Collection and Analysis

According to Saunders, Lewis, and Thornhill (2016), validity is the extent to which a research achieves what it is supposed to measure. The researcher will follow qualitative and quantitative approaches to collect data, choose the sampling method and presentation of results. Additionally, the study will not deviate from studying other things unknowingly. The process will be guided by the objectives and research questions. Besides, the validity of both external and internal for this research will apply continuous assessment and revision on methods used, assumptions and conclusions.

Saunders, Lewis, and Thornhill (2016) assert that the ability to reproduce a research measures its reliability. It measures the degree to which other scholars can carry out the same research and come up with similar results. As such, this study will follow the principles of research methods, both quantitative and qualitative to produce results that other researchers and can relate with. The data collection will be done cautiously, documenting each step to ensure that the goals and objectives of the study were met

Ethical consideration is very significant in any research activity. Mollet (2011) observes that both quantitative and qualitative approaches determine the validity and reliability of any study. Besides, the researcher will seek permission from parents before subjecting their children to this study. They also get to know the aim of the study before allowing their children to participate. Moreover, the data collected will only be used for the purpose of this research only.

Every research require time and resources to accomplish. This research thus will experience time to constraint. Considering the fact that the researcher is still a student, it will be strenuous to collect data for 300 participants. Again, financial resources to print questionnaires and bus fare is a challenge at this stage of research. Moreover, the research may experience challenges with uncooperative parents who may not like their children participating in this study.

My name is (your name), and I am a bachelors level student at the Coventry University Group (Indicate your department). Currently, we are doing a module called, Introduction to social science research methods. I am conducting qualitative research that requires parents and pupils of between 5 and seven years to participate. I have confirmed this research with the Coventry University Group authority and the school’s administration (Where your child learn) and I received your email information from them as a potential participant. Kindly, find the information about the research study below and your potential role in it. You can contact me regarding any questions you may have at (your email) or by calling (your cell phone number).

Significance and Contribution to Existing Research

You are requested to take part in a study seeking to examine the extent by which children are exposed to overweight complication when they are not fed on breast milk exclusively during the first year of living. The study will also examine a statistical relationship between overweight and breast feeding so that parents can understand the importance of feeding children on breast milk. The research draws observation that due to commitments in education, career, and business, many parent opt to introduce other solid foods to their children way below the recommended age by World Health Organization (WHO). Currently, WHO has declared overweight and obese as an epidemic and thus requires closer consideration by parents. Even though several research has been done on the benefits of breast feeding, this research intends to show the extent of damage parents expose their children to by not exclusively feeding their children on breast milk. This study could shed some light on this phenomenon.

This research will be based on questionnaires, observation, and measurements. As a parent, you will provide your demographic information and the feeding approaches you applied to your child under the study. Consequently, the researcher will measure the weight and height of your child to help in calculating their respective Body Mass Index (BMI). This measurement will be recorded and analysed by the researcher afterwards. This analysis will happen with a number of measurements and the researcher will look for common themes in the experiences of the various participants. After that, the respective BMI will be compared against the standard BMI of 85-95^th percentile for overweight children. From this calculation, the researcher shall know whether your child is overweight or no. In circumstances a child is overweight, the researcher will run a statistical test, specifically one sample t-test, one way ANOVA, and Pearson Correlation regression to determine the degree of deviation from the standard mean. From the deviations, the results shall be interpreted in percentages to determine the strength of significance between breast feeding and overweight.

This information will make up the findings of the study. The specific details of this interview that could in any way identify you will be kept completely confidential when being analysed or reported.

This research has no risks involved for the participant. There could be some discomfort in expressing your experience to the researcher. The potentially personal nature of this research is taken into account. However, if at any stage you wish to stop the process, this will be taken into consideration without question.

Conclusion and Future Directions

The research documents such as the transcript of the questionnaire, the measurements of height and weight; the notes taken through the analysis; and the findings will be kept by researcher confidentially for at least five years. After this time, this documentation will be destroyed. It should be noted that ownership of such documents would be vested in the researchers. This highlights the researcher’s responsibilities in this regard.

Firstly, this is an opportunity for you to express and explore your experience as a parent. A chance to reflect on this experience could be beneficial in understanding your lifestyle and that of your children. This can be very cathartic. Secondly, you will be a fundamental part of research in an area that is getting attention of the international community.  You will have an opportunity to review some of the raw themes that relate to your child or children when I am conducting my analysis. Your insight would offer a validation to the research.

Your personal information in this research will remain confidential as treated as so. For scientific purposes, the outcome of this research, including the measurement of your child’s weight and height, may be published but will not reveal your identity and those of your child or children. Moreover, the data collected will not be used on any other research apart from this study. On the other hand, any data or record the researcher obtains as you participate in this study may be inspected by the Coventry University Group Institutional Review Board, except in circumstances where law or a court of competent jurisdiction otherwise requires the disclosure.

You are at liberty to participate in this research or not. As such, there is no loss of benefit or penalty that you are otherwise entitled to if you choose not to take part. Besides, the researcher will provide you with important outcome arrived at in the course of this research, which may relate to or influence your enthusiasm to continue participating. In the event you decide to discontinue your participation in the study there will be no penalty or recourse. In addition, the researcher without your consent in an exceptional circumstance may terminate your participation in the study.

Having read and understood this content form, I am volunteering my child and I to take part in this research process. I also understand that there will be no financial gain in this process. However, my participation in this process is not taking away my legal rights and freedom as a citizen. I further acknowledge that I will receive a copy of this study and that consenting to this research does not contravene any applicable laws.

Activities	March  2018	March   2018	March   2018	April   2018	May 2018	May  2018	June 2018
Development and writing of the proposal
Editing and review of the Proposed study
Submitting the final proposal
Collection of data
Analysis of data
Final report writing
Submission of the final report

My name is (your name), and I am a bachelors level student at the Coventry University Group (Indicate your department). Currently, we are doing a module called, Introduction to social science research methods. I am conducting qualitative research that requires parents and pupils of kindergarten and lower primary as participants.  This research aims to find out the extent by which failing to feed children exclusively on breast milk exposes them to become overweight. Any information you give will only be used for the purposes of this research. Feel free to participate.

The collected data will be analysed using one sample t-test and one way ANOVA. These two tools of analysis are used since they give us an opportunity of comparing the means of related data with an existing mean. In this case, a BMI of 85-95th percentile for the overweight children. Additionally, to test for the strength of the relationship, the data shall be subjected to Pearson correlation and bivariate regression.

According to Wager III (2016), bivariate Pearson Correlation aids in producing a correlation coefficient, r, which helps to measure the direction and strength a of linear relationship between a pair of continuous variables (months of exclusive feeding of children on breast milk with respective body mass index). Besides, Pearson Correlation enable researchers to evaluate whether a statistical evidence exist in a linear correlation between similar pairs of variables in an identified population sample.

Furthermore, consistent with Frankfort-Nachmias and Leon-Guerrero (2018), correlation of variables takes a range of between -1 and 1. Additionally, the sign of the correlation indicate the direction of the relationship whereas the size of the correlation shows the strength of the relationship. Wager (2016) also notes that 0 shows no relationship, -1 indicates perfectly negative linear relationship, and +1 shows perfectly positive linear connection.

The table below show an expected output of Pearson Correlation test

Correlations
		Years of exclusive breast feeding	Body  mass index
Years of exclusive breast feeding	Pearson Correlation	1	– .717**
Sig. (2-tailed)		.000
N	300	300
Body mass index	Pearson Correlation	-.717**	1
Sig. (2-tailed)	.000
N	300	300
**. Correlation is significant at the 0.01 level (2-tailed).

The output show a strong negative correlation between months of breast feeding with the BMI. The more months mothers feed their children exclusively on breast milk, the less, they become overweight (which the researcher determines through the BMI).

There will be no special coding scheme since the number of months of exclusive breast feeding will be entered on SPSS with respective BMI of the child. From the data, statistical significance shall be established as well as the strength of the relationship.

References

American Cancer Society, 2018. Normal weight ranges: Body mass index (BMI). [Online] Available from: https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/body-weight-and-cancer-risk/adult-bmi.html

Bryhn, A.C. and Dimberg, P.H., 2011. An operational definition of a statistically meaningful trend. PLoS One, 6(4), p.e19241.

Frankfort-Nachmias, C. and Leon-Guerrero, A., 2018. Social statistics for a diverse society. Sage Publications.

Grube, M.M., von der Lippe, E., Schlaud, M. and Brettschneider, A.K., 2015. Correction: Does breastfeeding help to reduce the risk of childhood overweight and obesity? A propensity score analysis of data from the KiGGS study. PloS one, 10(4), p.e0126675.

Harder, T., Bergmann, R., Kallischnigg, G. and Plagemann, A., 2005. Duration of breastfeeding and risk of overweight: a meta-analysis. American journal of epidemiology, 162(5), pp.397-403.

Horta, B.L. and Victora, C.G., 2013. Long-term effects of breastfeeding-a systematic review.

Jing, H., Xu, H., Wan, J., Yang, Y., Ding, H., Chen, M., Li, L., Lv, P., Hu, J. and Yang, J., 2014. Effect of breastfeeding on childhood BMI and obesity: the China Family Panel Studies. Medicine, 93(10).

Krause, K.M., Lovelady, C.A. and Østbye, T., 2011. Predictors of breastfeeding in overweight and obese women: data from Active Mothers Postpartum (AMP). Maternal and child health journal, 15(3), pp.367-375.

Kent State University. 2018. SPSS Tutorials: Pearson Correlation. [Online] Available from: https://libguides.library.kent.edu/SPSS/PearsonCorr [Accessed March 21 2018].

Mollet, J., 2011. Ethical issues in social science research in developing countries: Useful or symbolic. In Transmission of academic values in Asian Studies workshop (2009: Australian National University, Canberra, ACT). The Australia-Netherlands Research Collaboration (ANRC).

McCrory, C. and Layte, R., 2012. Breastfeeding and risk of overweight and obesity at nine-years of age. Social science & medicine, 75(2), pp.323-330.

Ozgur, C., Kleckner, M. and Li, Y., 2015. Selection of Statistical Software for Solving Big Data Problems: A Guide for Businesses, Students, and Universities. SAGE Open, 5(2), p.2158244015584379.

Saunders, M., Lewis, P. and Thornhill, A. 2016. Research methods for business students. 1st ed. Harlow (Essex): Pearson.

Sekaran, U. and Bougie, R. J. 2016. Research methods for business: A skill building approach. John Wiley & Sons.

Uwaezuoke, S.N., Eneh, C.I. and Ndu, I.K., 2017. Relationship between exclusive breastfeeding and lower risk of childhood obesity: A narrative review of published evidence. Clinical Medicine Insights: Pediatrics, 11, p.1179556517690196.

Vafa, M., Moslehi, N., Afshari, S., Hossini, A. and Eshraghian, M., 2012. Relationship between breastfeeding and obesity in childhood. Journal of health, population, and nutrition, 30(3), p.303.

Whaley, S.E., Koleilat, M., Leonard, S. and Whaley, M., 2017. Breastfeeding is associated with reduced obesity in Hispanic 2-to 5-year-olds served by WIC. Journal of nutrition education and behavior, 49(7), pp.S144-S150.

Wagner III, W.E., 2016. Using IBM® SPSS® statistics for research methods and social science statistics. Sage Publications.

Yan, J., Liu, L., Zhu, Y., Huang, G. and Wang, P.P., 2014. The association between breastfeeding and childhood obesity: a meta-analysis. BMC public health, 14(1), p.1267.