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The Saanen and Beetal goats are currently the most popular dairy goat breeds in many countries, including Iran. Subclinical hypocalcemia is common in dairy goats during the first few days of lactation similar to that in cattle. The aim of the study was to predict postpartum subclinical hypocalcemia in dairy goats using prepartum serum magnesium, inorganic phosphorous, and potassium concentrations. Blood samples from 280 Saanen and 340 Beetal dairy goats were collected 10 days before and 1 day after parturition. Total serum calcium, magnesium, phosphorous, and potassium concentrations were quantified. The results of final logistic regression confirmed the association between prepartum serum concentration of magnesium and subclinical hypocalcemia at parturition in goats. A combination of prepartum serum magnesium, inorganic phosphorous, and potassium concentration variables using logistic and multiple linear regression models improved postpartum subclinical hypocalcemia predictive ability. [ABSTRACT FROM AUTHOR]

Background & Aims During the COVID-19 pandemic, vaccination is necessary for pregnant or lactating women which can prevent them from infection to severe case of disease. The present study aims to determine the factors related to the acceptance of COVID-19 vaccination among pregnant or lactating women in Zahedan, Iran using the health belief model (HBM). Materials & Methods This is a cross-sectional study. Participants were 260 pregnant or lactating women referred to comprehensive health service centers in Zahedan city in 2022. Sampling method was done as a convenience sampling method. Data collection was done using a demographic form and a HBM-based questionnaire. The reliability of the questionnaire was confirmed based on Cronbach’s alpha value of 0.7. Moreover, the content validity index value was 0.81 and the content validity ratio was 0.77. The data were analyzed using non-parametric Wilcoxon test, Mann-Whitney U test, Spearman correlation test, and regression analysis in SPSS software, version 22. Results The results of the regression analysis showed that the demographic variables explained 12.6% of the variance in vaccine acceptance behavior, where only the effect of age and educational level was significant, (P<0.05). The BM constructs along with age and educational level predicted 26.3% of the variance in vaccine acceptance behavior, where only age, self-efficacy and perceived benefits had a significant effect (P<0.05). Overall, the mentioned variables predicted 38.9% of the variance in vaccine acceptance behavior. Conclusion The factors of young age, high educational level, and the HBM constructs of self-efficacy and perceived benefits can predict the COVID-19 vaccine acceptance behavior of pregnant or lactating women in the South East of Iran. These findings can help policymakers and health care providers to use this model in designing program for improving vaccination acceptance of these high-risk groups. [ABSTRACT FROM AUTHOR]

Background: In premature ovarian insufficiency, the cessation of menstruation, and cessation of ovarian function occurs before the age of 40, and this phenomenon is associated with many complications and problems for women. Since several factors can affect this situation, this study was conducted to determine the relationship between fertility history, and premature ovarian failure. Methods: This cross-sectional study was conducted on the data of the first phase of cohort study, which was a sample of 10,000 people from an Iranian adult population (age: 35–70 years). 1276 women were included who naturally experienced menopause from this population. They were separated into three groups based on the age of menopause: premature ovarian failure for those who reached menopause before the age of 40, early menopause for those who reached menopause between the ages of 40 and 45, and natural menopause for those who reached menopause at or after the age of 45. The demographic and fertility characteristics of two groups of women, one with premature ovarian failure and the other with early menopause, were compared with a group of women experiencing normal menopause. The comparison was based on frequency and percentage. Moreover, the odds ratio (OR) of these two groups compared to normal group was crudely calculated, and adjusted based on age at the time of the interview using a logistic regression model. SPSS 23 software was used to fit models and calculations. Results: The prevalence of premature ovarian failure was 3%. The likelihood of premature ovarian failure decreases as the number of live births rises. The risk is considerably higher for births ranging from zero to three children compared to those with more than four. Increased duration of breastfeeding is associated to a reduced risk of premature ovarian failure compared to the spontaneous occurrence (OR = 0.98, 95% CI (0.97, 0.99)). This relationship is maintained even after adjusting for age (OR = 0.98, 95% CI (0.97, 0.99). Conclusion: Based on the results of present study, it can be concluded that the factor of the number of births, and the duration of breastfeeding affect reducing the occurrence of POI, therefore, in health and treatment programs and policies, encouragement to have children, which is now part of the policies population of Iran, and the importance, and benefits of breastfeeding for mother and baby should be emphasized more. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the genetics of imported semen and assess the genetic trend of production traits in Holstein cows during their first lactation in Iran. The data was collected from 28 different herds in Isfahan province between 2011 and 2020. Variance-covariance components were estimated by the restricted maximum likelihood method and the single and multi-trait animal model. The correlation between breeding values for bulls reported in catalogs and estimated in this was calculated. The mean of the least squares by countries shows that the daughters of Spanish bulls have the highest average for milk production, and the daughters of German, French, Spanish, and American bulls have the highest average percentage of fat and protein and the amount of fat and protein, respectively. Estimated heritability for milk production, fat, and protein percentage, and the amount of fat and protein were 0.34±0.011, 0.48±0.021, 0.41±0.016, 0.40±0.090, and 0.39±0.010 respectively. The mean genetic trend of milk production, fat percentage, protein percentage, fat content, and protein content were 92, 0.010, 0.004, 1.73, and 2.52, respectively. The correlation between the estimated and reported breeding value of bulls for milk production trait, percentage of fat and protein, and the amount of fat and protein was estimated at 0.48, 0.67, 0.69, 0.14, and 0.26, and all of the estimated correlations are statistically significant at the level of 0.05. Based on the results for the most critical production trait in Isfahan herds, milk production, American bulls have the best performance and genetic trend. [ABSTRACT FROM AUTHOR]

Aim: Oral health in pregnant and lactating women can affect maternal and child health. Dental treatments in this period should not have adverse effects on maternal and child health. This study was conducted to investigate the last-year dental students' knowledge of the prescription of analgesics and antibiotics for pregnant and lactating mothers in Isfahan city, Iran. Methods: A total of 104 last-year dental students of Khorasgan Islamic Azad University and Isfahan University of Medical Sciences were recruited in this descriptive-analytical study. They completed a 16-item questionnaire on the prescription of analgesics and antibiotics for pregnant and lactating mothers. Data were analyzed by SPSS (Version 22) statistical software(t-test). Results: The total mean score of students' knowledge was 9.02±1.91. The highest level of knowledge about the safest analgesic (acetaminophen) was reported for the pregnant patients so that 100% of them had correct information in this regard. Further, the lowest level of knowledge was found for the use of dexamethasone during lactation, as only 10.6% of respondents were able to provide a correct response in this regard. Conclusion: The dental students had average knowledge about the prescription of antibiotics and analgesics for pregnant and lactating patients. To prevent the possible risks for these patients, further information should be provided to dental students. [ABSTRACT FROM AUTHOR]

The main purpose was to determine the abundance of dominant phyla, Bifidobacterium spp., and Lactobacillus in breast milk of obese mothers versus normal-weights in fourth month of lactation in Iranian population. Sixty health women at the fourth month of breastfeeding, aged 18-40 years, were included and categorized based on body mass index (BMI) to the obese (BMI ≥ 30 kg/m 2 ) and normal-weights (18.5 ≤ BMI ≤ 24.9). Bacterial DNA was extracted and qPCR of the 16S region was performed after human milk donation in a sterile condition. A multiple linear mixed model was used to determine the effective factors on the phyla population. Bifidobacterium spp. was significantly higher in milk of normal-weight group than the obese. The current weight showed a significant effect on the Actinobacteria abundance in milk. The Bacteroidetes and Firmicutes were significantly lower in mother's milk with cesarean section (p = 0.04). Pre-pregnancy obesity decreased the Firmicutes and Lactobacillus abundance in maternal milk (p = 0.04 and p = 0.01). The Actinobacteria and Bifidobacterium spp. showed a significant effect on infant's height (p = 0.008 and p = 0.04). The maternal current and pre-pregnancy weight showed an important effect on abundance of Actinobacteria and Bifidobacterium spp., as the good phyla and genus in milk which are associated with the infant's height., (© 2024. The Author(s).)

Objectives: Breastfeeding is highly important for a child's health, and the widespread use of herbal medicines as galactagogues has been reported. The present study was conducted to evaluate the use of traditional, complementary, and integrative medicine (TCIM) and its determinants among breastfeeding mothers in Shiraz, Iran. Design: Cross-sectional study. Setting/Location: Neonatal clinics affiliated to Shiraz University of Medical Sciences. Subjects: Mothers elder than 18 years old. Interventions: Nothing. Outcome Measures: Prevalence and of the use of TCIM products and its associated factors. Methods: In this cross-sectional study, mothers older than 18 years who referred to neonatal clinics affiliated to Shiraz University of Medical Sciences were enrolled. Using a structured interview, the authors explored the prevalence and of the use of TCIM products and its associated factors. Results: Of 625 mothers who were approached, 483 agreed to participate (response rate: 77.3%). The average age was 27.3 ± 5.9 years. The prevalence of using TCIM products during current breastfeeding was 97.1%. There were 168 working mothers (44.9%); 163 mothers (34.1%) complaining of postpartum breastfeeding problems, and 327 mothers (68%) had no history of breastfeeding. Recommendations of medical staff or relatives were the most frequent reasons for the consumption of TCIM products (64.9%). Only 27% of mothers disclosed the use of TCIM products to their doctor or health care provider, although 62% of mothers were asked about the use of such products. Notably, 438 mothers (95.8%) considered TCIM to increase their milk. Based on multivariable logistic regression, literacy and past use of TCIM galactagogues were independently associated with TCIM products use. Conclusions: The use of TCIM galactagogues is highly common among breastfeeding mothers in south of Iran, showing a diverse range of determinants. It is necessary to evaluate the safety and efficacy of common herbal galactagogues, and evidence-based studies must be designed to achieve standardized complementary medicine approaches in this regard. [ABSTRACT FROM AUTHOR]

Present study aims to estimate genetic parameters for traits related to longevity for of Holstein cows in Iran. Five traits were defined to evaluate longevity consisting of number of days from first calving to the end of first lactation or culling (HL1), number of days from first calving to end of second lactation or culling (HL2), number of days from first calving to end of third lactation or culling (HL3), number of days from first calving to the end of the fourth lactation or culling (HL4) and number of days from first calving to the end of the fifth lactation or culling (HL5). Required information was obtained from the data collected by the National Breeding and Improvement of Animal Production Center of Iran, during years 1987-2014. To estimate heritability and breeding values, DMU software was used. Genetic trends were also calculated based on the mean of annual breeding values. Heritability estimates for HL1 to HL5 were 0.018, 0.088, 0.11, 0.085 and 0.05, respectively. The highest breeding value for longevity was predicted in HL2 (+100.18 days) and the lowest value for this trait was predicted in the HL5 (-82.73 days). Genetic trend, based on the annual mean of breeding values for studied traits, increased during first years and decreased afterwards. The obtained genetic trend for HL1 was different from other traits and showed a steady pattern during years of study. According to heritability estimates and genetic trend of traits related to longevity, culling cows in after the first calving and regardless of the future performance of cows in the next calving will result in a population of cows unable to express their actual life span. However, optimal herd life and maintaining the genetic reserves related to this trait will be obtained through keeping cows for longer times in the herd and letting them produce until the fourth or fifth year after the first calving. Then cows could be culled, by taking other important traits such as milk production and disease resistance into account. It will certainly reduce the replacement costs and increase the profit of dairy farms. Therefore, in order to improve longevity, it is suggested that culling at age of fourth or fifth year after the first calving should replace the current culling policy in dairy farms of Iran. [ABSTRACT FROM AUTHOR]

Retained placenta (RP) is as an important reproductive disorder which adversely affects the economic performance of dairy cows. Understanding the consequences and economic losses associated with RP can persuade dairy farmers to consider it more effectively in their management decisions. Hence, the aims of this research were to assess the effect of RP on production and reproduction attributes as well as economic losses in Iranian Holstein cows. The data was collected from nine Holstein dairy herds in Isfahan province of Iran. The final dataset comprised of 139,508 records of 58,086 cows which calved between March 2011 and December 2018. A linear mixed model was developed to evaluate the effect of RP on individual performance of primiparous and multiparous cows. The economic losses associated with the RP were finally estimated. The average incidence of RP per cow over a year was 12.3% (ranged between 9.0 and 15.4%). Each incidence of RP significantly reduced milk, fat and protein yields in primiparous and multiparous cows (P < 0.05). The adverse effect of RP on the milk production was much higher in the cows at the early phase of lactation (i.e. 100-d lactation group) than the cows in mid or late lactation. The estimated production losses (±standard deviation) due to the RP event were 282.1 ± 43.0 and 295.7 ± 40.8 kg per cow for a 305-d lactation period in primiparous and multiparous cows, respectively. However, the fertility performance was less affected by the RP in primiparous compared to multiparous cows. The average of days open increased by 8.3 ± 5.3 and 19.8 ± 7.1 d in primiparous and multiparous cows, respectively. The financial losses associated with RP were on average US$ 350.4 and US$ 481.2 per incidence in primiparous and multiparous cows, respectively, ranged from US$ 311.9 to 456.2 depending on the parity number (primi- or multiparous) and herd management. The highest financial losses due to RP were associated with reduction in milk production (38.5% of total loss) and low fertility (28.5% of total loss) had the highest contribution in in primiparous and multiparous cows, respectively. The results of our research highlight the economic importance of improved calving management to reduce RP occurrence in dairy cows. • Consequences of retained placenta (RP) and economic losses were estimated. • The decline in reproductive performance due to RP in multiparous cows was greater than primiparous cows • Productive and reproductive consequence of RP differs between primiparous and multiparous cows. • The financial loss due to a case of RP in multiparous cows was 37% higher than in Primiparous cows. • The highest financial losses due to RP were associated reduction in milk production and low fertility in primiparous and multiparous cows, respectively. • Sensitivity analysis showed that milk price was the most influential factor on the costs of RP. [ABSTRACT FROM AUTHOR]

So far, no study has been conducted on the effect of milk protein concentrations (MP%) in different time periods of lactation on subsequent calving intervals (CI). The purpose of this study was to evaluate the association between MP% at different stages of the first to fourth lactations and subsequent calving intervals in primiparous and multiparous Holstein dairy cows. Test day records (3X milking frequency) of milk yield measured on primiparous (n = 503793) and multiparous (n = 389237, 257347, 156035 and 87750 for parity 2, 3 and 4, and 5 respectively) Holstein dairy cows collected during 1984–2019 were obtained from Animal Breeding Center of Iran. To investigate the relationship between MP% at different time intervals of lactation and subsequent calving intervals (up to fifth parity), each lactation was divided into four time periods (≤50d, 50 < d ≤ 100, 100 < d ≤ 200 and 200 < d ≤ 305). At each period, protein concentrations were also divided into three classes: 1–3%, 3–5%, 5–7%. There was a negative relationship between MP% in the first 50 days of first lactation in primiparous and multiparous dairy cows and subsequent calving intervals in a way that calving intervals decreased as MP% increased and the shortest calving intervals were observed for the third class of milk protein concentrations. After the first 50 days of first lactation, the shortest subsequent calving intervals were detected for the second class of MP% and the CI increased non-significantly when MP% increased to 5–7. In general, due to the significant relationship between MP% and subsequent CI, this relationship can be further considered in breeding programs in dairy cattle. • A significant relationship between the %MP and subsequent calving intervals was detected. • During the first 50 days of lactations, CI decreased as MP% increased up to 5–7%. • After the first 50 days lactation, the shortest subsequent CI were registered when MP% was 3–5%. • This relationship could be used in breeding programs and selection of superior animals. [ABSTRACT FROM AUTHOR]

Background: The somatic cell count (SCC) of individual cow samples is a useful proxy for monitoring udder health status. Aims: The present study aimed to provide updated information about udder health in Iranian Holstein dairy cattle, and to quantify the effectiveness of the mastitis control program. Methods: A total of 17,990 monthly test-day records from 1,663 Holstein dairy cattle in 10 "regular" herds and 2,389 test-day records from 386 Holstein dairy cattle in 2 herds that were assigned to the 10-point mastitis control program ("controlled" herds) were included. Each test-day record comprised the date of recording, daily milk production (kg), fat and protein (%), days in milk, parity, and SCC. Results: Median (Q1-Q3) SCC x 10³ for "regular" and "controlled" herds were 136 (52-391) and 64 (24-204) cells/ml, respectively. Also, the percentage of records containing SCC >200,000 cells/ml (elevated SCC) for these groups were 40.3% and 25.5%, respectively. Mixed effects logistic analysis revealed that milk records from cows in the first lactation, early lactation, and with >40 kg daily milk yield had lower odds of elevated SCC. The odds of elevated SCC were lower in summer and autumn than in winter. Conclusion: Host and environmental characteristics influence SCC. This should be considered for the interpretation of SCC results. Mastitis control programs can support dairy producers to reach a standard level of udder health. [ABSTRACT FROM AUTHOR]

Mother's breast milk is a natural and complete food for infants but can be a main source of exposure to toxic pollutants. These pollutants can negatively affect the health of the infant. Therefore, conducting biomonitoring surveys is essential to evaluate such health effects in toxicological research. This study aimed to estimate the probable health risks for infants exposed to essential and non-essential trace elements through breast milk ingestion. This descriptive-analytical, cross-sectional study was performed on 90 breastfeeding mothers referred to the health centers in Mashhad, Iran in January 2021. The health risk assessments (carcinogenic and non-carcinogenic risk) were estimated using chronic daily intake (CDI), hazard quotient (HQ), hazard index (HI), and lifetime carcinogenic risk (CR), which were recommended by the US Environmental Protection Agency (US EPA). The results of the HQ values of trace elements through ingestion exposure for arsenic (90%), copper (90%), zinc (40%), and iron (10%) exceeded the threshold of HQ, and arsenic (66.59%), copper (16.91%), and zinc (9.68%) and iron (4.57%) had the highest contribution to increasing the HI index. The average value of CR was 5. 08 × 10 -3 . Chromium and iron showed significant relationships (P<0.05) with education level and disease background in this study, and the concentration of chromium, iron, and zinc in the breast milk samples significantly changed during lactation stages (P<0.05). Overall, the risk of carcinogenicity through exposure to breast milk for infants was higher than the safety level of US EPA risk. Therefore, there could be a potential health risk of trace elements, particularly arsenic, copper, and zinc for infants in Mashhad, Iran through the consumption of mothers' breast milk. More efforts are required to control and reduce routes of receiving trace elements in breastfeeding mothers by the competent authorities., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Exclusive breastfeeding (EBF) is essential during the first six months of life and confers countless benefits to mothers and infants. This study aimed to assess the effectiveness of a smartphone-based educational intervention to improve new mothers' breastfeeding for infants younger than six months of age in Urmia, Iran. Methods: A randomized controlled trial study was conducted from January to December 2019 with 40 new mothers and their first child aged < 3 months, assigned to the intervention (mobile app education + routine care) and control groups (routine care). The mean age of infants was 1.25 and 0.98 months for each group consequently. The designed app content categorized according to seven sections (the importance of breastfeeding, behavioral methods, complementary feeding and EBF, pumping and manual expression, managing common breast-related and breastfeeding problems, breastfeeding tips in special situations, and common queries) for educating the required knowledge to nursing mothers. Results: Forty mothers were assessed for primary outcomes in each group. At three months, the mothers' knowledge, attitude, and practice (KAP) had meaningful differences in the intervention group compared to the control group. In the intervention group, the degree of changes in knowledge and attitude were 5.67 ± 0.94 and 8.75 ± 1.37 respectively more than the control group (p < 0.001, p < 0.001). However, this amount for the practice score was 0.8 ± 0.49 which is considered to be marginally significant (p = 0.063). During the study, the mothers' breastfeeding self-efficacy showed significant progress in favor of the intervention group. The score enhancement was 26.85 ± 7.13 for the intervention group and only 0.40 ± 5.17 for the control group that was confirmed to be significant (p < 0.001). Conclusion: The smartphone-based app for educating new mothers on breastfeeding had a significantly positive effect on breastfeeding self-efficacy and maternal KAP. In future studies, the intervention can be tested in both prenatal and postpartum periods. [ABSTRACT FROM AUTHOR]

Context: Birthweight (BW), the weight of an animal taken within 24 h after birth, is the first trait that can be easily measured. Investigating the association between the BW of a calf and her performance later in life is important to realise the optimum weight at birth. Aim: The aim was to investigate the association between BW of females and their productive and reproductive performance later in life in Holstein dairy cows. Methods: Data used were 214 377 lactation records on 83 440 cows distributed in 134 herds collected from January 2008 to December 2018 by the Animal Breeding Centre of Iran (Karaj, Iran). Based on the BW, animals were classified into six classes: BW of 20.0–37.0 kg, 37.1–39.0 kg, 39.1–41.0 kg, 41.1–43.0 kg, 43.1–45.0 kg and 45.1–70 kg (BW1 to BW6, respectively). Multiple regression mixed models were used to investigate the association between the BW of females and their age at the first calving, lactation performance, 100- and 305-day somatic cell score, the length of the calving interval, calf BW and dystocia later in life. Key results: The mean (s.d.) BW across all animals (females) included was 40.9 (4.93) kg. Of the 83 440 animals included, 19.26% weighed ≤37.0 kg and 14.06% weighed ≥45.0 kg, whereas >23% weighed between 39.1 and 41.0 kg at birth. Increased BW of females was associated with a decrease in their age at the first calving; an increase in their 305-day milk, fat and protein yield; longer length of their calving interval; increased BW of their calves; and increased risk for dystocia. However, there was no association between BW of females and their 305-day fat and protein percentages, and 100- and 305-day somatic cell score. Conclusions: In any economic evaluation of BW, not only calf perinatal mortality, but also the association between the BW of females and their lactation performance later in life should be taken into account. Implications: The BW of a female calf is associated with her production and reproductive performance, and needs to be considered as an important trait in the dairy cattle breeding program. Investigating the association between the birthweight (BW) of a calf and her performance later in life is important to realise the optimum weight at birth. This study showed that increased BW of a female is associated with a decrease in age at the first calving, increased lactation performance, increased length of the calving interval and increased risk for dystocia. Therefore, in any economic evaluation of BW, the association between the BW of a female calf and her lactation performance should be considered. [ABSTRACT FROM AUTHOR]

Background: Despite strong evidence demonstrating the role of estrogen as a protective factor for kidney function in women, limited data are available regarding the influence of endogenous estrogen exposure (EEE) on chronic kidney disease (CKD). The present study aimed to assess the incidence of CKD in women with various levels of EEE. Methods: In a prospective population-based study over a 15-year follow-up, a total of 3043 eligible women aged 30–70 years, participating in Tehran-Lipid and Glucose-Study were recruited and divided into two groups (EEE < 11 and EEE ≥ 11 years). EEE calculated based on age at menarche, age at menopause, number and duration of pregnancies, lactation, and duration of oral contraceptive use after excluding the progesterone dominant phase of the menstrual cycle. Cox's proportional hazards model was applied to estimate the hazard ratio of CKD between the study groups, after adjusting for confounders. Results: The total cumulative incidence rate of CKD was 50.1 per 1000 person years; 95% CI: 47.7–52.6); this was 53.9 (95%CI, 50.2–57.8) and 47.1 (95%CI, 44.0–50.4) per 1000 person years in women with EEE < 11 and EEE ≥ 11 years, respectively. The model adjusted for age, BMI, smoking, hypertension, and diabetes showed that the hazard ratio (HR) of incidence CKD in women with EEE < 11 compare to those with EEE ≥ 11 years in the subgroup of women aged< 45 years was 2.66(95% CI, 2.2, 3.2), whereas, in the subgroup aged ≥45 years, it was 1.22 (95% CI, 1.04, 1.4). Conclusion: This study shows a higher HR of CKD incidence in women with low EEE levels in their later life. Screening of these women for CKD may be recommended. [ABSTRACT FROM AUTHOR]

Previous observational studies have produced strong evidence that metritis alone has an impact on reproductive performance in dairy cows; but few studies have examined the combined effect of metritis and other postpartum diseases on reproduction performance in dairy cows. Information on the combined effects of postpartum diseases on fertility in dairy cows can have practical herd-health management implications. The objective of the study reported here was to examine the observed and expected combined effects of metritis and other postpartum diseases (retained fetal membranes (RFM), clinical hypocalcemia, left displaced abomasum, clinical mastitis, lameness) on time to conception and rate of conception failure in first-lactation cows up to 150 days postpartum. The study was conducted on two commercial dairy herds in Iran. Median number of days to conception was higher in 30 cows affected with metritis and RFM (90 days), compared to 287 healthy cows (57 days), 16 cows affected with RFM alone (60 days) or 44 cows affected with metritis alone (60 days), after controlling for herd and calving month (p < 0.05). In cows affected with metritis and RFM, the rate of conception failure was 3.8 times greater than that of healthy cows, after controlling for study herd and calving month (hazard ratio = 3.8; 95% CI = 2.3, 6.6; p < 0.01); this observed combined effect on conception failure was two times higher than the expected combined effect based on adding or multiplying absolute independent excesses due to metritis or RFM. In addition, we observed an interaction effect between metritis and lameness on conception failure, after controlling for herd, calving month, and RFM; but study results were inconclusive. In this study, the observed combined effect of metritis and RFM on time to conception and rate of conception failure was far in excess, compared to that in cows exposed to metritis or RFM alone. Attending veterinarians or farm managers can consider this information when making breeding and culling decisions on dairy farms. • Few studies have investigated the combined effects of postpartum diseases on fertility in cows. • Data on combined effects of postpartum diseases on fertility in cows can impact herd-health management. • The combined effect of metritis and RFM on conception was far in excess, compared to each disease alone. • Attending veterinarians or farm managers can consider this information when making breeding/culling decisions on dairy farms. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate genotype by environment interaction as well as genetic parameters for somatic cell score (SCS) in first lactation Holstein cows in Iran. Data were collected by the National Animal Breeding Centre of Iran during 2003 to 2018. Data consisted of 1 031 885 SCS test-day records of 145 817 first lactation Holstein cows. Records were classified into the cold and moderate climate on data of synoptic stations. Variance components and genetic parameters were estimated using a random regression model and restricted maximum likelihood method. The analyses were performed using the AI-REML algorithm of the DMU package. The mean SCS was 1.859 (1.598) and 1.823 (1.522) for the cold and moderate climate, respectively. Genetic variance of SCS was lower than the corresponding permanent environmental variance. The permanent environmental variance in the moderate climate was higher than that of the cold climate during lactation. The highest values of heritability were observed in the early stage of lactation. However, the estimates of heritability during the lactation curve were low. The estimates of heritability for the entire 305-day lactation were higher in the cold climate than those in the moderate climate. Genetic correlation between the cold and moderate climate ranged from 0.25 to 0.81. The results indicated the existence of genotype × environment interaction and hence the need for different breeding program for SCS in the studied climates. [ABSTRACT FROM AUTHOR]

Abortion is an important trait with noticeable impacts on economic profit of dairy herds. This study was conducted to estimate variance components and genetic, environmental and phenotypic trends for abortions in Iranian Holstein Friesian cows. The data used were 247230 calving and abortion records of 84421 Holstein cows, collected during years 1991-2016, from 51 herds in Iran. Variance components and genetic parameters were estimated using a logit link function, fitting an animal mixed model by ASReml software. In this model, parity and milk yield were fixed, while direct additive genetic, herd-year-season and permanent environment effects were considered as random factors. Genetic, phenotypic and environmental trends were estimated as weighted regression coefficients of breeding values, phenotypic values and environmental deviations averages on birth year, respectively and the number of observations was considered as the weighting factor. Generally, abortion risk in the first parity was lower than the later parities and in autumn was lower than the other seasons. Abortion risk also increased by increase in milk yield level. Heritability and repeatability estimates for abortion were both 0.165 ± 0.010. A significant positive genetic trend (0.038 rate/year) and a significant negative environmental trend (-0.033 rate/year) were estimated for abortion, which indicated significant increase of genetic predisposition to abortions and improvement of environmental conditions to prevent abortion incidence. A significant positive phenotypic trend (0.002 rate/year) was also estimated, which showed overall increase of abortion rate during the studied years. Overall, it could be concluded that genetic predisposition to abortion is increasing in Iranian Holstein cows, but inclusion of abortion risk in bull proofs and selection indices may help to reduce abortion incidence and increase economic profit of dairy cattle industry. [ABSTRACT FROM AUTHOR]

In the present study, records on 115,291 heifers distributed in 113 herds were used to investigate the association between age at the first calving (AFC) and lactation performance, lactation curve, the length of the first calving interval (CI), calf birth weight (CBW), and the incidence of dystocia in Holstein heifers in Iran. Based on the AFC, the heifers were classified into eight classes: AFC of 541 to 690 d, 691 to 720 d, 721 to 750 d, 751 to 780 d, 781 to 810 d, 811 to 840 d, 841 to 900 d, and 901 to 1200 d (AFC1 to AFC8, respectively). Multiple regression mixed models were used to investigate the association between AFC and lactation curve parameters, partial and 305-d lactation performance, 100- and 305-d SCS, and the length of the first calving (CI) interval. The mean (SD) and median AFC across all heifers was 760.2 (74.01) and 750 d, respectively. Of 115,291 heifers included, 28,192 and 7,602 heifers were, respectively, ≤ 720 and > 900 d when calving for the first time. More than 44% of the heifers were at 691 to 750 d (23 to 25 months) of age when calving for the first time. An increased AFC was associated with increased partial and 305-d lactation performance, 100- and 305-d SCS, initial milk yield, milk production at the peak of lactation, upward and downward slopes of the lactation curve. The 305-d fat percentage was associated with AFC; however, there was no association between AFC and 305-d protein percentage. An increased AFC was also associated with decreased milk production persistency, delayed peak time, longer CI, and higher calf birth weight. Compared to heifers calving for the first time between 691 to 780 d (23 to 26 months) of age, both increasing and decreasing AFC were associated with increased risk of dystocia. Controlling AFC is an important management factor in achieving a lower risk of dystocia, higher lactation performance, lower SCS, and shorter length of the calving interval. [ABSTRACT FROM AUTHOR]

Risk factors for retained placenta (RP), as a common and economically important disorder, have been widely investigated. However, comprehensive studies are rare. Therefore, this study sought to identify herd-cow factors and their interactions on the risk of RP in Iranian dairy herds. The data were collected from nine Holstein dairy herds in Isfahan province, Iran. The final dataset included 154,048 records for 59,610 cows which calved between March 2011 and December 2018. A logistic regression model was used to separately analyze the risk factors and their interactions for RP in primiparous and multiparous cows. The average rate of RP was 12.3% (9.0–15.4%) at the herd level. The highest rate of RP was recorded in spring compared with other seasons. Regardless of calving season, occurrence of dystocia, stillbirth and twinning increased the odds ratio (OR) of RP. In primiparous cows, occurrence of dystocia and stillbirth increased OR of RP 4.30 and 3.33 times, respectively. In multiparous cows, dystocia, twinning and stillbirth increased OR of RP 4.36, 3.94 and 1.29 times, respectively. Cows with an age at first calving of >28 months had the highest rate of RP compared with other cows. Multiparous and primiparous cows with a short (less than 271 d) and long (more than 281 d) pregnancy, respectively, had the highest risk of RP compared to cows in other groups. Furthermore, multiparous cows with an extended dry period length (more than 75 d) and produced milk yield more than 13,000 kg/lactation were at higher risk of RP with an average of 13.5%. With an interaction analysis, although the potential effect of each factors depends on the effect of other factors, but in general dystocia, stillbirth, an extended age at first calving (>28 months), and calving during the spring increased risk of RP for both groups. In conclusion, identification of risk factors for RP with an interaction analysis can help farm managers to employ the best strategies to reduce the occurrence of this reproductive disorder. • Risk factors for retained placenta (RP) with considering the interaction terms were identified. • Considering of interaction terms in a risk factor analysis was informative. • Probability of RP differs between herd, age at first calving, parities, dry period length, milk yield level and calving season. • Twinning increased the risk of RP in multiparous cows but not in primiparus cows. • An experience of dystocia and stillbirth increased the risk of RP for both multiparous and primiparus cows [ABSTRACT FROM AUTHOR]

Iodine, a key constituent of thyroid hormones, plays an indirect role in prenatal and postnatal growth. This study aimed to investigate whether breast milk iodine concentration (BMIC) is associated with growth‐ and obesity‐related hormones and subsequently the infants' anthropometric measures. In present study conducted in Tehran (Iran), 94 lactating mothers and healthy infants who were exclusively breastfed were included. Concentrations of iodine, insulin‐like growth factor‐1 (IGF‐1), adiponectin (AD) and leptin (LP) were measured in breast milk samples collected during 3‐ to 5‐day postpartum. Anthropometric measures of infants were assessed at 6 months of life, and age‐ and sex‐specific z‐score values were calculated using the World Health Organization growth standards. The median (interquartile range) iodine, IGF‐1, AD and LP concentrations were 232.5 (157.5–296.0) μg L−1, 15.7 (11.9–21.1) ng ml−1, 13.2 (5.1–29.8) mg L−1 and 1.16 (0.86–1.70) ng ml−1 in breast milk, respectively. No significant correlations were found between BMIC and IGF‐1, AD and LP concentrations during the first few days postpartum. In adjusted regression model, BMIC was positively associated with weight‐for‐length z score of infants. In the presence of IGF‐1, AD or LP, the coefficients of BMIC for weight‐for‐length z score of infants were β =.003 (P =.021), β =.002 (P =.028) or β =.003 (P =.013), respectively. No other anthropometric measurements were associated with iodine or growth‐ and obesity‐related hormones in breast milk. Our findings indicate that BMIC is a potential contributor to infants' growth status, independent of IGF‐1, AD or LP concentrations in breast milk. The underlying mechanisms remain to be elucidated. [ABSTRACT FROM AUTHOR]

Background: Brucellosis is a zoonotic disease and humans get the infection mostly through consumption of raw milk. Vaccination is the best way to control brucellosis and Iran uses Rev.1 vaccine in sheep and goat flocks. It is evident that the vaccine may shed through milk so it can infect humans. The objective of the present study is to assess the shedding of the vaccine in lactating ewes and its possible immunity in their lambs through milk feeding. Methods: In a two-month period post-parturition, reduced dose Rev.1 vaccine was injected to 50 parturited ewes. From the first day of vaccination, mixed milk samples were collected and continued for 2 months. Then the samples were tested by PCR method and the sera from 70 lambs of the examined ewes were tested by modified Rose Bengal test while they were feeding milk. Results: From the 6th day until the 27th day post-vaccination, PCR represented the DNA of Rev.1 in the milk samples. All the lamb’s sera were negative in the serological test. Conclusion: As the presence of Rev.1 in milk was confirmed in this study, it is important to consider the role of the vaccine strain as a risk of infection in humans. Moreover, as the serological response in the lambs was negative, it seems that the vaccine strain didn’t immunize the lambs through milk feeding so the vaccination of lambs is necessary in small ruminant’s flocks. [ABSTRACT FROM AUTHOR]

Two selection goals of inclusion or exclusion of calving interval (CI) in the selection goal function for Holstein cows in Iran, besides milk yield, milk fat percentage, and milk protein percentage, were studied. Four selection indices were composed of using the information on production traits, CI and / or days from calving to first insemination (DFI). The results of the predicted genetic growth in selection goals showed that the index composed of all production and reproduction traits generated the greatest genetic growth. Although CI had a negative coefficient in the selection goal, it is genetic mean increased in any case. However, the magnitude of this undesirable increase was lower in the CI included selection goal. This implies that the inclusion of CI in the selection goal is necessary to control the undesirable growth of this trait. The comparison of indices in this goal reflected that the inclusion of CI along with the production traits resulted in a smaller undesirable change in this trait. Constraining the genetic change in CI in the selection goal impaired the selection efficiency. So, this constraint is not recommended for breeding programs. [ABSTRACT FROM AUTHOR]

The aim of the work reported here was to investigate the appropriateness of a sinusoidal function by applying it to model the cumulative lactation curves for milk yield and composition in primiparous Holstein cows, and to compare it with three conventional growth models (linear, Richards and Morgan). Data used in this study were 911 144 test-day records for milk, fat and protein yields, which were recorded on 834 dairy herds from 2000 to 2011 by the Animal Breeding Centre and Promotion of Animal Products of Iran. Each function was fitted to the test-day production records using appropriate procedures in SAS (PROC REG for the linear model and PROC NLIN for the Richards, Morgan and sinusoidal equations) and the parameters were estimated. The models were tested for goodness of fit using adjusted coefficient of determination $\lpar {R_{{\rm adj}}^2 } \rpar $ , root mean square error (RMSE), Akaike's information criterion (AIC) and the Bayesian information criterion (BIC). $R_{{\rm adj}}^2 $ values were generally high (>0.999), implying suitable fits to the data, and showed little differences among the models for cumulative yields. The sinusoidal equation provided the lowest values of RMSE, AIC and BIC, and therefore the best fit to the lactation curve for cumulative milk, fat and protein yields. The linear model gave the poorest fit to the cumulative lactation curve for all production traits. The current results show that classical growth functions can be fitted accurately to cumulative lactation curves for production traits, but the new sinusoidal equation introduced herein, by providing best goodness of fit, can be considered a useful alternative to conventional models in dairy research. [ABSTRACT FROM AUTHOR]

Introduction: Exclusive breastfeeding protects infants from diseases in the first 6-months of life. Awareness and attitude affect breastfeeding performance.This study assessed maternal awareness and attitude toward breastfeeding in Alzahra Hospital, a baby friendly, in Rasht, Iran. Objectives: To determine knowledge and attitudes of mothers on various aspects of breastfeeding and factors related to them among mothers under postpartum, Alzahra educational, medical and research center. Materials and Methods: This descriptive cross-sectional study was conducted on 384 post-natal mothers. It was done by sampling and simple random in post-partom unit of Alzahra Hospital, Rasht. A questionnaire consisting of 3 main parts; demographic information, knowledge and attitude, was used in the study. Attitude and knowledge scores were also calculated. Data were analyzed by Man-Whitney, Kurskal-Wallis and Spearman Correlation Coefficient tests, using SPSS-software in version21. Results: In this study, 32.6% had good levels of knowledge about breastfeeding and majority of them (39.1%) had an average knowledge. All of mothers had positive attitude, but 20.3% of mothers had more positive attitude and most of individuals (67.2%) were in the intermediate state and the rest had a more negative attitude. In the multivariate analysis in the regression logestic model attitude status (P<0.0001), experience of breastfeeding(P=0.006), breastfeeding training (P=0.004), income (P=0.03) and mother’s job (P=0.001) were anticipating factors of high knowledge, and the status of knowledge(P=0.043), mothers’education(P=0.004), natural delivery compared to cesarean section (P=0.008), type of infant’s feeding (P=0.0001) were anticipating factors related to positive attitude status. Also, a significant poor positive relationship was found between age and the score of knowledge (r=0.158, P=0.002) and attitude (r=0.128, P=0.062). Conclusion: A significant number of mothers had moderate knowledge about breastfeeding, which necessitates intervention programming, especially for mothers with low levels of education. [ABSTRACT FROM AUTHOR]

Background: Donor milk is a newly emerging phenomenon in Iran and its banks are currently operating at a limited level. Nurses' knowledge and attitudes toward this issue play a key role in the adoption of human donor milk by families. This study aimed to determine the knowledge and attitude of nurses working in Neonatal Intensive Care Units (NICUs) regarding the use of human donor milk and its advantages and disadvantages. Methods: This research was a descriptive cross-sectional study. One hundred nurses working in the NICUs of three hospitals affiliated to Iran University of Medical Sciences were recruited by census method. The study data were collected by "nurses' questionnaire towards donor milk and the pros and cons" and "attitude of nurses towards donor milk". The obtained data were analyzed by the independent t test and analysis of variance in SPSS V. 22. Results: Most nurses had appropriate knowledge about donor milk. About 68% of them believed that human donor milk would reduce the growth rate of the baby, but 33% said that the formula milk was easier to find and less stressful than donor milk. Nurses did not express a positive attitude toward donor milk in most questions. Approximately 48% were opposed to receiving human donor milk. Forty-five percent of the nurses blamed its costs and investment as the strongest barriers toward consuming donor milk in their cities. Around 68% supported the establishment of a human milk bank in the area or city where they work and reside. The results also showed the knowledge (P=0.031), and attitude (P<0.00) of the nurses were significantly associated with their marital status. Conclusion: The nurses had appropriate knowledge about human donor milk; however, in most cases, they lacked a favorable attitude toward it. It seems that cultural and religious issues might have played a role in this respect. [ABSTRACT FROM AUTHOR]

Background: Given the limited availability of research on the association between COVID-19 infection and breastfeeding success, the primary objective of this study is to conduct a comprehensive evaluation of this relationship., Methods: This prospective cohort study included 260 women who were on the postnatal ward of an academic hospital affiliated with Tehran University of Medical Sciences during the COVID-19 pandemic (between March and August 2021). Among these women, 130 had tested positive for COVID-19 in pregnancy, while the remaining 130 were considered healthy. The study aimed to assess various factors, including sociodemographic characteristics and the results of four validated questionnaires: The Bristol Breastfeeding Questionnaire, The Multidimensional of Perceived Social Support (MPSS), The Breastfeeding Self-Efficacy Scale (BSES), and The Postpartum Partner Support Scale (PPSS). These questionnaires were administered to each participant to gather relevant data. After eight weeks, a telephone follow-up was carried out to assess the success of breastfeeding. The evaluation focused on determining if exclusive breastfeeding was maintained or not. Data was collected by questioning mothers about their infants' feeding habits in the past 24 h. Exclusive breastfeeding refers to the exclusive use of breast milk without the introduction of other liquids or solid foods., Results: Women with a previous COVID-19 infection (case group) had a lower mean infant gestational age (P < 0.001) and a higher prevalence of cesarean section (P = 0.001) compared to the control group. The proportion of women who exclusively breastfed was higher in the control group (98.5%) than in women with a history of COVID-19 infection (89.2%) (P = 0.011). Furthermore, the case group reported lower scores in perceived social support and the Breastfeeding Self-Efficacy Scale, in contrast to the control group. Notably, there was a significant correlation between breastfeeding success and women's breastfeeding self-efficacy score., Conclusions: The findings of this study offer valuable insights for healthcare professionals, enabling them to promote early initiation of breastfeeding in mothers with a history of COVID-19 infection, while ensuring necessary precautions are taken., (© 2023. The Author(s).)

Background: Lactation persistency influences cow health and reproduction and has an impact on the feed costs of dairy farms. Objective: To estimate (co)variance components and genetic parameters of 100- and 305-d milk yield, and lactation persistency in Holstein cows in Iran. Methods: Records collected from January 2000 to December 2012 by the Animal Breeding Center of Iran (Karaj, Iran) were used. The following four measures of lactation persistency were used: P21: Ratio of milk yield in the second 100-d in milk (DIM) divided by that of the first 100-d. P31: Ratios of milk yield in the third100-d divided by that of the first 100-d. PW: The persistency measure derived from the incomplete gamma function. PJ: The difference between milk yield in day 60th and 280th of lactation. Results: The estimated heritability of lactation persistency for the three first parities (first, second, and third lactation) ranged from 0.01 to 0.06, 0.02 to 0.10, and 0.01 to 0.12, respectively. Genetic correlations among lactation persistency measures for the three first parities ranged from 0.77 to 0.98, 0.65 to 0.98, and 0.58 to 0.98, respectively; while corresponding values for genetic correlations among lactation persistency with 305-d milk production ranged from 0.18 to 0.63, 0.32 to 0.75, and 0.41 to 0.71, respectively. The estimated repeatability for lactation persistency measures ranged from 0.06 to 0.20. Conclusion: The moderate positive genetic correlation between lactation persistency and 305-d milk yield indicates that selection for increasing milk yield can slightly improve lactation persistency. [ABSTRACT FROM AUTHOR]

In this study, 146,177 lactations on 81,677 cows distributed in 112 herds were used to investigate the association between calf birth weight (CBW) with dam's subsequent lactation curve, partial and 305-d lactation performance in Holstein cows in Iran. Based on the CBW, the records were classified into five categories: 20 to 37.5 kg, 37.6 to 40.5 kg, 40.6 to 42.5 kg, 42.6 to 45.5 kg, and 45.6 to 70 kg. The mean [SD] CBW was 41.42 [5.24] Kg. The mean [SE] CBW in primiparous cows giving birth to a bull or heifer was 41.70 [0.04], and 39.44 [0.04], respectively. The corresponding values in multiparous cows were 44.11 [0.04] and 41.58 [0.04] kg. There was a consistent association between CBW and dystocia, such that higher CBW was always associated with greater odds of dystocia. The mean rate of dystocia in primiparous cows was 10.48% and varied between 6.50% and 22.4% for cows belonging to the first and fifth category of CBW, respectively. In multiparous cows it was 5.46% and varied between 3.40% and 7.99% for cows belonging to the first and fifth category of CBW, respectively. Higher CBW was always associated with more lactation performance. Primiparous cows belonging to the fifth category of CBW in compared with those belonging to the first category of CBW produced 165 [8], 344 [15], 508 [23], 11 [0.8], and 13 [0.8] kg more 100-, 200- and 305-d milk, 305-d fat and 305- d protein, respectively. The corresponding values for multiparous cows were 357 [8], 630 [16], 802 [24], 25 [0.8], and 19 [0.8] kg. Multiparous cows belonging to the first category of CBW reached their peak most late and had the highest lactation persistency. In multiparous cows, higher CBW was always associated with earlier days in milk at peak. In both primiparous and multiparous, cows belonging to the first category of CBW had the lowest initial yield. However, there was no association between CBW with factors associated with the upward and download slopes of the lactation curve. [ABSTRACT FROM AUTHOR]

Despite substantial progress in the global elimination of iodine deficiency, lactating mothers and their infants remain susceptible to insufficient iodine intake. This cross-sectional study was conducted to compare iodine statuses of breast-fed and formula-fed infants and their mothers at four randomly selected health care centres in Tehran. Healthy infants <3 months old and their mothers were randomly selected for inclusion in this study. Iodine was measured in urine and breast milk samples from each infant and mother as well as commercially available infant formula. The study included 124 postpartum mothers (29·2 (sd 4·9) years old) and their infants (2·0 (sd 0·23) months old). The iodine concentrations were 50–184 µg/l for infant formula, compared with a median breast milk iodine concentration (BMIC) of 100 µg/l in the exclusive breast-feeding group and 122 µg/l in the partial formula feeding group. The median values for urinary iodine concentration in the exclusive breast-feeding group were 183 µg/l (interquartile range (IQR) 76–285) for infants and 78 µg/l (IQR 42–145) for mothers, compared with 140 µg/l (IQR 68–290) for infants and 87 µg/l (IQR 44–159) for mothers in the formula feeding group. These differences were not statistically significant. After adjustment for BMIC, ANCOVA revealed that feeding type (exclusive breast-feeding v. partial formula feeding) did not significantly affect the infants' or mother's urinary iodine levels. Thus, in an area with iodine sufficiency, there was no difference in the iodine statuses of infants and mothers according to their feeding type. [ABSTRACT FROM AUTHOR]

Background: The objective of this study is to determine the effect of a consultation model, Beliefs, Attitudes, Subjective Norms and Enabling Factors (BASNEF), and the counselling steps using GATHER-Greet clients, Ask clients about themselves, Tell clients about their choices, Help clients choose, Explain what to do, and Return for follow-up-on the continuation rates of exclusive breastfeeding in mothers of premature infants. Methods: This is a randomized controlled clinical trial carried out on 124 mothers with premature infants hospitalized in Fatemieh Hospital, city of Hamadan, in 2014. Participants were randomly assigned to either the intervention or control groups. The initial demographic questionnaire carried out in both groups included three questions about the continuation of exclusive breastfeeding, BASNEF, a checklist related to the lactation performance documented by mothers and the weight gain of their infants. Five breastfeeding consultation sessions based on the BASNEF model and counselling steps using GATHER, were held for the mothers in the intervention group for five consecutive days. Then follow-up weight gain and the questionnaire completion were performed in both groups at 1, 2, 3 and 4 months after the intervention. Results: Baseline characteristics were similar in the two groups. There were no significant differences between both groups in the rate of exclusive breastfeeding, lactation performance and infant weight at baseline. The intervention group had significantly higher rates of exclusive breastfeeding, 72.6% versus the control group of 16.1%, at the end of the 4 month follow-up. Also the intervention group had significantly higher mean scores of lactation performance (8.62 ± 2.08 vs 6.40 ± 1.84 in the control group) and infant weight (5694.80 ± 779.43 vs 4760.17 ± 859. 12 in the control group) at the end of the 4 month follow-up. Conclusion: Breastfeeding consultation of mothers based on the BASNEF model and using GATHER counselling steps increased the rate of exclusive breastfeeding, lactation performance and weight gain of premature infants. Therefore, breastfeeding counselling sessions are recommended for all mothers of premature infants. Trial registration: Iranian Registry of Clinical Trials number IRCT2014111013405N6 and date registered, January 5, 2015. [ABSTRACT FROM AUTHOR]

Background: One of the effective factors on BF (Breastfeeding) continuation is Breastfeeding self-efficacy (BFSE). This study was conducted to determine the relationship between Health Literacy (HL) and BFSE in lactating mothers referring to primary health care centers., Methods: This cross-sectional descriptive study was carried out on lactating mothers referring to primary health care centers in 2022. Multi-stage cluster sampling was done with 160 samples. The data were collected using demographic questionnaire, Persian shortened form of the BSES is a self-reported instrument for measuring a mother's Breastfeeding self-efficacy and Health Literacy for Iranian Adults (HELIA). Data were analyzed using ANOVA, independent t-test, correlation test and liner regression by SPSS version 16, with a significance level of 5%., Results: There was a significant positive correlation between the HL score and its four domains( Reading, Behaviour and decision making, Accessing, and Understanding) except for the appraisal domain with BFSE score. The variables of use of formula, HL, duration of breastfeeding, and education were considered predictors of BFSE., Conclusion: In general, the results indicate a possible relationship between BFSE and mothers' HL. Therefore, improving mother's HL can have a positive effect on promoting infants' nutrition., (© 2023. The Author(s).)

Background: Despite the many signs of progress in pharmacotherapies, metabolic syndrome (MetS) is one of the main public-health burdens worldwide. Our study aimed to compare the effect of breastfeeding (BF) in women with and without gestational diabetes mellitus (GDM) on MetS incidence., Methods: Of females who participated in the Tehran Lipid and glucose study, women who met our inclusion criteria were selected. The Cox proportional hazards regression model, with adjustment of potential confounders, was done to evaluate the relationship between duration of BF and incident of MetS in women with a GDM history compared to non-GDM., Results: Out of 1176 women, there were 1001 non-GDM and 175 GDM. The median follow-up was 16.3 (11.9, 19.3) years. Results of the adjusted model illustrated that the total BF duration was negatively associated with MetS incidence risk (hazard ratio (HR) 0.98, 95% CI 0.98-0.99) in total participants indicating that per one-month increase of BF duration, the hazard of MetS reduced by 2%. The HR of MetS in Comparison between GDM and non-GDM women demonstrated significantly more reduced MetS incidence with a longer duration of exclusive BF (HR 0.93, 95% CI 0.88-0.98)., Conclusions: Our findings illustrated the protective effect of BF, especially exclusive BF, on MetS incidence risk. BF is more effective in reducing the risk of MetS among women with a history of GDM than among women without such a history., (© 2023. The Author(s).)

This study aimed to investigate the concentration of some toxic metals (gold (Au), cadmium (Cd), chromium (Cr), mercury (Hg), nickel (Ni), lead (Pb), tin (Sn), and vanadium (V)) and arsenic (As) in breast milk based on demographic characteristics and the diet of mothers. In this cross-sectional study, 100 lactating mothers from Kermanshah, Western Iran, were included. The mean age of the participants was 29.5 (ranging from 16 to 43 years) with a mean BMI of 26.9 (± 3.81) kg (range: 17.0-39.1). The results of the pairwise correlation coefficient of trace elements illustrated that correlation was mostly positive and weak to moderate. A few exceptions of strong correlations were Cr-Ni (r = 0.82), Au-As (r = 0.64), Cr-V (r = 0.64), and Ni-V (r = 0.58). Moreover, results indicated that BMI (p = 0.008), cooking oil (0.042), and potato intake (p = 0.010) affected the trace element levels significantly. The concentrations of V (p = 0.044), Sn (p = 0.036), Au (p < 0.001), and As (p < 0.001) in the breast milk of women was affected by the BMI. The results of univariate linear regression analysis showed that the concentration of Pb in the milk of mothers who use cosmetics was significant (p < 0.05). Since the lifestyle of lactating women, such as cosmetics usage can impact the content of some elements in breast milk, they should be educated in this part., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: This study aims to investigate the concentrations of lead, cadmium, and arsenic in the human milk, and to assess the effect of jujube fruit consumption by lactating mothers in reducing the concentration of these heavy metals in their milk. Materials and Methods: This randomized controlled trial was conducted in 2014 among forty postpartum mothers in Isfahan, the second largest and polluted city in Iran. Mothers were randomized into two groups; the intervention group received 15 g/day of fresh jujube fruit, and the controls received routine care for 8 weeks. Results: In the beginning, the concentrations of lead, cadmium, and arsenic were high, without significant difference between groups. The mean (standard deviation) concentrations of lead, cadmium, and arsenic were 29.49 (16.6), 4.65 (3.51), and 1.23 (0.63) µg/L, respectively. The smoothed empirical distribution of environmental pollutants showed that in both groups the mean values and variance of toxic metals decreased after 8 weeks, with a sharper decline in the intervention group. Quantile regression analysis showed that in the intervention group, lead concentration decreased by 2.54 µg/L at the 90th quintile, and cadmium decreased by 0.19 µg/L at 75th quintile; without significant change in arsenic level. The corresponding figures were not significant in the control group. Conclusion: The concentrations of heavy metals were high in human milk, and the consumption of jujube fruit had some beneficial effects in reducing these harmful elements. Pregnant and lactating mothers should be advised to reduce their exposure to environmental pollutants, and consumption of some natural medicinal foods can be useful in reducing the concentration of pollutants in human milk. Because of numerous benefits of breast milk, in spite of the existence of some toxic trace elements, breastfeeding must be encouraged because such contaminants are also found in water and formula. The impact of the current findings on the primary prevention of chronic disease should be determined in future longitudinal studies. [ABSTRACT FROM AUTHOR]

Objective: Pregnancy is associated with insulin resistance in tissues. Although this condition is resolved after termination of pregnancy, subtle metabolic changes can remain and prompt incidence of metabolic syndrome. However, lactation causes increased metabolic load and energy needs and it may confer with unfavorable effects of pregnancy in metabolic status. We conduct this study to evaluate impacts of lactation on development of metabolic syndrome (MetS) among women.Study Design: In this cross-sectional study, we enrolled 978 women aged between 40 and 70 years who had at least one previous live birth, referred to population research center of Amol, Iran in 2011. We surveyed medical registries of participants of Amol health cohort and filled the checklist we had designed for our study. The checklist included main variables like age, number of pregnancies, life-time lactation duration, waist size, systolic and diastolic blood pressures, blood triglyceride level, and blood glucose level.Results: We included 978 women among which, the mean age of participants was 53.24±7.8 years. Calculated odds ratio (OR) for relationship of number of parities and metabolic syndrome (OR=1.14 [95% CI=1.02-1.28] p-value=0.017) was found to be statistically significant. However, calculated odds ratio for relationship of lactation duration and MetS (OR=0.99 [95% CI=0.99-1.00], p-value=0.322) was not statistically meaningful. Moreover, we calculated OR and Pearson correlation coefficient in different strata of number of parities, none of which were statistically significant and hence did not support protective roles of lactation in development of metabolic syndrome.Conclusions: Our data did not support protective roles of lactation in development of metabolic syndrome, since in our study longer lactation durations as well as higher number of parities were seen among participants with metabolic syndrome. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effect of milking frequency (three times daily vs. two times daily) on the lactation curve shape, partial and 305-d lactation performance in Holstein dairy cows in Iran. Data from February 2000 to December 2012 comprising 217345 lactations on 141364 cows distributed in 324 herds collected by the Animal Breeding Center of Iran were used. The mean milking frequency was 2.88 (0.32) times and increased from 2.72 (0.004) times in 2000 to 2.97 (0.002) times in 2012. The shape of the lactation curve for cows milked thrice daily tended to be higher and flatter than that for those milked twice. The first parity cows milked twice daily had a significant lower days in milk (DIM) until peak (79.52 (0.49) days) than those milked thrice (88.66 (0.28) days). In all parities except for parity ≥ 4, lactation persistency was higher in the cows milked thrice daily than in those milked twice. The percentages of increase in 305-d milk yield due to increasing milking frequency from two times to three times daily, were 12.34, 14.02, 12.79 and 14.76% for cows in parity 1 to parity ≥ 4, respectively. The 305-d milk yield was higher by 959 (28.89), 1175 (32.7), 1099 (38.6) and 1271 (45.0) kg for cows milked thrice daily than those milked twice in parity 1 to parity ≥ 4, respectively. The corresponding values for the 305-d fat yield were 4.35 (0.98), 16.68 (1.11), 17.19 (1.28) and 18.76 (1.51) kg. Based on the results of this study, it can be concluded that increasing milking frequency not only increased milk yield but also improved the initial yield, peak yield and lactation persistency. [ABSTRACT FROM AUTHOR]

Aim We aimed to explore the effect of lactation on development of metabolic syndrome in a prospective population-based study. Methods From among 4028 female participants of the Tehran Lipid and Glucose Study, aged 15-50 years, without metabolic syndrome at the initiation of the study, 925 women were randomly selected to fill out the lactation questionnaire. Women were assigned to five groups based on lactation duration including: none, 1-6 months, 7-12 months, 13-23 months and 24 months or more. Over a 9-year follow-up, metabolic syndrome was compared between these groups, before and after adjustment for possible confounding variables. Results Metabolic syndrome was developed in 12.1% of non-lactating women; it was 28.6%, 34.0%, 26.2% and 26.7% in women with 1-6, 7-12, 13-23 and 24 months or more of lifetime duration of lactation, respectively ( P < 0.002). Adjustment for confounders revealed that women with 1-6 and 7-12 months of duration of lactation had significantly higher odds of metabolic syndrome in comparison to 24 months or more (1.4 and 1.3 times, respectively). Conclusion It seems that the longer duration of lactation up to 12 months may protect women against metabolic syndrome, in a dose-response manner. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the effect of censoring, the situations in which incomplete at the time, out of range, and/or delayed records were considered, in the estimation of genetic parameters for age at first calving (AFC) and days open (DO) in Iranian Holstein cows. The dataset included 281,772 records collected from 1991 to 2019 by the Vahdat Cooperative Company, a pioneer dairy farm in Isfahan Province, the central part of Iran. Five animal models including linear model (LM), penalty model (PM), modified penalty model (MPM), linear-threshold model (LTM), and modified linear-threshold model (MLTM) were used for genetic evaluation of the trait studied. The predictive ability of the models was assessed using cross-validation. The lowest mean square of error and highest r(y,y) were obtained under MLTM for AFC and under LTM for DO, indicating that MLTM and LTM are recommended for genetic evaluation of AFC and DO with censored records in Iranian Holstein cows, respectively. The prediction accuracy of the models for AFC was relatively similar, ranging from 0.46 (under LM) to 0.48 (under PM, LTM, and MLTM). For DO, prediction accuracy values ranged from 0.36 (under LM) to 0.47 (under PM and LTM). The posterior mean for heritability of AFC under MLTM was 0.11. There was no significant difference among posterior means for the heritability of AFC under different models. Therefore, LM is preferred for genetic evaluation of AFC in Iranian Holsteins, and taking censored records into account is unnecessary. The posterior mean for heritability of DO under LTM was 0.09. There were no statistically significant differences among the heritability estimates of DO under LTM, PM, and MLTM. But considering censored records for genetic evaluation of DO affects the estimation of heritability and improved model accuracy for this trait. Therefore, LTM is preferred and recommended for genetic evaluation of DO in Iranian Holsteins., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Breast milk is a complete food for the development of the newborn, but it can also be an important route for environmental pollutants transmission to the infants. This study was aimed to evaluate the status of heavy metals including lead (Pb), mercury (Hg), cadmium (Cd) and arsenic (As) in the breast milk of Iranian mothers. The international databases including Scopus, PubMed, Web of Science and the Persian electronic databases including Scientific Information Database, IranMedex and Magiran were examined to find relevant articles published until July 2021. A total of 23 studies examined the levels of toxic metals in Iranian breast milk samples. According to the findings, the pooled average concentrations (µg/L) of Pb, Cd, Hg and As were 25.61, 2.40, 1.29 and 1.16, respectively. The concentration of Hg and Pb in colostrum milk was more than twice of mature milk. The Hg mean concentration in the breast milk of mothers with at least one amalgam-filled tooth was approximately three times that of mothers without amalgam-filled teeth. Risk assessment analysis indicated that the intake of Pb and Hg by infants through breastfeeding can be considered a health concern in Iran. It seems necessary to reduce the Pb exposure of pregnant and lactating women in Iran. However, more extensive studies are needed to clarify the toxic metals' exposure status of infants through breast milk in other parts of the country., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Dental caries is a costly and very common disease, especially in pregnant women. Reasons such as not paying attention to oral health, poor diet and also lack of adequate education in this regard cause this to happen. Performing well-designed educational interventions using primary health system's forces, can improve oral health of pregnant women and help control this disease. We conducted this study to evaluate the effectiveness of some oral health interventions on pregnant women dental caries., Methods: A field trial study was done in comprehensive Health Centers in Varamin, Tehran, Iran to assess 439 mothers' dental health status from pregnancy up to 2 years after delivery in intervention (n = 239) and control groups (n = 200). Mothers in intervention groups received oral health-related education consisted of nutritional and behavioral messages via either of four methods: A: comprehensive method including all following methods together (n = 74), B: group discussion by dentists (n = 59), C: face to face education by primary health care providers (n = 53), and D: social network applications (n = 53); while those in control group only received routine maternal and oral health care. We used a questionnaire to collect mothers' demographic, socioeconomic and dental care behavior data and also performed oral examinations to assess their DMFT at baseline and 24 months after delivery to evaluate the effectiveness of these educational oral health interventions., Results: From 454 mothers participated the examination session, 18 pregnant women discontinued during the follow-ups and 439 were remained with mean age of 27.47. In the intervention group, the frequency of daily brushing among women increased from 64% at baseline to 85.6% at the last follow-up and the mean D significantly decreased nearly 1unit at same period (P < 0.05). Most and least dental caries changes were in comprehensive intervention group and social network intervention group compared to other intervention groups, respectively., Conclusions: Performing educational interventions during and after pregnancy using various message delivery methods and messengers (oral health professionals and trained PHCPs), could improve oral health status and behaviors of pregnant and lactating mothers in a feasible and applicable manner., (© 2022. The Author(s).)

Background: Nutritional status assessment is a method for nutritional care which aims to determine nutritional needs and to meet nutritional requirements. Pregnant and lactating mothers are considered vulnerable groups. The use of this method, especially for determination of calorie and protein intake has positive effects on growth of neonates. Thus, the purpose of this study is to assess the nutritional status of pregnant women. Materials and Methods: In this cross-sectional study, 80 pregnant mothers were selected from private and public hospitals in Arak. Data were gathered through a questionnaire including general information concerning pregnant mothers and their nutritional diet. The analysis of dietary intake was done by nutritionist IV software. Data were analyzed using SPSS software. Results: The average weight gain for pregnant mothers at the end of pregnancy was 10.1kg. The mean of body mass index for the mothers was 22.2 kg/m2 , and the average weight for neonates was 2.5 kg. The average energy intakes in mothers were equal compared with RDA, and the average protein intake was greater compared with RDA. There was a significant positive correlation between weight gain during and total body weight at the end of pregnancy (r=0.93) (P<0.01). Also, there was a significant negative correlation between weight of pre pregnancy and percent of weight gain at the end of pregnancy (r=-0.39) (P<0. 01). A significant positive correlation was found between total body weight at the end of pregnancy and birth weight of neonates (r=0.34) (P<0. 01). Conclusion: Adequate nutritional status of mothers influenced normal body weight in neonates. [ABSTRACT FROM AUTHOR]

Abstract: We conducted a longitudinal retrospective study in order to assess the effect of health disorders (HDs) on culling in the 1st or 2nd lactation cows, in Iranian dairy herds. In total, 7067 first- and second-parity Holstein cows, from 32 Iranian dairy herds, which calved from March 2007 to March 2008, were followed until the next calving or culling. Parametric survival models with time-dependent covariates were used to capture the effect of HDs with different duration and recurrence episodes on the risk of culling. Mastitis, locomotor disorders, ovarian cysts, abortion, diarrhea, rumen disorders, displaced abomasum and respiratory disorders were associated with an increased risk of culling. Hazard ratios and 95% confidence intervals were 2.78 (2.31; 3.35), 3.4 (2.79; 4.13) and 1.62 (1.15; 2.78) for mastitis, locomotor disorders and ovarian cysts as common HDs, respectively. Parity and milk-yield were identified as confounder and effect modifier, respectively. The risk of culling in the presence of uterine infection or traumatic reticulo-peritonitis increased with decreasing milk yield. [Copyright &y& Elsevier]

Background & Aims: Breastfeeding has many advantages for both mothers and infants. Several factors have negative effect on the duration of breastfeeding, one of them being mode of delivery. Caesarean sectioned mothers need more help and support, especially in positioning of infant on their breast. In addition, the role of partner and family during initial weeks after birth to support and encouragement of mothers, is very important. The aim of this study was to determine the effect of home visit after caesarean delivery on exclusive breastfeeding. Materials & Methods: The study was a randomized controlled trial with 100 mothers who admitted in an educational hospital of Iran University Medical Sciences and gave birth through cesarean delivery. Patients were selected continually and allocated randomly in two groups of experimental and control. During the trial some of samples excluded from research and finally 67 pair of mother and infant remained. Data collection tools included a questionnaire which was completed via interview with mothers about infant's feeding. Four home visits were performed at 3rd, 10th, 30th, and 60th day after discharge from hospital in the experimental group. In these days the type of infant's feeding in control group was recorded after telephone interview with mothers. Data were analyzed with the Statistical Package for the Social Sciences. Result: According to the results, after teaching good positioning, there was significant increasing in ratio of mothers who breastfed their baby exclusively during six month after birth (P=0. 02). The number of mothers who perceived milk insufficiency, decreased significantly and there was significant differences in exclusive breastfeeding during six month postpartum in two groups (P=0. 000). Conclusion: During the initial weeks postpartum, if cesarean sectioned mothers were taught good positioning during feeding baby, the rate of exclusive breastfeeding increases and mother's perception of milk insufficiency decreases. Successful nutrition with mother's milk during first week after birth is associated with support and encouragement of midwife, partner and family at home. [ABSTRACT FROM AUTHOR]

The expression of genes and their regulation during lactation in Ghezel sheep breed remains less understood. To explore the underlying molecular mechanism of the lactation process in the mammary gland, transcriptome profiles of Iranian fat-tailed Ghezel sheep breed milk at two stages, before (BF) and after peak (AF) stages of lactation were investigated. Functional impacts of differentially expressed genes (DEGs) between BF and AF stages were surveyed using Gene Ontology (GO) and Protein-Protein Interaction (PPI) network analysis. Totally, 75 DEGs were identified between BF and AF stages of lactation. The RNA-Seq results were validated by Q-RT-PCR. Gene ontology of DEGs mainly enriched in metabolic process and oxidative phosphorylation. PPI network analysis also highlighted the contribution of peroxisome proliferator-activated receptors (PPAR) signaling, oxidative phosphorylation and metabolic pathways in the lactation process. Intriguingly, the genes involved in fat metabolism dominantly down-regulated at AF stage. Our results provide new insight into transcriptional changes and add to growing body of knowledge on the lactation process in fat-tailed sheep breeds.

Background: Aflatoxins are highly toxic, immunosuppressive, mutagenic, teratogenic, and carcinogenic compounds. Aflatoxin M1 (AFM1) is a hydroxylated metabolite of aflatoxin B1 (AFB1) formed in liver and excreted into breast milk. It is considered to impose certain hygienic risks to infant health. The aim of this study was to evaluate the presence of aflatoxin in breast milk using AFM1 in milk as a biomarker for exposure to AFB1. We also tried to determine the level of AFM1 in lactating mothers in Isfahan, Iran. Methods: The study was carried out on 80 lactating women who were randomly selected from 2 urban health centers. Milk samples and information on food intake were collected from the participants using the structured food-frequency questionnaire. Breast milk samples were tested to determine AFM1 levels by a competitive enzyme-linked immunosorbent assay (ELISA) technique. Findings: Our findings showed that the incidence of contamination with AFM1 in our participants was 1.25%. AFM1 was found only in one sample at a concentration of 6.8 ng/L. Chi-square analysis revealed the presence of AFM1 to be significantly associated with consumption of sausages (P < 0.001). AFM1 level was found to be lower than the maximum tolerable limit (25 ng/l) accepted by the European Communities and Codex Alimentarius. Conclusion: The benefits of breast milk have been well documented. Therefore, early childhood exposure to the environmental toxicants like aflatoxins may be a critical determinant of later health effects. The findings of this study pointed out that AFM1 was present in only one milk sample. The findings confirmed the need for developing strategies to reduce exposure to aflatoxin in foods and also to routinely carry out biological monitoring of aflatoxins as a food quality control measure. [ABSTRACT FROM AUTHOR]

Introduction: Learning how to use medications rationally is an important and key issue in medical education. The aims of this study were needs assessment, designing and implementing practical training on pharmacotherapeutic issues in special populations (pregnant women, nursing mothers who are breastfeeding, infants, and elders) for medical interns. Methods: This study was conducted in two consequent stages. The first stage was carried out by holding focus groups with medical residents who were randomly selected. For this purpose, six separate sessions with four groups of four to five-member residents were held to determine educational needs about pharmacotherapy in special populations. Notes from group discussions were taken. Then in the next stage, the viewpoints of 12 medical graduates who were chosen by purposive sampling were asked about the importance and priority of defined objectives. Finally, the curriculum of this course was designed and implemented based on achieved educational needs and objectives. Results: Sixteen major training needs were defined based on needs assessment. The most important needs of medical interns in Isfahan University of Medical Sciences in this regard were recognizing oral and topical medications as well as injections and inhalers; special considerations about pharmacotherapy in special populations, especially pregnant women, mothers who are breast-feeding, infants, elders and patients with advanced renal failure; and also knowledge about respiratory, dermatology, hepatic and renal diseases due to drug administration. Conclusion: Providing education about the above mentioned needs seems to be necessary for promoting medical graduates competency in rational use of medications according to therapeutic and physiologic needs of special populations [ABSTRACT FROM AUTHOR]

Fatty liver syndrome is a metabolic disorder that is caused by negative energy balance in high-producing dairy cows during early lactation. The diagnosis of fatty infiltration of the liver in dairy cattle is presently based mostly on biochemical analysis, biopsy, and histological analysis of hepatic tissue. In this study, a total of 287 dairy cows in early lactation (1-4 weeks postpartum) were randomly selected from 14 commercial dairy herds in southeast Iran. Blood samples from all of the cases, midstream urine samples from 46 of 287 cattle, and liver samples from 94 of 287 cows that were slaughtered due to other postparturient disorders were collected. A spectrophotometer was used to measure the levels of aspartate aminotransferase and glucose concentrations in the serum samples. Ketone bodies were detected by highly sensitive test strip method in the urine samples. The submersion of liver samples into water and copper sulfate solutions with specific gravities of 1.025 and 1.055 was used as a test to estimate lipid contents. Formalin-fixed liver samples were stained with hematoxylin and eosin and confirmed by the Sudan IV staining method on frozen sections. Fatty liver syndrome was detected in ten out of 14 dairy herds. Eleven (11.7%) postpartum cows were suffering from mild (13% < fat content < 25%) fatty liver, and ketone bodies were detected in five (11.11%) urine samples from a total 46 cows. All of the five cases were suffering from hypoglycemia (serum glucose concentrations <45 mg/dl) and mild hepatic lipidosis. In conclusion, the results of this study show that the prevalence of fatty liver syndrome in dairy herds in southeast Iran is considerable. Furthermore, proper nutritional programs for the early lactating cows will prevent the disease. [ABSTRACT FROM AUTHOR]

Objective: Although a lot of interventional studies may be found which have investigated the effects of education on nursing mothers regarding advantages of breast-feeding behavior, but very few studies in developing countries have examined whether mothers are conscious of the risks associated with formula and bottle-feeding on children. Knowing that Breast-feeding Index has decreased in Iran and feeding behaviors are not suitable and adequate in nursing mothers, we studied the effect of education based on PRECEDE Model on improving mothers' breast-feeding behaviors in Yazd, Iran. Methods: Cluster stage sampling was employed to recruit 60 pregnant mothers who had one month to the time of their delivery. Before and 3 months after implementing the educational program through group discussion, lectures and pamphlets , a self-prepared questionnaire was completed by the respondents. Validity and reliability of the scales were approved. SPSS software was used for the purpose of data entry, manipulation, and analysis. Findings: Mean age was 25.9 (±5.8) years; 96.6% were housewives. After implementing the educational program, mothers' knowledge (38%) and attitude (12.3%) were significantly increased (P=0.001). After implementing the program, 85% of the mothers fed their children exclusively with mother's milk and 15%, breast-fed together with formula. The children, who were formula-fed, were breast-fed 4-5 times daily as well. Moreover, none of them was formula-fed from the time of birth and formula-feeding was used as a result of improper weight getting in these children. Conclusion: In order to design effective educational programs, healthcare professionals should better understand the determinants of feeding behaviors in nursing mothers and develop stage-specific interventions, within which, promoting predisposing factors like knowledge and attitude are priorities of the program. The PRECEDE Model, as a basic model for programming, was found to be helpful in addressing the effects of education on formula and bottle-feeding behaviors and their predisposing factors in nursing mothers. [ABSTRACT FROM AUTHOR]