{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:18:26Z","timestamp":1788257906005,"version":"build-2803163510"},"reference-count":50,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100017576","name":"American Beverage Foundation for a Healthy America","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017576","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute of Digestive Diseases and Disorders of the Kidney","award":["R01DK107565"],"award-info":[{"award-number":["R01DK107565"]}]},{"name":"National Center for Research Resources Clinical and Translational Science Program","award":["UL1TR001878"],"award-info":[{"award-number":["UL1TR001878"]}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"crossref","award":["F31NR021344"],"award-info":[{"award-number":["F31NR021344"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Breastfeeding has been shown to reduce the risk of several diseases\u2014including those that disproportionately affect Black or African American women and children. Adverse social determinants of health (SDOH) have been associated with a higher prevalence of postpartum depressive symptoms and are negatively associated with breastfeeding outcomes and the timing of solid food introduction. Prior research has focused on each individual SDOH in isolation and has not, to the best of our knowledge, examined the mediating role of depressive symptoms and timing of introduction to solid foods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to examine (1) the association between multiple adverse SDOH and timing of breastfeeding cessation and (2) if this relationship is mediated by maternal depressive symptoms and the timing of introduction to solid food.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      This secondary data analysis used data from an existing, longitudinal birth cohort study with Black or African American women (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 242). Multivariable logistic regression and regression-based causal mediation analyses were used to address the objectives of this study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Findings showed multiple adverse SDOH were associated with increased odds of stopping breastfeeding at 4 and 6 months of age (4 months: odds ratio [OR] = 3.49, 95% confidence interval [CI]: 1.11, 10.97; 6 months: OR = 5.03, 95% CI: 1.54, 16.47). This relationship was partially mediated by the introduction of solid foods at 4 months of age (indirect effect: OR = 1.53, 95% CI = 1.18, 2.34) but not mediated by maternal depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Multiple adverse SDOH demonstrated relationships with the timing of both breastfeeding cessation and introduction to solid foods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253261464816","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T06:16:28Z","timestamp":1782972988000},"page":"548-558","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Examining Relationships Between Multiple Adverse Social Determinants of Health, Maternal Depressive Symptoms, Timing of Solid Food Introduction, and Breastfeeding Duration Among Black or African American Women"],"prefix":"10.1177","volume":"21","author":[{"given":"Courtney N.","family":"Slater","sequence":"first","affiliation":[{"name":"University of Pennsylvania School of Nursing, Philadelphia, PA, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liming","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babette S.","family":"Zemel","sequence":"additional","affiliation":[{"name":"Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA."},{"name":"Division of Gastroenterology, Hepatology and Nutrition, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane L.","family":"Spatz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA."},{"name":"Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Margo","family":"Brooks Carthon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA."},{"name":"Center for Pediatric Nursing Research &amp; Evidence-Based Practice, Children\u2019s Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja V.E.","family":"Kral","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022746"},{"key":"e_1_3_6_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00504-2021"},{"key":"e_1_3_6_4_1","unstructured":"3.American Heart Association. Heart disease and stroke in Black women. 2025. Available from: https:\/\/www.goredforwomen.org\/en\/about-heart-disease-in-women\/facts\/heart-disease-in-black-women [Last accessed: December10 2025]."},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd21.240049"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd20.230199"},{"key":"e_1_3_6_7_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6834a3"},{"key":"e_1_3_6_8_1","unstructured":"7.Social Determinants of Health - Healthy People 2030. n.d. Available from: https:\/\/odphp.health.gov\/healthypeople\/priority-areas\/social-determinants-health [Last accessed: December10 2025]."},{"key":"e_1_3_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2021.11.010"},{"key":"e_1_3_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-023-00544-6"},{"key":"e_1_3_6_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2020.0352"},{"key":"e_1_3_6_12_1","unstructured":"11.CDC. Center for Disease Control and Prevention (CDC)\u2019s Early Childhood Nutrition Report 2025. 2025. Available from: https:\/\/www.cdc.gov\/nutrition\/media\/pdfs\/2025\/CDC-Early-Childhood-Nutrition-Report-National-2025-508.pdf [Last accessed: December10 2025]."},{"key":"e_1_3_6_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-057988"},{"key":"e_1_3_6_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2014.0152"},{"key":"e_1_3_6_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-025-07693-y"},{"key":"e_1_3_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.40255"},{"key":"e_1_3_6_17_1","unstructured":"16.Roach JM. Restoring Our Own Through Transformation. ROOTT\u2019s theoretical framework of the web of causation between structural and social determinants of health and wellness. 2016. 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