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Pre
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n
a
d
o
lescen
ts
as
m
o
th
er
s
an
d
th
e
f
etu
s
th
ey
co
n
tain
.
T
h
e
p
h
y
s
ical
co
n
d
itio
n
a
n
d
g
r
o
wth
o
f
t
h
e
r
e
p
r
o
d
u
ctiv
e
o
r
g
an
s
th
at
h
av
e
n
o
t
b
ee
n
f
u
ll
y
co
m
p
leted
ca
u
s
e
p
r
eg
n
a
n
cy
an
d
ch
ild
b
ir
th
to
b
e
at
r
is
k
,
in
clu
d
in
g
;
ab
o
r
tio
n
,
g
estatio
n
al
h
y
p
er
te
n
s
io
n
,
r
is
k
o
f
p
r
e
m
atu
r
e
b
i
r
th
,
lo
w
b
ir
th
weig
h
t
(
L
B
W
)
,
lack
o
f
p
r
en
atal
ca
r
e
an
d
p
o
s
tp
ar
tu
m
d
e
p
r
ess
io
n
.
Pre
g
n
a
n
cy
in
ad
o
lescen
ce
is
co
r
r
elate
d
with
lo
wer
lev
els
o
f
ed
u
ca
tio
n
an
d
p
o
v
e
r
ty
.
T
h
e
l
ev
el
o
f
ed
u
ca
tio
n
a
f
f
ec
ts
a
p
er
s
o
n
'
s
ab
il
ity
to
d
ea
l
with
p
r
o
b
lem
s
,
in
clu
d
in
g
th
e
ab
ilit
y
to
co
p
e
with
p
o
s
tp
ar
tu
m
d
e
p
r
ess
io
n
an
d
lack
o
f
p
r
en
atal
ca
r
e
.
T
h
is
co
n
d
itio
n
is
also
in
f
lu
e
n
ce
d
b
y
s
elf
-
co
n
f
id
en
ce
in
t
h
eir
ab
ilit
y
to
b
r
ea
s
tf
ee
d
o
r
s
elf
-
ef
f
icac
y
w
h
ich
h
as
a
n
im
p
ac
t
o
n
th
e
f
ailu
r
e
to
p
r
o
v
id
e
b
r
e
ast
m
ilk
(
ASI
)
,
s
tu
n
ted
b
ab
y
g
r
o
wth
a
n
d
th
e
ec
o
n
o
m
ic
im
p
ac
t
o
f
t
h
e
f
am
ily
.
Mo
th
er
s
u
n
d
er
2
0
y
ea
r
s
o
f
ag
e
h
av
e
lo
w
s
elf
-
ef
f
icac
y
in
b
r
e
astfe
ed
in
g
an
d
ten
d
to
d
ec
lin
e
d
u
r
in
g
th
e
f
ir
s
t
s
ix
m
o
n
th
s
.
Pre
g
n
an
c
y
in
ad
o
lescen
ce
wh
ich
is
n
o
t
b
ased
o
n
s
tr
o
n
g
p
h
y
s
ical,
p
s
y
ch
o
lo
g
ical
a
n
d
m
en
tal
ca
p
ac
ities
,
r
ed
u
ce
s
s
elf
-
co
n
f
id
en
ce
in
ca
r
r
y
in
g
o
u
t th
e
d
u
ties
o
f
a
n
ew
r
o
le
as a
m
o
th
er
[
5
]
,
[
6
]
.
B
r
ea
s
tf
ee
d
in
g
s
elf
-
ef
f
icac
y
is
th
e
r
esp
o
n
s
e
o
f
in
d
iv
id
u
als
wh
o
b
e
h
av
e
in
c
h
o
o
s
in
g
to
b
r
ea
s
tf
ee
d
,
th
e
ef
f
o
r
t
an
d
ab
ilit
y
to
f
ac
e
th
e
c
h
allen
g
es
o
f
b
r
ea
s
tf
ee
d
in
g
,
p
a
tter
n
s
o
f
th
in
k
i
n
g
an
d
ac
tio
n
,
em
o
tio
n
al
r
ea
ctio
n
s
o
f
a
m
o
th
er
.
Self
-
co
n
f
id
en
ce
o
r
s
elf
-
ef
f
ic
ac
y
f
o
r
b
r
ea
s
tf
ee
d
in
g
,
th
e
m
o
th
er
s
h
o
u
ld
h
av
e
h
ad
s
in
ce
s
h
e
was
p
r
eg
n
a
n
t
[
7
]
,
[
8
]
.
B
r
ea
s
tf
ee
d
in
g
s
elf
-
ef
f
icac
y
h
as
th
r
ee
d
i
m
en
s
io
n
s
,
n
am
ely
th
e
tech
n
i
ca
l
d
im
en
s
io
n
,
th
e
in
tr
ap
er
s
o
n
al
th
i
n
k
in
g
d
im
e
n
s
io
n
an
d
t
h
e
s
u
p
p
o
r
t
d
i
m
en
s
io
n
.
T
h
e
tech
n
ical
d
i
m
en
s
io
n
r
elate
s
to
ac
tiv
ities
/actio
n
s
to
ac
h
iev
e
s
u
cc
ess
in
b
r
ea
s
tf
ee
d
in
g
.
T
h
e
d
im
en
s
io
n
o
f
i
n
tr
ap
er
s
o
n
al
th
in
k
in
g
in
clu
d
es
th
e
mot
h
er
'
s
b
elief
s
,
p
er
ce
p
tio
n
s
an
d
attitu
d
es
to
war
d
s
b
r
ea
s
tf
ee
d
in
g
b
e
h
av
io
r
,
wh
ile
th
e
s
u
p
p
o
r
t
d
im
e
n
s
io
n
in
clu
d
es
all
th
in
g
s
th
at
s
u
p
p
o
r
t
m
o
th
e
r
s
to
b
r
ea
s
tf
ee
d
b
y
i
n
v
o
lv
in
g
em
o
tio
n
al
an
d
p
h
y
s
ical
[
9
]
,
[
1
0
]
.
T
h
is
m
ater
n
al
s
u
p
p
o
r
t f
o
r
b
r
ea
s
tf
ee
d
in
g
will h
elp
m
o
th
er
s
b
r
ea
s
tf
ee
d
lo
n
g
e
r
an
d
ex
clu
s
iv
ely
[
1
1
]
.
T
h
e
lev
el
o
f
s
elf
-
co
n
f
i
d
en
ce
o
r
b
r
ea
s
tf
ee
d
i
n
g
s
elf
-
e
f
f
icac
y
af
f
ec
ts
h
o
w
m
u
ch
ef
f
o
r
t th
e
m
o
t
h
er
m
a
k
es
to
b
r
ea
s
tf
ee
d
h
er
b
a
b
y
o
r
n
o
t,
as
well
a
s
h
o
w
th
e
m
o
th
er
o
v
er
co
m
es
all
d
if
f
icu
lties
wh
ile
b
r
ea
s
tf
ee
d
in
g
[
1
2
]
,
[
1
3
]
.
T
h
er
e
is
a
s
ig
n
if
ica
n
t
ef
f
ec
t
b
etwe
en
m
o
th
er
'
s
s
elf
-
ef
f
icac
y
o
n
b
r
ea
s
tf
ee
d
i
n
g
e
f
f
ec
ti
v
en
ess
[
1
4
]
,
[
1
5
]
.
B
r
ea
s
tf
ee
d
in
g
co
n
f
id
en
ce
is
in
f
lu
en
ce
d
b
y
f
o
u
r
f
ac
to
r
s
,
i
n
clu
d
in
g
ac
h
iev
em
en
t
in
th
e
f
o
r
m
o
f
p
r
ev
io
u
s
s
u
cc
ess
f
u
l
b
r
ea
s
tf
ee
d
in
g
ex
p
e
r
ien
ce
s
,
o
b
s
er
v
in
g
o
th
er
p
eo
p
le
'
s
b
r
ea
s
tf
ee
d
in
g
ex
p
e
r
ien
ce
s
,
v
er
b
al
p
e
r
s
u
asio
n
in
th
e
f
o
r
m
o
f
r
ein
f
o
r
ce
m
en
t
o
r
a
d
v
ice
g
iv
en
b
y
in
f
lu
e
n
tial
p
eo
p
le
wh
o
b
ec
o
m
e
a
s
o
u
r
ce
o
f
s
tr
en
g
th
f
o
r
th
e
m
o
th
er
,
an
d
p
h
y
s
io
lo
g
ical
r
esp
o
n
s
es
in
th
e
f
o
r
m
o
f
r
ea
ctio
n
s
.
s
o
m
atic
r
esp
o
n
s
e
to
ev
en
ts
th
at
h
av
e
th
e
p
o
ten
tial
to
ca
u
s
e
s
tr
ess
,
an
x
iety
,
an
d
f
atig
u
e
[
1
6
]
.
Fo
u
r
f
ac
to
r
s
th
at
in
f
lu
e
n
ce
teen
ag
e
p
r
eg
n
a
n
t
wo
m
e
n
f
o
r
b
r
ea
s
tf
ee
d
in
g
s
elf
-
ef
f
icac
y
in
clu
d
e:
wh
eth
er
th
e
m
o
th
er
d
ec
id
es
to
b
r
ea
s
tf
ee
d
o
r
n
o
t;
h
o
w
m
u
ch
wo
r
k
is
d
o
n
e;
wh
eth
er
s
h
e
will
h
av
e
a
m
in
d
s
et
th
at
en
co
u
r
ag
es
g
o
o
d
o
r
b
a
d
f
o
r
h
er
,
a
n
d
h
o
w
s
h
e
will
r
esp
o
n
d
em
o
tio
n
a
lly
to
d
if
f
icu
lties
in
b
r
ea
s
tf
ee
d
in
g
[
1
7
]
,
[
1
8
]
.
Self
-
co
n
f
id
en
ce
is
v
er
y
im
p
o
r
tan
t
i
n
th
e
p
er
f
o
r
m
a
n
ce
o
f
ce
r
tain
b
eh
av
io
r
s
b
ec
au
s
e
it
ca
n
r
ef
lect
in
d
i
v
id
u
als'
p
er
ce
p
tio
n
s
o
f
th
eir
a
b
ilit
ies
[
1
9
]
,
[
2
0
]
.
T
h
e
f
o
r
m
atio
n
an
d
c
h
an
g
es
in
h
ea
lth
b
eh
av
io
r
n
ee
d
to
b
e
p
u
r
s
u
ed
th
r
o
u
g
h
h
ea
lth
p
r
o
m
o
tio
n
an
d
h
ea
lth
ed
u
ca
tio
n
b
o
th
to
th
e
d
ir
ec
t
ta
r
g
et
g
r
o
u
p
,
in
th
is
ca
s
e
p
r
eg
n
a
n
t
wo
m
en
an
d
th
eir
f
am
ilies
.
T
h
e
f
am
ily
f
u
n
ctio
n
h
as
an
im
p
o
r
tan
t
r
o
le
to
h
elp
ca
r
r
y
o
u
t
h
ea
lt
h
p
r
o
m
o
tio
n
,
b
ec
au
s
e
th
e
f
u
n
ctio
n
o
f
t
h
e
f
am
ily
ca
n
af
f
ec
t
th
e
h
ea
lth
ca
p
ac
ity
a
n
d
welf
ar
e
o
f
all
f
am
ily
m
em
b
er
s
.
T
h
e
f
am
i
ly
f
u
n
ctio
n
h
er
e
ca
n
p
r
o
v
id
e
d
ir
ec
tio
n
,
af
f
ec
tio
n
,
in
ter
ac
tio
n
b
etwe
en
f
am
ily
m
e
m
b
er
s
wh
o
h
elp
p
r
eg
n
an
t
wo
m
en
at
th
e
a
g
e
o
f
teen
a
g
er
s
in
p
r
o
v
id
in
g
k
n
o
wled
g
e
an
d
u
n
d
er
s
tan
d
i
n
g
a
b
o
u
t
ex
cl
u
s
iv
e
b
r
ea
s
tf
ee
d
in
g
to
th
eir
b
a
b
ies
later
,
s
o
th
at
m
o
th
e
r
s
ar
e
m
o
r
e
m
o
tiv
ated
to
p
r
ep
ar
e
m
en
tally
an
d
h
a
v
e
h
ig
h
co
n
f
id
en
ce
to
b
r
ea
s
tf
ee
d
[
2
1
]
.
Pre
g
n
an
t
w
o
m
en
with
h
ea
lt
h
y
f
am
ily
f
u
n
ctio
n
s
will
h
av
e
h
ig
h
s
elf
-
ef
f
icac
y
,
wh
er
e
m
o
th
e
r
s
will
b
e
en
co
u
r
ag
ed
to
lear
n
n
ew
th
in
g
s
r
elate
d
to
b
r
ea
s
tf
ee
d
in
g
,
as
a
f
o
r
m
o
f
an
ticip
atio
n
if
th
er
e
ar
e
b
r
ea
s
tf
ee
d
in
g
d
if
f
ic
u
lties
o
r
p
r
o
b
lem
s
,
h
av
e
a
g
o
o
d
p
er
ce
p
tio
n
o
f
in
f
a
n
t
s
atis
f
ac
tio
n
wh
ile
b
r
ea
s
tf
ee
d
in
g
,
an
d
alwa
y
s
tr
y
in
g
t
o
g
et
v
a
r
io
u
s
in
f
o
r
m
atio
n
ab
o
u
t b
r
ea
s
tf
ee
d
in
g
[
2
2
]
,
[
2
3
]
.
T
h
e
s
u
cc
ess
o
f
b
r
ea
s
tf
ee
d
in
g
,
wh
ich
h
as
b
ee
n
p
r
ep
ar
ed
s
in
ce
p
r
eg
n
an
cy
,
ca
n
n
o
t
b
e
s
ep
ar
ate
d
f
r
o
m
th
e
lar
g
e
r
o
le
o
f
th
e
f
am
ily
w
h
ich
ca
n
b
e
s
ee
n
f
r
o
m
t
h
e
f
a
m
ily
in
ca
r
r
y
in
g
o
u
t its
f
u
n
ctio
n
s
.
T
h
er
e
ar
e
ei
g
h
t
f
am
ily
f
u
n
ctio
n
s
ac
co
r
d
in
g
to
th
e
Nati
o
n
al
Po
p
u
lat
io
n
a
n
d
Fam
ily
Plan
n
in
g
Ag
e
n
cy
(
B
KKBN)
wh
ich
in
clu
d
e
r
elig
io
u
s
f
u
n
ctio
n
s
,
s
o
cio
-
cu
ltu
r
al
f
u
n
ct
io
n
s
,
lo
v
e
f
u
n
ctio
n
s
,
p
r
o
tectio
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lescen
t
p
r
im
ig
r
av
id
a
m
o
th
er
s
is
d
ir
ec
tly
p
r
o
p
o
r
tio
n
al,
wh
ich
m
ea
n
s
th
at
th
e
h
ea
lth
ier
th
e
f
am
ily
f
u
n
ctio
n
,
th
e
h
ig
h
er
th
e
b
r
ea
s
tf
ee
d
in
g
co
n
f
id
en
ce
in
ad
o
lescen
t p
r
eg
n
an
t w
o
m
e
n
.
T
h
e
r
esu
lts
o
f
th
is
s
tu
d
y
f
o
u
n
d
th
at
alm
o
s
t
all
r
esp
o
n
d
e
n
t
s
(
9
0
.
3
%)
h
ad
h
ea
lth
y
f
a
m
ily
f
u
n
ctio
n
s
,
alm
o
s
t
all
r
esp
o
n
d
en
ts
(
8
3
.
9
%)
h
ad
h
ig
h
s
elf
-
e
f
f
icac
y
.
Fa
m
ily
f
u
n
ctio
n
in
th
is
s
tu
d
y
wa
s
m
ea
s
u
r
ed
f
r
o
m
t
h
e
g
en
er
al
f
u
n
ctio
n
d
im
en
s
io
n
s
,
r
o
le
d
im
en
s
io
n
s
an
d
co
m
m
u
n
icatio
n
.
Fam
ily
f
u
n
ctio
n
was
o
b
tain
ed
f
r
o
m
g
e
n
er
al
f
u
n
ctio
n
d
im
en
s
io
n
s
(
3
8
.
9
%),
r
o
le
d
im
en
s
io
n
s
(
2
7
.
8
%)
a
n
d
c
o
m
m
u
n
icatio
n
(
2
5
.
4
%).
T
h
at
h
ea
lth
y
f
am
ily
f
u
n
ctio
n
s
h
av
e
an
in
f
lu
e
n
ce
o
n
th
e
d
ev
el
o
p
m
en
t o
f
o
n
e'
s
s
elf
-
ef
f
icac
y
.
T
h
e
m
o
r
e
ef
f
ec
tiv
e
th
e
f
u
n
ctio
n
i
n
g
o
f
th
e
f
am
ily
,
it
will
p
r
o
d
u
ce
s
tr
o
n
g
s
elf
-
ef
f
icac
y
in
a
p
er
s
o
n
.
Hea
lt
h
y
f
am
ily
f
u
n
ctio
n
s
ca
n
b
alan
ce
s
tab
ilit
y
an
d
ch
a
n
g
e
o
r
ad
a
p
tatio
n
in
th
e
f
ac
e
o
f
tr
an
s
itio
n
s
f
r
o
m
a
d
ev
elo
p
in
g
p
er
io
d
,
in
th
is
ca
s
e
th
e
teen
ag
e
y
ea
r
s
th
at
ch
an
g
e
to
th
e
d
ev
elo
p
m
e
n
t
o
f
p
r
eg
n
an
cy
an
d
ch
ild
b
ir
th
.
T
h
u
s
,
a
h
ea
lth
y
f
am
ily
f
u
n
ctio
n
will
b
u
ild
a
b
elief
s
y
s
tem
a
s
well
as
v
alu
es
an
d
n
o
r
m
s
.
Fam
ilies
ar
e
m
ea
n
in
g
f
u
l
i
n
p
r
o
v
i
d
in
g
p
o
s
itiv
e
ex
p
er
ien
ce
s
f
o
r
th
eir
m
e
m
b
er
s
th
at
f
o
r
m
f
am
ily
id
e
n
tity
[
2
5
]
,
[
2
6
]
.
I
n
lin
e
with
th
e
r
esu
lts
o
f
r
esear
ch
b
y
G
u
i
m
a
r
ã
e
s
et
a
l
.
h
ig
h
s
c
o
r
es
o
n
s
elf
-
ef
f
icac
y
in
b
r
ea
s
tf
ee
d
in
g
in
ad
o
lescen
t
m
o
th
er
s
ar
e
r
elate
d
to
f
am
ily
in
v
o
lv
em
e
n
t
(
h
u
s
b
a
n
d
,
m
o
t
h
er
an
d
o
th
e
r
f
am
ilies
)
af
ter
g
iv
in
g
b
ir
th
.
On
th
e
o
th
e
r
h
a
n
d
,
lo
w
s
elf
-
ef
f
icac
y
is
ac
co
m
p
a
n
ied
b
y
a
lo
w
in
d
ex
o
f
r
elatio
n
s
h
i
p
s
atis
f
ac
tio
n
with
a
p
a
r
tn
er
,
u
n
h
ea
lth
y
c
o
m
m
u
n
icatio
n
,
u
n
h
ea
lth
y
atten
tio
n
,
a
n
d
u
n
h
ea
lth
y
b
eh
av
i
o
r
co
n
tr
o
l.
Self
-
ef
f
icac
y
f
o
r
b
r
ea
s
tf
ee
d
in
g
is
o
wn
ed
b
y
m
o
th
er
s
w
h
o
h
av
e
h
ig
h
r
elatio
n
s
h
ip
s
atis
f
ac
tio
n
,
h
av
e
h
ea
lth
y
f
a
m
ily
f
u
n
ctio
n
s
,
wh
ich
af
f
ec
t
th
ei
r
d
eter
m
in
atio
n
to
b
r
ea
s
tf
ee
d
t
h
eir
b
ab
ies
[
7
]
,
[
2
7
]
,
[
2
8
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
F
a
mily
fu
n
ctio
n
s
to
in
crea
s
e
b
r
ea
s
tfeed
in
g
s
elf
effica
cy
o
f a
d
o
lescen
t p
r
imig
r
a
vid
a
(
R
a
t
n
a
Hid
a
ya
ti
)
1851
T
ab
le
1
.
I
d
en
tific
atio
n
o
f
f
a
m
ily
f
u
n
ctio
n
f
r
e
q
u
en
c
y
an
d
b
r
ea
s
tf
ee
d
in
g
co
n
f
id
en
ce
in
ad
o
lescen
t p
r
im
i
g
r
av
id
a
m
o
th
er
s
No
D
a
t
a
F
r
e
q
u
e
n
c
y
P
e
r
c
e
n
t
a
g
e
(
%)
1.
F
a
mi
l
y
f
u
n
c
t
i
o
n
s
H
e
a
l
t
h
y
U
n
h
e
a
l
t
h
y
1
1
2
12
9
0
.
3
9
.
7
2.
S
e
l
f
-
e
f
f
i
c
a
c
y
f
o
r
b
r
e
a
st
f
e
e
d
i
n
g
H
i
g
h
Lo
w
1
0
4
20
8
3
.
9
1
6
.
1
T
ab
le
2
.
C
h
ar
ac
ter
is
tics
o
f
r
esp
o
n
d
en
ts
No
D
a
t
a
F
r
e
q
u
e
n
c
y
P
e
r
c
e
n
t
a
g
e
(
%)
1.
A
g
e
10
-
1
3
y
e
a
r
s
14
-
1
7
y
e
a
r
s
18
-
1
9
y
e
a
r
s
0
20
1
0
4
0
1
6
.
1
8
3
.
9
2.
G
e
st
a
t
i
o
n
a
l
a
ge
Tr
i
mes
t
e
r
I
Tr
i
mes
t
e
r
I
I
Tr
i
mes
t
e
r
I
I
I
32
64
28
2
5
.
8
5
1
.
6
2
2
.
6
3.
O
c
c
u
p
a
t
i
o
n
W
o
r
k
N
o
t
w
o
r
k
56
68
4
5
.
2
5
4
.
8
4.
Ed
u
c
a
t
i
o
n
N
o
sc
h
o
o
l
El
e
m
e
n
t
a
r
y
s
c
h
o
o
l
M
i
d
d
l
e
sc
h
o
o
l
H
i
g
h
sc
h
o
o
l
0
0
88
36
0
0
7
1
.
0
2
9
.
0
5.
F
a
mi
l
y
s
h
a
p
e
s
N
u
c
l
e
a
r
f
a
mi
l
y
Ex
t
e
n
d
e
d
f
a
mi
l
y
O
t
h
e
r
s
16
1
0
8
0
1
2
.
9
8
7
.
1
0
6.
W
h
o
l
i
v
e
w
ith
H
u
sb
a
n
d
H
u
sb
a
n
d
+
P
a
r
e
n
t
s
O
t
h
e
r
s
12
1
1
2
0
9
.
7
9
0
.
3
0
T
ab
le
3
.
An
aly
s
is
o
f
t
h
e
r
elatio
n
s
h
ip
b
etwe
en
f
am
ily
f
u
n
ctio
n
an
d
b
r
ea
s
tf
ee
d
in
g
co
n
f
id
en
c
e
in
ad
o
lescen
t
p
r
im
ig
r
av
i
d
a
m
o
th
e
r
s
No
F
a
mi
l
y
f
u
n
c
t
i
o
n
s
H
i
g
h
se
l
f
e
f
f
i
c
a
c
y
Lo
w
s
e
l
f
e
f
f
i
c
a
c
y
To
t
a
l
f
%
f
%
F
%
1
H
e
a
l
t
h
y
1
0
4
8
3
.
9
8
6
.
5
1
1
2
9
0
.
4
2
U
n
h
e
a
l
t
h
y
0
0
12
9
.
6
12
9
.
6
To
t
a
l
1
0
4
8
3
.
9
20
1
6
.
1
1
2
4
1
0
0
.
0
Rh
o
S
p
e
a
rm
a
n
t
e
st
,
p
-
v
a
l
u
e
=
0
.
0
0
0
;
α
=
0
.
0
5
;
r
=
0
.
7
4
6
T
h
e
m
ajo
r
ity
o
f
r
esp
o
n
d
en
ts
i
n
th
is
s
tu
d
y
wer
e
ag
e
d
1
8
-
1
9
y
ea
r
s
at
8
3
.
9
%.
T
h
is
a
g
e
is
s
t
ill
an
a
g
e
wh
er
e
teen
ag
er
s
ac
tiv
ely
in
ter
ac
t
with
th
eir
f
r
ien
d
s
,
ex
p
l
o
r
e
t
h
e
wo
r
ld
an
d
f
in
d
th
ei
r
id
en
tit
y
.
ev
en
s
o
,
p
r
eg
n
a
n
t
co
n
d
itio
n
s
at
th
is
ag
e
ar
e
s
till
ab
le
to
a
d
ap
t
s
o
th
at
t
h
ey
h
av
e
p
o
s
itiv
e
co
n
f
id
e
n
ce
to
b
r
ea
s
tf
ee
d
th
eir
b
ab
y
later
wh
en
th
ey
g
i
v
e
b
ir
th
.
T
h
e
r
esu
lts
o
f
th
is
s
tu
d
y
ag
r
ee
with
G
u
i
marãe
s
et
a
l.
[
7
]
w
h
er
e
th
e
r
esu
l
ts
o
f
th
eir
r
esear
ch
also
f
o
u
n
d
th
at
y
o
u
n
g
m
o
th
e
r
s
(
5
4
.
2
6
%)
h
a
d
h
ig
h
s
elf
-
ef
f
ica
cy
in
b
r
ea
s
tf
ee
d
i
n
g
.
E
n
ac
tiv
e
attain
m
en
t
o
r
b
r
ea
s
tf
ee
d
in
g
ex
p
e
r
ien
ce
is
u
s
u
ally
a
s
o
u
r
ce
o
f
in
f
o
r
m
atio
n
o
n
s
elf
-
ef
f
icac
y
in
b
r
ea
s
tf
ee
d
in
g
f
o
r
a
m
o
th
er
.
d
if
f
er
en
t
in
th
e
r
esu
lts
o
f
th
is
s
tu
d
y
with
p
r
im
ig
r
a
v
id
a
r
esp
o
n
d
e
n
ts
o
r
m
o
th
er
s
wh
o
ar
e
p
r
eg
n
a
n
t
f
o
r
th
e
f
i
r
s
t
tim
e
s
o
th
ey
d
o
n
o
t
h
a
v
e
ex
p
er
ie
n
ce
in
b
r
ea
s
tf
ee
d
in
g
,
b
u
t
h
av
e
h
ig
h
s
elf
-
ef
f
icac
y
.
Me
an
wh
ile,
Ku
s
u
m
an
in
g
tiar
an
d
W
ah
id
ah
[
2
9
]
r
ep
o
r
ted
th
e
r
esu
lts
o
f
th
eir
r
esear
ch
th
at
b
r
ea
s
tf
ee
d
in
g
ex
p
er
ien
ce
is
an
im
p
o
r
tan
t
f
ac
to
r
in
in
cr
ea
s
in
g
s
elf
-
ef
f
icac
y
.
T
h
e
p
o
s
i
t
i
v
e
i
m
p
a
c
t
o
f
t
h
e
e
x
is
t
e
n
c
e
o
f
a
f
a
m
i
l
y
t
h
a
t
a
lw
a
y
s
s
u
p
p
o
r
t
s
,
e
m
b
r
a
c
e
s
a
n
d
p
r
o
t
e
c
t
s
f
a
m
i
ly
m
e
m
b
e
r
s
w
i
ll
f
a
c
i
l
it
a
t
e
t
h
e
p
r
o
c
e
s
s
o
f
a
d
j
u
s
t
m
e
n
t
t
o
c
r
i
s
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s
i
t
u
a
t
i
o
n
s
o
r
r
o
l
e
t
r
a
n
s
i
t
i
o
n
s
,
esp
e
c
i
a
l
l
y
i
n
t
h
is
c
a
s
e
p
r
e
g
n
a
n
t
w
o
m
e
n
w
h
o
a
r
e
s
t
i
ll
i
n
t
h
e
i
r
t
e
e
n
s
.
P
h
y
s
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c
al
l
y
,
t
h
e
y
m
u
s
t
b
e
a
b
l
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t
o
a
d
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p
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2
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[
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[
14
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M
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7
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a
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n
tac
ted
a
t
e
m
a
il
:
in
d
h
iat
e
lu
@g
m
a
il
.
c
o
m
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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:
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2
5
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8
8
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n
t J Pu
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lth
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1
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Dec
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b
er
20
24
:
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Wa
h
y
u
S
r
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As
tu
tik
is
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lec
tu
re
r
in
th
e
field
o
f
m
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n
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n
n
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rs
in
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n
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t
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h
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tan
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Ke
d
iri
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y
u
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ri
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tu
ti
k
h
o
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a
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a
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lo
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s
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re
e
in
n
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rsin
g
fro
m
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d
o
n
e
sia
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i
v
e
rsity
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k
a
rta
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m
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ste
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m
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in
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.
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ted
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m
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:
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m
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.
c
o
m
.
Evaluation Warning : The document was created with Spire.PDF for Python.