Intention and practice on breastfeeding among pregnant mothers in Malaysia and factors associated with practice of exclusive breastfeeding: A cohort study

Background Exclusive breastfeeding rate in Malaysia is low despite its known health benefits. This study aims to determine the prevalence of intention to breastfeed among pregnant mothers, the prevalence of exclusive breastfeeding practice after delivery, and factors associated with exclusive breastfeeding practice. Methods This was a prospective cohort study. All pregnant women at 36 weeks gestation or above from 17 antenatal health clinics in an urban district were invited to participate in the study. A self-administered questionnaire was used, encompassing sociodemographic, breastfeeding knowledge, attitude, and intention towards the practice of breastfeeding. The participants were followed up one month post-natal for their practice of breastfeeding via telephone or during their post-natal follow-up appointment. Results 483 pregnant mothers participated in the study initially. 462 (95.7%) were contactable after one month. 99.4% (459/462) of participants intended to breastfeed. 65.4% (302/462) of participants practiced exclusive breastfeeding. There was no significant association between intention and practice of exclusive breastfeeding. Multiple logistic regression analysis shows, pregnant mothers with high breastfeeding knowledge (AOR = 1.138; 95% CI 1.008–1.284) and Malay ethnicity (AOR = 2.031; 95% CI 1.066–3.868) were more likely to breastfeed their infant exclusively. Conclusions Prevalence of exclusive breastfeeding practice at one month in the studied district was 65.4%. Malay mothers and mothers with high breastfeeding knowledge were more likely to breastfeed exclusively. Thus, we recommend targeted intervention towards non-Malay mothers and increasing breastfeeding knowledge to all pregnant mothers.

Media counseling of breastfeeding practice improved newborn growth outcomes in Ngombol Public Health Center, Purworejo-Indonesia

Exclusive breastfeeding practice in Ngombol public health center is below the regency target which was only 54.4% from 80% in Purworejo in 2019. Program to improve exclusive breastfeeding such as counseling is one of the best ways to increase community participation as this is a crucial phase to fulfill newborn nutrition needs. The aim of this study was to determine the effect of media counseling on increasing breastfeeding practice and improving newborn weight in the first-month-old. We created a quasi-experimental design with one group pre-test and a post-test with a control group design. Of 40 post-partum mothers and newborns were recruited in this study. Data collection was gathered such as socio-demography, breastfeeding observation form, and newborn’s weight both before and after the one-month intervention. The intervention group had been counseled with media such as leaflets, breastfeeding flipcharts, breast props, and newborn dolls. On the other hand, the control group had no received counseling with media. A statistical paired t-test test was created to find the association between those variables using SPSS 20.0 for windows. The mean average of newborn weight after the intervention was 1,005.55 g and 964,50 g for the intervention and control group, respectively. There were differences before and after a month of giving exclusive breastfeeding between the control and intervention groups (p<0.001). Mothers in the intervention group had 80% achieved minimum recommended weight gain (≥800 g/month). Exclusive breastfeeding counseling with media has an impact on improving newborn weight at the first-month-old in Ngombol Public health Center, Purworejo-Indonesia. Using media during breastfeeding counseling regularly may help the awareness and knowledge of exclusive breastfeeding for mothers, yet improve breastfeeding practice.

Exclusive breastfeeding practice and its associated factors among children aged 6-23 months in Woldia Town, Northwest Ethiopia

Background: Inappropriate practice of exclusive breastfeeding (EBF) is still a major problem worldwide.Objective: To identify exclusive breastfeeding practice and its associated factors among children aged 6-23 months in Woldia Town.Methods: A Community based cross-sectional study was carried out.Interviewer-administered questionnaire was utilized to collect the data. The questionnaire was adapted from the 2016 Ethiopia Demographic and Health Survey. Hosmer-Lemeshowmodel was fitted at a P-value of 0.91. Finally, Variables having P-Value <0.05 with 95% CI was considered as significant factors.Result: The prevalence of exclusive breastfeeding practice was 46.2% (95% CI: 42.0, 49.8). Being employed mothers (AOR=0.62,95% CI:0.44,0.87), being head of a household (AOR=0.52,95% CI:0.32,0.83),not g getting husband support (AOR:0.5,95%CI:0.34,0.74),not fed colostrum’s (AOR:0.36,95%CI:0.23,0.57),not affected by traditional belief (AOR:3.59,95% CI:2.09-6.17) shows significant association with Exclusive breast feeding practice.Conclusion: The prevalence of exclusive breast feeding practice was relatively lower than the National prevalence. Some demographic variable and traditional beliefs were significantly associated with exclusive breast feeding. Designing model policies that empower the role of women and eradicating bad traditional beliefs in the community is fundamental step. Keywords: Exclusive Breastfeeding; Breastfeeding practice; Breastfeeding Promotion.

Health care providers’ awareness of breastfeeding practice recommendations during COVID-19 pandemic and associated factors in Northwest Ethiopia, 2021: A multicenter study

Background Prevention of coronavirus disease 2019 (COVID-19) transmission to newborns is one of the basic components of perinatal care in the era of the COVID-19 pandemic. As such, scientific evidence is compulsory for evidence-based practices. However, there was a scarcity of evidence on health care providers’ awareness of breastfeeding practice recommendations during the COVID-19 pandemic in Ethiopia, particularly in the study setting. Objective The study aimed at assessing healthcare providers’ awareness of breastfeeding practice recommendations during the COVID-19 pandemic and associated factors among healthcare providers in northwest Ethiopia, 2021. Methods A multicenter cross-sectional study was conducted among 405 healthcare providers working in hospitals of Gondar province from November 15, 2020, to March 10, 2021. A simple random sampling technique was employed to select the study subjects. Data were collected via a structured-self-administered questionnaire. EPI INFO version 7.1.2 and SPSS version 25 were used for data entry and analysis respectively. Binary logistic regression analyses were done to identify associated factors and the adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of <0.05 was used to declare significant association. Results The healthcare providers’ awareness of breastfeeding practice recommendations during the COVID-19 pandemic was 40.7% (95% CI: 35.9, 45.6). Working in a tertiary hospital (AOR = 3.69; 95% CI: 2.24, 6.08), using COVID-19 guideline updates (AOR = 3.34; 95% CI: 2.1, 5.3), being trained on COVID-19 (AOR = 2.78; 95% CI: 1.74, 4.47), owning a smartphone and/or a computer (AOR = 2.26; 95% CI: 1.39, 3.68), and perceiving that COVID-19 is dangerous (AOR = 1.78; 95% CI: 1.05, 3.01) were factors positively associated with healthcare providers’ awareness of breastfeeding practice recommendations during the pandemic of COVID-19. Conclusion Only two in five healthcare providers were aware of recommendations on breastfeeding practice during the COVID-19 pandemic and related to information of accessibility information on COVID-19. Therefore, expanding COVID-19 related information through the provision of COVID-19 training and guidelines to all levels of hospitals would improve health care providers’ awareness of breastfeeding practice recommendations amid the COVID-19 pandemic.

Improved Baby Lactation Management and Stimulation for Family Welfare Empowerment (FWE)

Background : Exclusive breastfeeding is breastfeeding alone without additional food, including water during breastfeeding, except for medical indications. Breast milk and baby stimulation support optimal health, growth and development of babies. Exclusive breastfeeding is recommended as long as it is still sufficient for the baby's needs, breastfeeding has an effect on brain development, and is effective in improving children's cognitive understanding, but exclusive breastfeeding has not reached the expected target. The aim of this research is; (1) Provide learning about lactation management and infant stimulation, (2) To determine the effect of the workshop on the knowledge and skills of Family Welfare Empowerment (FWE) mothers regarding lactation management and infant stimulation. Materials And Methods : Quasi-experimental design research, conducted in Gresik Regency, East Java. Research time; February to June 2021. A sample of 80 people was selected by quota sampling. The dependent variable is skills in breastfeeding practice and baby stimulation. The independent variable was a workshop on lactation management and infant stimulation. Data collection using questionnaires and observation sheets. Data were analyzed using t test. Results : The mean value of breastfeeding practice correctly after the workshop (mean=86.80 SD=4.16) was higher than before the workshop (mean=; 48.52; SD=8.69), and statistically significant (p<0.001), and the score was statistically significant (p<0.001). the average stimulation skills of infants 3-6 months after the workshop (mean = 87.89; SD=3.53) were higher than before the workshop (mean=53.88; SD=8.76), and statistically significant (p<0.001). Conclusion : Knowledge about lactation management and infant stimulation is still not widely known to the public. Support from families and the surrounding community, especially mothers for Family Welfare Empowerment (FWE), is needed to disseminate knowledge and lactation management.

Breastfeeding Supportive Services in Baby-Friendly Hospitals Positively Influenced Exclusive Breastfeeding Practice at Hospitalization Discharge and Six Months Postpartum

Background: Studies have shown that implementing the Ten Steps to Successful Breastfeeding of the Baby-Friendly Hospital Initiative can protect, promote, and support breastfeeding. However, few studies have valuated the quality of breastfeeding supportive services provided by Baby-Friendly Hospitals from the perspective of service users. Methods: This was a hospital-based prospective study, conducted at eight Baby-Friendly Hospitals with a total of 707 pregnant women in Shanghai, China between October 2016 and September 2021. Breastfeeding supportive services during hospitalization were assessed at childbirth discharge using a 12-question questionnaire based on the Chinese “Baby-Friendly Hospital Evaluation Standards”. Women were followed up on six months postpartum. The impact of breastfeeding supportive services during hospitalization on the exclusive breastfeeding at discharge and six months postpartum were assessed. Results: Of the 707 mothers who completed the survey at discharge, 526 were followed up on six months after delivery. The overall exclusive breastfeeding rate among participants was 34.4% at discharge and 52.1% at six months postpartum. Mothers who received better breastfeeding supportive services during hospitalization were more likely to practice exclusive breastfeeding at hospitalization discharge compared with mothers who received poorer services (aOR: 3.00; 95% CI: 2.08, 4.35; p < 0.001). Furthermore, they were also more likely to exclusively breastfeed at six months postpartum (aOR: 1.50; 95% CI: 1.03, 2.22; p = 0.033). Conclusion: Better breastfeeding supportive services during hospitalization were significantly associated with higher rate of exclusive breastfeeding at discharge and six months postpartum. More effective measures should be adopted to improve the implementation of the breastfeeding supportive services in Baby-Friendly Hospitals to promote exclusive breastfeeding and better maternal and child health.

ASSOCIATION OF INFANT FEEDING PRACTICES AND FOOD NEOPHOBIA AMONG PRE-SCHOOL CHILDREN IN OROGUN COMMUNITY, IBADAN

This study determined food neophobia (FN) and the relationship of infant feeding practice (IFP) and (FN) among pre-school children in Orogun community, Ibadan. Three hundred and seventy mothers of pre-school children were chosen using a systematic random sampling technique from a pre-survey house to house list of eligible children. A semi-structured questionnaire that included socio-demographic characteristics, retrospective breastfeeding practice, retrospective complementary feeding practice (CFP) and FN scales were used to collect information. Data were analyzed using descriptive and logistic regression. The exclusive breastfeeding (EBF) rate was 26.8% and 38% of the mothers had a good breastfeeding practice. Timely initiation of complementary feeding was 54%. The prevalence of FN was 35%. Logistic regression analysis showed that the odds for FN was higher among children who were initiated to breastfeeding late (OR = 1.45, 95% CI: 0.886 – 2.31), children that were not breastfed on demand (OR = 1.766, 95% CI: 0.925 – 3.372), those not exclusively breastfed for six months (OR = 1.366, 95% CI: 0.834 – 2.240) and children introduced to complementary food before 6 months (OR = 1.473, 95% CI: 0.787 – 2.760). Most rejected foods were from the fruits and vegetable group. There were suboptimal IFP in the study and prevalence of FN was high. Poor IFP were associated with FN. Community-based nutrition education programs should be encouraged to improve IFP.

Exclusive Breastfeeding Practice And Associated Factors Among Employed And Unemployed Mothers In Ethiopia: Comparative Cross Sectional Study Using EDHS 2016

Introduction Contrary to the recommendation, children under the age of 6 months be exclusively breastfed, many infants are also fed with other liquids such as water, non-milk liquids, and other milks before 6 months. Because of level of education and proportion of employed women in Ethiopia has been increasing gradually. Consequently the practice of exclusive breastfeeding became very lower. The main objective of this study was to assess the magnitude and factors associated with the practice of exclusive breastfeeding among employed and unemployed mothers in Ethiopia, using dataset from EDHS 2016. METHOD Data was extracted from Ethiopia Demographic and Health Survey (EDHS-2016). A total of 1089 mothers with infants aged 0 to 6 months in the data set were included in the analysis. Descriptive analysis, chi-square and binary logistic regression models were used. RESULT This study has demonstrated a 64.7%, 95%CI(58.9-70.5) and 75.4%, 95%CI(72.378.2) prevalence of EBF practices among employed and unemployed mothers respectively in the 24h preceding the survey. Other factors associated with EBF practice included being unemployed mother, larger to normal birth weight; infant aged 0-3 month old, infant being male, have radio in the house, infant being wanted, delivery by non CS mode and presence of ANC follow up during pregnancy were found to be significantly associated with exclusive breastfeeding practice. Conclusion the prevalence of exclusive breast feeding practice among employed mothers was significantly lower than that of unemployed mothers. Thus, Having in consideration the impact of appropriate infant and young children feeding practice on children’s nutritional status and mortality rate, policy makers still need to give more emphasis on promotion of exclusive breastfeeding through creating an enabling environment targeting the extension of postnatal maternity leave up to the first six month.

Factors associated with exclusive breastfeeding practice among mothers in nine community health centres in Nanning city, China: a cross-sectional study

Background The prevalence of exclusive breastfeeding (EBF) is suboptimal in China. There is limited evidence of effective interventions to increase EBF in China. Therefore, it is urgent to explore the potential factors that may be effective in promoting exclusive breastfeeding. Previous studies have mainly focused on socio-demographic factors and the Han ethnic group. This study explores more modifiable influencing factors of EBF in the Guangxi Zhuang Autonomous Region of China. Methods The cross-sectional data used in this study were collected to provide baseline information on EBF prevalence for a breastfeeding promotion project. A total of 494 mothers of infants aged 0–5 months were recruited from nine community health centres in Nanning, China, in October 2019. Data were collected through face-to-face interviews using structured questionnaires. Infant feeding was measured by 24-h recall. The Chinese version of the Breastfeeding Self-Efficacy Scale–Short Form was used to examine the maternal breastfeeding self-efficacy. Univariate and multivariate logistic regressions were used to examine the factors associated with EBF practices. Results In the present study, the prevalence of exclusive breastfeeding was 37.0%. Higher breastfeeding self-efficacy scores (adjusted odds ratio [AOR] 1.93; 95% confidence interval [CI] 1.25, 2.98), a college degree or above (AOR 2.15; 95% CI 1.24, 3.71), and early initiation of breastfeeding (AOR 2.06; 95% CI 1.29, 3.29) were positively associated with EBF practice. However, the preparation for infant formula before childbirth (AOR 0.30; 95% CI 0.17, 0.52) and premature birth (AOR 0.30; 95% CI 0.10, 0.87) were negatively associated with EBF practice. Conclusions Exclusive breastfeeding practice was suboptimal and associated with various factors in the study area. The prevalence of EBF was positively associated with higher breastfeeding self-efficacy, education level of mothers, and early initiation of breastfeeding, whereas premature birth and preparation for infant formula before childbirth were barriers to exclusive breastfeeding. Future intervention projects should target mothers with premature babies, lower levels of education, and breastfeeding self-efficacy. Breastfeeding-friendly practices, such as the early initiation of breastfeeding and regulations on breastmilk substitutes, should also be encouraged.

One-week recall period gives a more accurate estimate of exclusive breastfeeding practice than 24-h recall among infants younger than six months of age

Background The World Health Organization recommends a 24-h recall period to estimate breastfeeding practice of mothers of infants aged younger than six-months. Though 24-h recall was preferred for its low recall bias and for practical reasons, it can overestimate exclusive breastfeeding practice (EBF). Validating this indicator will help account for the deviation from the true estimate. This prospective cohort study measured accuracy of the 24-h recall method and validates a week recall as an alternative approach for use in a small sample population. Method The study was conducted from March to April 2018 involving 408 mother-infant pairs living in Butajira Health and Demographic Surveillance Site (HDSS), Southern Ethiopia. Participants were prospectively followed for 14 consecutive days; where their breastfeeding practice in the past 24 h was measured daily. Exclusive breastfeeding prevalence estimate obtained using the 24-h recall method and recall periods spanning a varying number of days (short period recalls) was compared against the cumulative of the responses from a prospectively measured repeated 24-h recalls over the course of 14 days. McNemar statistics was used to assess statistical significance of the difference in the EBF prevalence estimates of the single 24-h recall and the reference standard. Sensitivity, specificity, positive predictive value and negative predictive values were calculated to determine the level of accuracy. Receiver Operating Characteristics curve was used to measure the difference in performance between the two methods. Result The highest prevalence (71.4%) of exclusive breastfeeding practice was estimated using the single 24-h recall method whereas the lowest breastfeeding practice (47.1%) was obtained from a cumulative of 14 repeated 24-h recalls. A week recall (a recall over 7 days’ period), resulted in the smallest discrepancy in estimate (7.1%) as compared to cumulative estimate of 14 repeated 24-h recalls. Comparing against our reference standard, a week recall had 96.7% sensitivity and 83.5% specificity in estimating exclusive breastfeeding practice. Conclusions Using single 24-h recall method overestimated exclusive breastfeeding prevalence. However, a week recall gave an estimate close to the estimate from the standard method. A week recall has a potential to balance the tradeoff between the accuracy of EBF estimates and the resource implication of using multiple prospective measurements that have a proven superior accuracy.