Abstract
BackgroundThe past ten years have witnessed a rising trend in the prevalence and duration of breastfeeding in Italy, but breastfeeding rates increase in an unequal way; they are higher in the North of Italy than in the South. The purpose of this study was to describe the experiences, expectations and beliefs of a sample of mothers, and to identify differences, if any, between the North and the South of Italy.MethodsThe study was conducted in two regions of Italy, Friuli Venezia Giulia in the Northeast and Basilicata in the South. Two hundred and seventy-nine mothers of infants and children 6 to 23 months of age were interviewed using an 85-item questionnaire including closed and open questions on infant feeding experiences and beliefs, sources of information and support, reasons for intended and actual choices and practices, and some demographic and social variables. Face-to-face interviews were conducted between May 2001 and September 2002. Quantitative and qualitative methods were used for data analysis.ResultsThe distribution of the mothers by age, education, employment and parity did not differ from that of the general population of the two regions. The reported rates of initiation and duration of breastfeeding were also similar: 95% started breastfeeding, exclusive breastfeeding was 32% at three and 9% at six months, with 64% and 35% of any breastfeeding, respectively. Some differences were reported in the rates of full breastfeeding, reflecting different ages of introduction of non-nutritive fluids. These, as well as nutritive fluids – including infant formula – and complementary foods, were introduced far too early. Advice on infant feeding was generally provided by health professionals and often was not based on up-to-date recommendations. Mothers were generally aware of the advantages of breastfeeding, but at the same time reported problems that they were not able to solve alone or through social and health system support. Most mothers would welcome the support of a peer counsellor. More mothers in Basilicata than in Friuli Venezia Giulia reported difficulties with breastfeeding related to returning to work and were not familiar with their rights on breastfeeding and maternity leave.ConclusionProgrammes for the protection, promotion and support of breastfeeding in these and similar regions of Italy should concentrate on better training of health professionals with regards to lactation management, communication, and counselling skills. The addition of trained peer counsellors could reinforce the work done by the health system and, through community involvement, could help change social prejudice in the mid- and long-term. The differences between regions should be taken into account in formulating these programmes to avoid increasing, and possibly to decrease, the current gaps.
Highlights
The past ten years have witnessed a rising trend in the prevalence and duration of breastfeeding in Italy, but breastfeeding rates increase in an unequal way; they are higher in the North of Italy than in the South
Most importantly, breastfeeding rates increase in an unequal way; they are higher among mothers with higher levels of income and education [6,7], which is consistent with reports from other countries in Europe and elsewhere [8,9,10,11,12]
There were significant differences as far as employment is concerned: 49 (36%) were unemployed in BAS compared with 39 (27%) in Friuli Venezia Giulia (FVG) (p = 0.007), with a lower proportion of women employed as clerks and professionals in the former
Summary
The past ten years have witnessed a rising trend in the prevalence and duration of breastfeeding in Italy, but breastfeeding rates increase in an unequal way; they are higher in the North of Italy than in the South. Most importantly, breastfeeding rates increase in an unequal way; they are higher among mothers with higher levels of income and education [6,7], which is consistent with reports from other countries in Europe and elsewhere [8,9,10,11,12] They are higher in the North of Italy than in the South. Other personal and social determinants have been found to be associated with the prevalence and duration of breastfeeding [15,16], and it has been recently suggested that individual attitudes related to the intended duration of breastfeeding or the mother's perception of her partner's preference might be important predictors of infant feeding choices and practices [17,18]
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