Abstract
Understanding the underlying determinants of maternal knowledge and attitude towards breastfeeding guides the development of context-specific interventions to improve breastfeeding practices. This study aimed to assess the level and determinants of breastfeeding knowledge and attitude using validated instruments in pregnant women in rural Ethiopia. In total, 468 pregnant women were interviewed using the Afan Oromo versions of the Breastfeeding Knowledge Questionnaire (BFKQ-AO) and the Iowa Infant Feeding Attitude Scale (IIFAS-AO). We standardized the breastfeeding knowledge and attitude scores and fitted multiple linear regression models to identify the determinants of knowledge and attitude. 52.4% of the women had adequate knowledge, while 60.9% of the women had a neutral attitude towards breastfeeding. In a multiple linear regression model, maternal occupation was the only predictor of the BFKQ-AO score (0.56SD; 95%CI, 1.28, 4.59SD; p = 0.009). Age (0.57SD; 95%CI, 0.24, 0.90SD; p = 0.001), parity (−0.24SD; 95%CI, −0.47, −0.02SD; p = 0.034), antenatal care visits (0.41SD; 95%CI, 0.07, 0.74SD; p = 0.017) and the BFKQ-AO score (0.08SD; 95% CI, 0.06, 0.09SD; p < 0.000) were predictors of the IIFAS-AO score. Nearly half of the respondents had inadequate knowledge and most women had a neutral attitude towards breastfeeding. Policymakers and managers could address these factors when planning educational interventions to improve breastfeeding practices.
Highlights
Exclusive breastfeeding (EBF) of infants during the first six months of life is recommended [1], given the several benefits that have been identified for both mother and infant [2,3,4,5,6,7,8,9,10,11,12]
For the knowledge assessing questionnaire, we conducted a literature search to find a valid and reliable instrument to assess maternal knowledge about breastfeeding, and we found two instruments: the Breastfeeding Knowledge Questionnaire that was developed in America [40], and a questionnaire assessing knowledge of breastfeeding that was developed in Malaysia [41]
With the goal of improving breastfeeding rates in rural Ethiopia, we conducted a randomized controlled trial in which we provided pregnant women with a breastfeeding education and support intervention (BFESI), that comprised of prenatal breastfeeding education and postnatal peer support [42]
Summary
Exclusive breastfeeding (EBF) of infants during the first six months of life is recommended [1], given the several benefits that have been identified for both mother and infant [2,3,4,5,6,7,8,9,10,11,12]. In. Ethiopia, early initiation of breastfeeding is at 78%, while 58% of children under 6 months old are exclusively breastfed [14]. The current rate of early initiation and EBF are high compared to the overall global rate, both are below the 2020 national targets of. After birth, the EBF rate in Ethiopia declines rapidly from 74% between 0–1 month to 36% at 4–5 months [14].
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