Abstract

BackgroundUnder-nutrition is a public health problem in Myanmar. Despite current efforts, the exclusive breastfeeding rate (EBF) for children under six months is only 24%. Intention to breastfeed is a strong predictor for long-term breastfeeding, however, little is known about pregnant women’s breastfeeding intentions in Myanmar. We, therefore, aimed to identify the factors associated with women’s intention to EBF.MethodData in this article was collected in a baseline survey for a randomized controlled trial, which aimed to assess the impact of mobile text messages on the breastfeeding practices of women in Yangon, Myanmar. A total of 353 pregnant women at 28–34 weeks of gestation, recruited into the trial from the antenatal clinics of the Central Women’s Hospital, Yangon, Myanmar, responded to the baseline survey questions, which included background information and breastfeeding related characteristics. To determine factors associated with women’s intention to EBF logistic regression was used to analyse individual demographic, household economic and breastfeeding characteristics. In-depth interviews were performed with a sub-sample of 24 women who participated in the survey, to gain a further understanding of these associated factors.ResultsAfter adjusting for potential confounders, working women were less likely to intend to EBF (adjusted odds ratio (AOR) = 0.30, CI 0.17–0.53). Women from rich households (AOR = 2.43, CI 1.08–5.47) and middle income households (AOR = 1.79, CI 1.01–3.16); those who had high (AOR = 10.19, CI 3.43–30.23) and medium (AOR = 5.46, CI 1.79–16.72) breastfeeding knowledge levels, and received information from health professionals (AOR = 2.29, CI 1.29–4.03) and mobile internet (AOR 3.62, CI 2.04–6.41) had a higher intention to EBF. These findings were supported by qualitative analysis, which revealed that returning to work was the main barrier; health staff and printed media are reliable sources and; women with higher knowledge had high intentions to EBF.ConclusionsEBF intention was influenced by many factors. Breastfeeding promotion programs should target the poor, working women and women with lower breastfeeding knowledge. Breastfeeding education via health staff and the Internet, breastfeeding facilities at the work place and longer maternity leave in the private sector should all be encouraged.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12615000063516.

Highlights

  • Under-nutrition is a public health problem in Myanmar

  • After adjusting for potential confounders, working women were less likely to intend to exclusive breastfeeding rate (EBF) (adjusted odds ratio (AOR) = 0.30, CI 0.17–0.53)

  • Women from rich households (AOR = 2.43, CI 1.08–5.47) and middle income households (AOR = 1.79, CI 1.01–3.16); those who had high (AOR = 10.19, CI 3.43–30.23) and medium (AOR = 5.46, CI 1.79–16.72) breastfeeding knowledge levels, and received information from health professionals (AOR = 2.29, CI 1. 29–4.03) and mobile internet (AOR 3.62, CI 2.04–6.41) had a higher intention to EBF. These findings were supported by qualitative analysis, which revealed that returning to work was the main barrier; health staff and printed media are reliable sources and; women with higher knowledge had high intentions to EBF

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Summary

Introduction

The exclusive breastfeeding rate (EBF) for children under six months is only 24%. World Health Organization (WHO) recommends that all infants should be exclusively breastfed (EBF) in the first six months of life [1]. Several studies acknowledge that breastfeeding is an ideal food for healthy growth and development of infants, serves as a key protective factor against common childhood infectious diseases, and has short and long term benefits for children and mothers [2,3,4,5]. In Myanmar, breastfeeding is practiced universally and 90% of mothers were aware of breastmilk benefits and 76% fed breastmilk to their newborn within one hour after birth, only 24% of babies under six months of age were EBF [13]. Though the government has made several efforts to improve infant feeding practices in Myanmar, it is a challenge to find reliable data to inform the health program design

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