The influence of infant feeding attitudes on breastfeeding duration: evidence from a cohort study in rural Western Australia.

Kylee N Cox,Roslyn C Giglia,Colin W Binns

doi:10.1186/s13006-015-0048-3

Abstract

BackgroundBreast milk is the optimal source of nutrition for infants in the first six months of life. Promoting and protecting breastfeeding is reflected in public health policy across the globe, but breastfeeding rates in both developing and industrialised countries continue to demonstrate that few mothers meet these recommendations. In addition to sociodemographic factors such as age, education and income, modifiable factors such as maternal infant feeding attitudes have been shown to influence breastfeeding duration. The objective of this paper was to describe the influence of infant feeding attitudes on breastfeeding duration in rural Western Australia.MethodsA cohort of 427 women and their infants were recruited from hospitals in rural Western Australia and followed for a period of 12 months. Information about feeding methods was gathered in hospital and at a further seven follow-up contacts. Infant feeding attitude was measured using the Iowa Infant Feeding Attitude Scale (IIFAS), and a score of > 65 was considered positive towards breastfeeding.ResultsMothers with an IIFAS score of > 65 were approximately twice as likely to be exclusively breastfeeding at six months, and breastfeeding at any intensity to 12 months. The median duration of exclusive breastfeeding for mothers with an IIFAS score of > 65 was 16 weeks (95 % CI 13.5, 18.5) compared with 5 weeks for those with a score < 65 (95 % CI 3.2, 6.8) (p < 0.0001). The median duration of any breastfeeding to 12 months was more than twice as long for mothers with an IIFAS score > 65 (48 vs. 22 weeks, p < 0.001).ConclusionsWomen in this rural cohort who had a more positive attitude towards breastfeeding had a longer duration of both exclusive breastfeeding to six months and any breastfeeding to 12 months. Further research examining the breastfeeding attitudes of specific subgroups such as men, grandparents and adolescents in rural areas will contribute to the evidence base and help to ensure that breastfeeding is seen as the normal method of infant feeding.

Highlights

Breast milk is the optimal source of nutrition for infants in the first six months of life
Women who had been discharged from hospital in the first 24 h, who were not on the ward at the times that the researcher visited, or who had been identified as not appropriate to contact by midwifery or medical staff accounted for those not contacted
The median duration of exclusive breastfeeding for mothers with an Iowa Infant Feeding Attitudes Scale (IIFAS) score of > 65 was 16 weeks (95 % Confidence Interval (CI) 13.5, 18.5) compared with five weeks for those with a score < 65 (p < 0.0001)

Summary

Introduction

Breast milk is the optimal source of nutrition for infants in the first six months of life [1] and the promotion and protection of breastfeeding is reflected in public health policy across the globe. Influences on infant feeding in developed countries are varied, but include sociodemographic factors such as maternal age, level of education and family income [3, 7,8,9]. Whilst these variables are strong predictors of breastfeeding practice, they are not amenable to modification and are difficult to address through breastfeeding promotion interventions [10]. Exposure to positive role models and societal values which promote breastfeeding as normal and desirable contribute to positive breastfeeding attitude [12, 21]

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