Breastfeeding Attitudes Research Articles

Using the theory of planned behavior model to predict factors influencing breastfeeding behavior among preterm mothers at week 6 postpartum: the mediating effect of breastfeeding intention.

Exclusive breastfeeding (EBF) in the first 6 weeks postpartum is key to continued breastfeeding. This study aimed to explore the role of EBF-related predictors (particularly breastfeeding intention) in breastfeeding behavior among preterm mothers at week 6 postpartum based on the theory of planned behavior (TPB). A total of 352 mothers of preterm infants were recruited, 340 of whom participated in this study. Prior to discharge, participants completed the Chinese versions of the modified Breastfeeding Attrition Predictive Tool, the Breastfeeding Knowledge Questionnaire (BKQ), the Infant Feeding Intention, and the Edinburgh Postnatal Depression Scale. Responses to the items of the Breastfeeding Behavioral Questionnaire (BBQ) were also collected by telephone at week 6 postpartum. The final analyses included 321 participants who completed the full two-wave data collection. The fitness indices of the modified TPB model were acceptable. Breastfeeding knowledge and EBF before discharge positively impacted breastfeeding intention, whereas depression had a negative impact. Before discharge, breastfeeding intention fully mediated the impacts of breastfeeding attitude, social and professional support, knowledge, depression, and EBF on breastfeeding behavior and partially mediated the influence of perceived breastfeeding control on breastfeeding behavior. These findings indicate that TPB accurately predicts breastfeeding behavior among preterm mothers at week 6 postpartum, and breastfeeding intention is key to the above-mentioned EBF-related factors and breastfeeding behavior. The findings underline the need for further longitudinal studies and corresponding interventions for preterm mothers with a high risk of EBF attrition.

Postpartum Breastfeeding Practices and Attitudes in Parents: A Randomized Study to Evaluate the Effects of Individual and Group Breastfeeding Education of Mothers and Fathers.

Background Antenatal breastfeeding training is defined as the provision of breastfeeding information during pregnancy, which can be given in various ways, such as individual training and group training. The inclusion of fathers in this educational approach is associated with the initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding. However, studies involving fathers are limited. This randomized controlled study aimed to compare the effects of individual and group training given to parents and those of normal hospital practices on mothers' breastfeeding self-efficacy and fathers' attitudes toward breastfeeding. Methods The study was conducted randomly in a training and research hospital between March 2014 and September 2014 and included 180 people. Of them, 90 were prospective mothers who were in the third trimester of their pregnancy and were living with their husbands and received service from the obstetrics outpatient clinic of the hospital. The expecting mothers and their husbands were randomly assigned to three groups: individual training, group training and control group. After randomization, prospective mothers and fathers in all groups received training. In the first week, sixth week, and fourth month after delivery, the mothers' breastfeeding self-efficacy and breastfeeding attitudes as well as the attitudes of the fathers' toward breastfeeding were evaluated. Results There were no differences between the groups in terms of variables such as age, education status, family type, breastfeeding education status, and mode of delivery. There were significant differences between the scores obtained from the Breastfeeding Self-Efficacy Scale and its subscales in all three groups during the postpartum period (p <0.05). The highest scale scores were obtained at the postpartum fourth month in the individual training and control groups and at the postpartum sixth week in the group training group. There were differences between the scores obtained by the mothers and fathers during the postpartum process from the Iowa Infant Feeding Attitude Scale (p<0.05). Conclusion The analysis of all the results indicates that breastfeeding education given to parents in the antenatal period increases their breastfeeding self-efficacy and provides them with a positive attitude toward breastfeeding. However, further research is needed to determine whether individual or group training contributes to the development of breastfeeding self-efficacy and attitudes.

Factors associated with exclusive breastfeeding during postpartum in Lanzhou city, China: a cross-sectional study.

Breastfeeding generates short-term and long-term benefits for both mother and child. Exclusive breastfeeding (EBF) is promoted in China for years, but its practice still lags far behind the international average, even among low- and middle- income countries. This study aimed to investigate factors associated with EBF during postpartum. This study was conducted in a tertiary referral hospital in Gansu Province, Northwest China from October 2019 to April 2020. 3,738 postnatal women were finally included and each of them completed an elaborately designed questionnaire. Infant feeding patterns (EBF or not) and reasons for NEBF (non-exclusive breastfeeding) were collected. The feeding knowledge score was based on 17 questions in relation to breastfeeding. The total score ranges from 0 to 17. Higher score means better understanding about breastfeeding knowledge. Multivariate logistic regression models were used to determine associated factors of EBF during postpartum. A subgroup analysis was conducted to investigate the association between feeding knowledge score and exclusive breastfeeding. Six weeks after childbirth, 1891 mothers (50.6%) maintained EBF. Among the NEBF mothers, 57.01% (n = 1,053) of them stopped exclusive breastfeeding due to self-perceived lack of breast milk production. Factors associated with NEBF were higher maternal age, ethnic minorities and cesarean section. Protective factors of EBF included multipara, positive feeding attitude and high breastfeeding knowledge score. In subgroup analysis, we found the breastfeeding knowledge score had a significant impact on the mothers of Han nationality, underwent cesarean or natural delivery, both primiparous and multiparous, and those with positive attitude towards breastfeeding (p < 0.05). We need a comprehensive and individualized framework of strategies to support children, mothers and their families. During puerperium, improving maternal knowledge of breastfeeding is beneficial to EBF practice. However, for ethnic minorities and those with less active breastfeeding attitudes, breastfeeding knowledge is of limited use, more researches are needed to explore the uncovered reasons, so that more personalized interventions could be developed for them.

Social media intervention for promoting breastfeeding among WIC participants.

Social media have emerged as a promising communication channel for promoting breastfeeding among a new generation of mothers. Yet, there is no published study reporting the effects of a large-scale social media intervention on key breastfeeding-related perceptions, attitudes, and behaviors. As a component of its breastfeeding promotion campaign, the Women, Infants, and Children (WIC) program implemented a 12-month intervention using Facebook and Instagram and subsequently evaluated the outcomes by surveying WIC-participating women (N = 832) twice, immediately before and after the intervention. Based on their level of exposure to the intervention messages, the women were retrospectively classified into two groups, resulting in a two-group (no-low exposure vs. medium-high exposure) quasi-experiment. Women in the medium-high exposure group, in comparison with women in the no-low exposure group, exhibited higher campaign awareness (p < .001), visits to the campaign website (p < .001), and engagement with the website content (p < .001). They also reported more positive breastfeeding attitudes (M = 17.26 vs. M = 16.51, p < .05), self-efficacy (M = 54.48 vs. M = 49.94, p < .01), and social support (M = 27.37 vs. M = 25.11, p < .001). But they did not differ from women in the no-low exposure group in breastfeeding initiation (p > .05) and duration (p > .05). In conclusion, a social media-based intervention resulted in more positive breastfeeding attitudes, higher self-efficacy, and higher perceived social support. Future studies need to investigate the optimal level of intervention message dosage that prompts significant behavioral changes.

A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge and Attitude regarding Breastfeeding and Weaning Practices among Post-natal Mothers in Channasandra Urban, Bangalore City

A study to assess the effectiveness of structured teaching programme on knowledge and attitude regarding breast feeding and weaning practices among post-natal mothers in channasandra urban, Bangalore city. The Research approach adopted for this study is evaluative Approach. The research design adopted for the study was quasi experimental, one group pre-test and post-test design was applied. The non-probability convenient cluster sampling was used to select the sample for the study. The sample consists of the 40 post-natal mothers who are in channasandra urban area in Bangalore city. Karnataka. The instrument used for the data collection was self-administered questionnaire. Analysis result showed that overall knowledge pre-test mean was 24.65, mean% 62.20% with SD 4.60518. And post-test knowledge mean was 30.175, and mean% 77.37% with SD 05.13853. An overall attitude pre-test mean was 10.575, mean% 66.09% with SD 2.06171.and post-test attitude mean12.625, mean% 78.90% with SD2.30593. So the knowledge and attitude score of 40 postnatal mothers regarding breast feeding and weaning practices had an enhancement of knowledge score observed is 14.17% and enhancement of attitude score as observed 12.18%. Since the post-test value was more than the pre0test, the STP was effective. The comparison of pre-test and post-test knowledge of postnatal mothers regarding breast feeding and weaning reveals that the overall knowledge pre-test mean 24.65 with SD 4.60518 and post0test mean 30.175 with SD 5.13853. The paired “t” test value 6.485988 which is higher than the table value, which is highly significant at 0.05 levels. So it indicates the STP was effective. The variables between knowledge mean 24.65 with SD 4.60518 in pre-test. And attitude mean 10.575 with SD 2.06171, the “r” value of knowledge and attitude was r-0.0244, a positive correlation which shows the study is significant. There was significant association between pre-test level of knowledge with selected demographic variables such as Age 10.719, df=4 S*and post-test knowledge Age 8.697 df=2 S*, mother’s education 13.561 df= 4 S*, father’s occupation 9.061 df=3 S*, sources of information 10.239 df=3 S*. Since the obtained value is more than the table value at 0.05 level of significance. So the results shows there is a significant association between pretest and post test knowledge score with their selected demographic variables so H3 Hypothesis is accepted. The findings of the study recommended the further interventional approach regarding knowledge and attitude on breast feeding and weaning practices among post-natal mothers is required. The present study was proved the standard teaching program was effective in increasing the knowledge and attitude of breast feeding and weaning practices among post-natal mothers.

Co-Parenting Impact on Breastfeeding: Systematic Review and Meta-Analysis.

Background: Although the beneficial effects of exclusive breastfeeding (EBF) on infants and mothers have been identified, EBF rates remain unsatisfactory. Co-parenting interventions for perinatal couples have not been systematically evaluated and analyzed for their effects on breastfeeding outcomes. Aims and Objectives: To systematically evaluate the effects of co-parenting interventions on the rate of EBF, breastfeeding knowledge, breastfeeding attitude, breastfeeding self-efficacy, parental relationship, and partner support. Methods: Randomized controlled trials and quasi-experimental studies were systematically screened in eight online databases from inception to November 2022. Trials included in this review were assessed using the Cochrane Risk of Bias Assessment Tool. Eligible trials were used to conduct a meta-analysis using Review Manager software. The I2 statistic was used to assess heterogeneity between studies. When it was not possible to conduct a meta-analysis, a descriptive analysis was used to present the findings due to insufficient data from the included studies. Results: Fifteen of the 1,869 articles reviewed met the inclusion criteria. Co-parenting interventions significantly improved the EBF rate at 16 weeks (odds ratio [OR] = 3.85, 95% confidence interval, CI [1.84 to 8.03], p < 0.001, I2 = 69%) and 6 months (OR = 2.82, 95% CI [1.47 to 5.41], p = 0.002, I2 = 85%). This study revealed that co-parenting interventions made statistically significant improvements in parental relationship (standardized mean difference [SMD] = 0.26, 95% CI [0.13 to 0.38], p < 0.001, I2 = 80%). There was no evidence of the effectiveness of interventions in terms of overall parental support (SMD = 0.75, 95% CI [-0.46 to 1.97], p < 0.001, I2 = 96%). Given the discrepant and limited research data, findings on breastfeeding knowledge, breastfeeding attitudes, and breastfeeding self-efficacy were presented descriptively. Conclusion: Co-parenting interventions effectively increase EBF rates at 16 weeks and 6 months postpartum, and improve breastfeeding knowledge, breastfeeding attitude, and parental relationships.

Association of Maternal Preferred Language with Breastfeeding Attitudes, Intentions, and Knowledge.

Assessing intentions, attitudes, and knowledge about breastfeeding among different language groups is important because the languages reflect cultural differences. We compared attitudes, subjective norms, perceived behavioural control, intentions, and knowledge of breastfeeding among mothers with the five most common preferred languages spoken at a New York City hospital. This cross-sectional study surveyed women (n = 448) in the prenatal clinic and the post-partum unit of a New York City hospital. The survey questions were about breastfeeding attitudes, subjective norms, perceived behavioural control, and intentions, based on the Theory of Planned Behavior. We also administered the Iowa Infant Feeding and Attitude Scale and measured the knowledge of the mothers about breastfeeding. The preferred language spoken by the mother was the main predictor variable. English, Russian, Spanish, Urdu, and Uzbek were the languages studied. Multivariate linear regression analyses showed that Russian (B = 2.24, SE = 1.09, p = 0.04), Urdu (B = 2.90, SE = 1.45, p = 0.046), and Uzbek (B = 4.21, SE = 1.35, p = 0.002) speakers all had significantly more positive attitudes toward breastfeeding than did English speakers. Spanish and English language speakers did not differ from each other in their attitudes towards breastfeeding. The language groups did not differ significantly for subjective norms, perceived behavioural control, intention to breastfeed, the Iowa Infant Feeding and Attitude Scale, nor in knowledge regarding breastfeeding. Urdu, Uzbek, and Russian speakers had significantly more positive attitudes towards breastfeeding than did English speakers. To the extent that preferred language is a proxy for culture, clinicians can use this parameter as a basis for directing approaches toward lactation education.

Kuram Temelli Araştırmaların Emzirme Üzerine Etkisi: Sistematik Derleme ve Metaanaliz

The aim of this study is to systematically review the results of theory-based research on breastfeeding and to perform a meta-analysis of the available evidence. The literature review for this systematic review was conducted between September and October 2022 by using five electronic databases PubMed, Cochrane Library, Web of Science, ULAKBIM. Published articles were scanned using MeSH-based keywords. Only Randomized Controlled Trials (RCTs) conducted in the last five years were included. The data were analyzed using the Review Manager computer program (Version 5.3).Two randomized controlled trials were included in the meta-analysis. All of the studies were combined for breastfeeding information, time to start breastfeeding, and five-course (breast milk only, breast milk, and formula). The meta-analysis revealed that theory-based education increased the rate of breastfeeding information of pregnant women in the postpartum period (OR: 0.73 95% CI: 0.51 to 1.05, Z = 1.69, p: 0.09), the rate of exclusive breastfeeding (OR: 1.80 95% CI: 1.26 to 2.57, Z = 3.23, p: 0.001) and decreased the rate of feeding intake (OR: 0.49 95% CI: 0.33 to 0.74, Z = 3.41, p: 0.0007). The study findings found that education did not affect the rate of early initiation of breastfeeding between groups ((OR: 1.31 95% CI: 0.91 to 1.90, Z = 1.45, p: 0.15) and was not significant. This study provides sufficient evidence that theory-based training has positive effects on breastfeeding attitudes and behaviors.

Determinants of breastfeeding attitudes of mothers in Jordan: A cross-sectional study.

Breastfeeding provides the optimal nutrition for an infant. However, breastfeeding practice is on decline globally. Attitude toward breastfeeding may determine the practice. This study aimed to examine postnatal mothers' attitude to breastfeeding and its determinants. A cross-sectional study was conducted, and data on attitude were collected using the Iowa Infant Feeding Attitude Scale (IIFAS). A convenience sample of 301 postnatal women were recruited from a major referral hospital in Jordan. Data on sociodemographic characteristics, pregnancy and delivery outcomes were collected. SPSS was used to analyze the data and identify the determinants of attitudes to breastfeeding. The mean total attitude score for participants was 65.0 ±7.15, which is close to the upper limit of the neutral attitude range. Factors associated with attitude that is positive to breastfeeding were high income (p = 0.048), pregnancy complications (p = 0.049), delivery complications (p = 0.008), prematurity (p = 0.042), intention to breastfeed (p = 0.002) and willingness to breastfeed (p = 0.005). With binary logistic regression modelling, determinants of attitude positive to breastfeeding were highest income level and willingness to breastfeed exclusively (OR = 14.77, 95%CI = 2.25-99.64 and OR = 3.41, 95%CI = 1.35-8.63 respectively). We conclude that mothers in Jordan have neutral attitude to breastfeeding. Breastfeeding promotion programs and initiatives should target low-income mothers and the general population. Policymakers and health care professionals can use the results of this study to encourage breastfeeding and improve breastfeeding rate in Jordan.

The Attitudes and Practices Among Neonatal Nurses Regarding Breastfeeding Support in The Neonatal Intensive Care Unit During Covid-19

Objective: Neonatal nurses have a main role which include promote and facilitate breastfeeding in in the Neonatal Intensive Care Unit (NICU). This study was conducted to determine the practices and attitudes of nurses towards breastfeeding support, which has critical importance in breastfeeding for newborns hospitalized in NICU during the Covid-19 pandemics. Material and method: The study was a cross-sectional descriptive survey design conducted with 252 nurses who were members of the Neonatology Nurses Society. The Data Collection Form, Survey Questionnaire, and the Iowa Infant Feeding Attitude Scale (IIFAS) were used for data collection. Results: The IIFAS median score of the participants was 70.0 (IQR=9.0). Statistically differences in the IIFAS scores were found according to age (χ2=11.703, p=0.008), education status in nursing (χ2=9.257; p=0.01), and status of attending to international scientific meetings (Z=-2.360; p=0.018). Participants who were age between 26-30 years (n=76, 30.2%), had post-education degree in nursing (n=32, 12.7%), and attended to international scientific meetings (n=47, 18.6) had higher positive attitudes of breastfeeding. The nurses (n=126, 50%) stated that it was difficult to reach mothers in terms of breastfeeding for newborns, and 61.8% of them (n=156) stated that they had difficulty initiating the mother-baby attachment process in the NICU. Conclusions: Although the attitudes of NICU nurses towards breast milk and breastfeeding were at a moderate level in our study, they struggled to support and maintain the lactation and they implemented to a number of supportive feeding practice in NICUs.

Determinants of High Breastfeeding Self-Efficacy among Nursing Mothers in Najran, Saudi Arabia.

This is a descriptive cross-sectional study investigating the determinant of BSE among 1577 nursing mothers in primary health centers in Najran City, Saudi Arabia. The study uses a cluster random sampling technique. Data collection was performed from June 2022 to January 2023 using a self-reported questionnaire that encompasses the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Gender Friendly Breastfeeding Knowledge Scale (GFBKS), Iowa Infant Feeding Attitude Scale (IIFAS), and a basic data questionnaire to assess women's demographic factors and obstetric history. The mean score for all BSES-SF items was between 3.23-3.41, the highest mean score was in mothers who felt comfortable breastfeeding with family members present (3.41 ± 1.06), and the lowest mean was in mothers who could breastfeed their baby without using formula as a supplement (3.23 ± 0.94). The overall BSE score was high among 67% of the study participants. Binary logistic regression showed that being a housewife, being highly educated, having breastfeeding experience, and being multiparous are positive predictors for high BSE (p ≤ 0.001). In addition, having adequate breastfeeding knowledge and positive breastfeeding attitudes were positively associated with higher BSE (p = 0.000). BSE can be predicted by modifiable predictors such as mothers' education, working status, parity, breastfeeding experience, adequate breastfeeding knowledge, and positive attitudes toward breastfeeding. If such predictors are considered during breastfeeding-related educational interventions, it could lead to more effective and sustainable effects in community awareness regarding breastfeeding.

Exploring the reasons why mothers do not breastfeed, to inform and enable better support.

Infant and maternal breastfeeding benefits are well documented, globally. Despite efforts to increase global breastfeeding rates, the majority of high-income settings fall short of recommended targets. Breastfeeding rates in the UK are especially poor, and physiological difficulties (e.g., inverted nipples), fail to account for the observed breastfeeding intention-behaviour gap. The current online study sought to investigate the infant feeding experiences of 624 UK formula feeding mothers, through open text survey responses. A content analysis identified the following clusters of reasons for formula feeding: Feeding Attitudes, Feeding Problems, Mental Health, and Sharing the Load. Feeding Attitudes explained a large percentage of reasons given for formula feeding. Recommendations are made to improve antenatal breastfeeding education and to develop an intervention with an aim to improve maternal breastfeeding attitudes and subsequent practice. Feeding Problems also explained a large portion of combination feeding and started but stopped infant feeding accounts. The current paper calls for more comprehensive and tailored antenatal breastfeeding education to refine practical breastfeeding skills necessary for successful breastfeeding establishment and maintenance. Mental Health explained relatively small coverage. Suggestions are therefore made to train mental health practitioners on infant feeding with an aim to provide more extensive support, which may serve to disrupt the bidirectional relationship between poor mental health and poor breastfeeding outcomes. Finally, Sharing the Load explained moderate coverage across never breastfed, combination fed, and started but stopped feeding groups. Recommendations are made, in light of these findings, to tighten workplace legislation to protect breastfeeding women.

A Survey of Breastfeeding Attitudes and Health Locus of Control in the Nigerian Population

ObjectivesBreastfeeding is important to infant health and survival in sub-Saharan Africa. To promote breastfeeding effectively, understanding of psychological factors associated with infant feeding choices is required. This study investigated breastfeeding attitudes and health locus of control (HLoC) in a Nigerian community sample.MethodsMen and women (N = 400) (71% female; mean age 34.2 years/ range 18–86 years) were recruited through community groups in Nigeria. Self-report survey by questionnaire measured breastfeeding attitudes using the Iowa Infant Feeding Attitude Scale (IIFAS) and health locus of control using the Multidimensional Health Locus of Control Scale (MHLoCs).Results MeanIIFAS scores (mean = 57.7; sd = 7.8) became less favourable with increasing age (p = 0.02). Men had higher IIFAS scores (mean = 58.6; sd = 7.6) than women (mean = 56.6; sd = 8.0) indicating more favourable attitudes toward breastfeeding (p = 0.02). Women scored higher than men on external chance HLoC (ECHLoC) (p = 0.003) and external powerful others HLoC (EPHLoC) (p = 0.02). Increasing age was associated with higher scores on ECHLoC (p < 0.01) and EPHLoC (p < 0.01). Multiple linear regression analysis was significant (p < 0.001) and explained 7.8% of variance in breastfeeding attitude. Lower IIFAS scores, reflecting more negative attitudes to breastfeeding, were associated with higher ECHLoC (p < 0.01) and EPOHLoC (p < 0.05). Higher IIFAS scores, reflecting more positive attitudes to breastfeeding, were associated with greater IHLoC (p < 0.01). Neither age nor gender were associated with IIFAS scores in the final model.ConclusionsThis implies a need to explore health locus of control when promoting positive attitudes to breastfeeding and supporting families in breastfeeding advocacy.

Knowledge and attitude of breast feeding of female students

To assess knowledge and attitude of college girls, Medicine, Phannacy and Arts in Baghdad City towards breast feeding. Across-sectional study with a random sample of 258 female studies during period of 1994-1998 from girls, medical, pharmacy &amp; art college in Baghdad City, using a self-administered questionnaire. The ages of the females ranged from 18 to 32 years. About 13% of them received some health education about breast feeding. One-quarter reported that they leamed about breast feeding at school. About 4% of students learned from their mothers. Less than half the students in the sample (qOVr) larew the meaning of colosfum. Only 22Yo students gave the right answer about the right time for the first feed. Regarding the frequeniy of breast feeding, one third gave the right answer.The study showed considerable deficiency in the knowledge of the college femalg shrdents about breast feeding. Relevant knowledge and skills about breast feeding should be included in the curriculum of college to prepare them successfirl breast feeding.

HUBUNGAN PEKERJAAN, PENDIDIKAN IBU NIFAS TERHADAP SIKAP PEMBERIAN AIR SUSU IBU (ASI) DI PRAKTEK MANDIRI BIDAN NURYANTI

Breast milk is a natural food that contains nutrients needed by babies in the first six months. Breast milk can meet the nutritional needs of infants during the first year to the second year of life. Breastfeeding is the first immunization of children, providing protection from respiratory tract infections, diarrheal diseases, and other potentially life-threatening diseases. Breastfeeding also has a protective effect against obesity and non-communicable diseases. Objective: This study was to examine the relationship between employment, education of postpartum mothers on breastfeeding attitudes in the Independent Practice of Midwives Nuryanti in 2022. Methods: The research design was cross sectional with a population of all postpartum mothers who Maternity in the Independent Practice of Midwives Nuryanti with a sample of 45 people. Results: Analysis using the Square-Test, the results of the research that got a job, the education of postpartum mothers on breastfeeding attitudes with a value (p value = 0.000). Conclusion: where it can be concluded that there are the relationship between work, education of postpartum mothers on breastfeeding attitudes.

Does benefits-of-breastfeeding language or risks-of-formula-feeding language promote more-positive attitudes toward breastfeeding among midwives and nurses?

BackgroundMidwives and nurses are crucial in breastfeeding support. Few studies have explored appropriate language for nursing education on breastfeeding. We assessed the impact of the language used on breastfeeding attitudes among midwives and nurses.MethodsA quasi-experimental study was conducted online in Japan among 174 midwives and nurses who had work experience in obstetrics or pediatrics. Participants were allocated to three groups to receive different text messages as the intervention (the benefit of breastfeeding for Group 1; the risk of formula feeding for Group 2; the importance of childcare for Group 3 as the comparison). The Japanese version of the Iowa Infant Feeding Attitude Scale (IIFAS-J) was used to assess breastfeeding attitudes before and after reading the texts. Also, participant reactions to the text were assessed by their responses to three statements. ANOVA, the chi-square test, and the t-test were used for outcome assessments.ResultsThe post-test IIFAS-J score was significantly higher than the pre-test score only for Group 1 (p < 0.01). The percentage of participants who agreed with the content of the text was 70.7% in Group 1 and 48.3% in Group 2. The percentage of participants who reported discomfort with the text was 34.5% in Group 1 and 55.2% in Group 2. No significant difference among groups existed regarding interest in the text. In all three groups, participants who agreed with the text had a higher post-test IIFAS-J score than those who disagreed with the text (6.85 points higher, p < 0.01 in Group 1; 7.19 points higher, p < 0.01 in Group 2; 8.00 points higher, p < 0.02 in Group 3). Discomfort with the text and interest in the text were associated with a significantly higher post-test IIFAS-J score in Group 1 and Group 2 but not in Group 3.Conclusions“Benefits of breastfeeding” language, which conveys the information in a positive manner, appears to be more appropriate than “risks of infant formula” language for creating a positive attitude toward breastfeeding in nursing education.Trial registrationThis study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000023322). Registered 05/08/2016.

The influence of breastfeeding attitudes on breastfeeding behavior of postpartum women and their spouses

PurposeThis study aimed to explore: (1) the influence of maternal sociodemographic factors on breastfeeding attitudes, (2) the relationship between breastfeeding attitudes of postpartum women and their spouses, (3) the predictors of breastfeeding behavior (mixed breastfeeding) at two months postpartum, and (4) to establish the reliability of the Chinese version of the paternal Iowa Infant Feeding Attitude Scale (IIFAS) in Taiwan. MethodsA correlational and follow-up study design was used on a convenience sample of 215 women and 215 fathers recruited from a regional teaching hospital in central Taiwan from July 2020 to December 2020. The participants completed the IIFAS during postpartum hospitalization and a follow-up via telephone at 8 weeks postpartum for information on feeding methods and duration. The Cox proportional hazards model was used to analyze the predictors of breastfeeding duration. ResultsMaternal breastfeeding attitude scores ranged from 42 to 79, with a mean score of 59.78 (SD ± 6.68). Spouses' breastfeeding attitude scores ranged from 46 to 81, with a mean score of 59.60 (SD ± 6.93). Mother and spouse’s IIFAS scores were highly correlated (r = 0.50, p < 0.001), and the scores of both parents were significantly associated with the duration of breastfeeding. With each increased point on maternal and paternal IIFAS scores, the odds of breastfeeding during the first 8 weeks increased 6% and 10%, respectively. ConclusionThis is the first study to validate the IIFAS (Chinese version) with paternal participants in Taiwan. Identifying and understanding the infant feeding attitudes of mothers and their spouses should be an early step in designing and implementing breastfeeding interventions.

Breastfeeding knowledge, attitude, intention and practice of women in Purdah in Ibadan, Nigeria

Background: Religious beliefs and practices have been implicated in mothers’ breastfeeding practices; however, little is known about the breastfeeding intention and practices of women in Purdah. Aims: To assess the breastfeeding knowledge, attitude, intention and practices of women in Purdah in Ibadan, Nigeria. Subjects and Methods: Three hundred and sixty-three consenting women in Purdah (250 married and 113 unmarried) from seven Islamic and Arabic schools (Madrasah) participated in this cross-sectional study. A semi-structured interviewer-administered questionnaire was used to elicit data on the respondents’ sociodemographic characteristics, breastfeeding knowledge and breastfeeding attitude. Breastfeeding intention and practices were also obtained from unmarried and married respondents respectively. Results: The average age of the respondents was 31.2 ± 6.6 years, 68.9 % were married while 56.4 % of the unmarried were engaged to getting married (Khitba). Two-thirds of the married women had adequate breastfeeding knowledge while 56.6 % of the unmarried women had inadequate breastfeeding knowledge. Overall, 6 out of every 10 women in Purdah had adequate breastfeeding knowledge. Also, 6 out 10 of the respondents had positive attitudes toward breastfeeding (65.2 % for married and 58.4 % for unmarried), however, less than half of the unmarried and married women had appropriate intention (47 %) to breastfeeding and good breastfeeding practices (47.2 %) respectively. A Significant relationship was found between breastfeeding knowledge, attitude and intention among unmarried women. Similarly, significant association also existed between breastfeeding knowledge, attitude and practices among married women in Purdah. Conclusions: Targeted breastfeeding intervention that would improve breastfeeding intention and practices of women in Purdah should be adopted in the teaching curriculum at Islamic and Arabic schools. Keywords: breastfeeding, Muslim women, Islamic and Arabic schools, Purdah.

The Effect of Antenatal Education on Expectant Fathers’ Attitudes toward Breastfeeding and Attachment to the Fetus

This study explores the effect of antenatal education on fathers' attitudes toward: (i) breastfeeding and (ii) attachment to the fetus. A secondary aim is to explore the relationship of fathers' demographic and the psycho-emotional characteristics that come with breastfeeding and attachment. This is a longitudinal study involving a group of 216 Greek expectant fathers who participated with their partners in an antenatal educational program performed by midwives in Athens, Greece (September 2020-November 2021). The Iowa Infant Feeding Attitudes Scale (IIFAS) and Paternal Antenatal Attachment Scale (PAAS) were administered at two time points: (a) 24th-28th gestation week and (b) 34th-38th gestation week. The T-test and Univariate Analyses of Variance (ANOVA) were performed. The expectant fathers' scores show that breastfeeding intention/exclusivity and prenatal attachment to the fetus were higher after their participation in the antenatal education program, but the difference was not statistically insignificant. Expectant fathers with a cohabitation agreement (p = 0.026), who felt very much supported by their partners (p = 0.001) and had no relationship difficulties with their partners (p < 0.001), as well as those who reported being very happy during pregnancy (p < 0.001), showed greater paternal antenatal attachment to the fetus. Although the difference was statistically insignificant, antenatal education appears to have an impact on paternal breastfeeding attitudes and antenatal attachment to the fetus. Additionally, several paternal characteristics were associated with greater antenatal attachment. Future research should be directed toward the investigation of additional factors that impact antenatal-paternal attachment and breastfeeding attitudes so that effective education programs can be designed.

Levels and Determinants of Antenatal Breastfeeding Attitudes among Pregnant Women: A Cross-Sectional Study

Breastfeeding attitudes are strong predictors of breastfeeding behavior. Gaining a deeper understanding on the levels and determinants of antenatal breastfeeding attitudes is crucial. This cross-sectional study involved 124 pregnant women at a tertiary hospital in Hunan, China. A self-administered questionnaire, the Iowa Infant Feeding Attitude Scale, the Edinburgh Postnatal Depression Scale, the Pregnancy Stress Rating Scale, the Childbirth Attitude Questionnaire, the Perceived Social Support Scale, and the Breastfeeding Knowledge Questionnaire were assessed during their first-trimester, second-trimester, and third-trimester hospital visit. Multiple linear regression was conducted to identify the determinants of breastfeeding attitudes. The participants reported neutral (56.39 ± 5.69) levels of breastfeeding attitudes. The determinants of antenatal breastfeeding attitudes were other family members' support for exclusive breastfeeding: moderate (β = 0.278, p < 0.05), depressive symptoms (β = -0.191, p < 0.05), and breastfeeding knowledge (β = 0.434, p < 0.001). The variables explained 33.9% (adjusted R2) of the total variation in breastfeeding attitudes scores (F = 4.507, p < 0.001). Namely, other family members' support for EBF was a negative influence on positive breastfeeding attitudes. The women whose other family members were moderate of EBF had more positive attitudes toward breastfeeding compared to those whose other family members were very supportive of EBF. The depressive symptoms were negatively associated with positive breastfeeding attitudes, and lower levels of depressive symptoms were associated with higher levels of positive breastfeeding attitudes among pregnant women. Additionally, breastfeeding knowledge was positively associated with positive breastfeeding attitudes. The more knowledgeable about breastfeeding, the more positive the attitude towards breastfeeding. Health professionals should identify these modifiable factors that may contribute to poorer breastfeeding attitudes, which is useful in targeting promotions of breastfeeding.