Continued Breastfeeding Research Articles

Infant and young child feeding practices among conflict-affected Ukrainian households: A cross-sectional survey in Kyiv, Lviv and Odesa regions.

Infant and young child feeding practices (IYCF) are crucial for children's growth and development but often deteriorate during periods of instability. A cross-sectional survey conducted in three oblasts of Ukraine-Kyiv City and Kyiv, Lviv, and Odesa-enroled 724 children 0-23 months of age from 699 households. Using global WHO IYCF Guidelines, 12 indicators of optimal IYCF practices were evaluated. The study found IYCF practices to be relatively stable since 2015, despite the continued escalation of conflict, with an improvement in exclusive breastfeeding (EBF). EBF was reported by 51% of mothers, while breastfeeding was initiated early in 65% of children. Complementary feeding practices were optimal for most children, with 79% having a minimum acceptable diet. Infant formula assistance was independently associated with suboptimal breastfeeding practices in multi-variable models. Children from households that received formula assistance had 67% (adjusted odds ratio [aOR] 0.33, 95% confidence interval [CI] 0.14-0.73) lower odds of being exclusively breastfed, 65% (aOR 0.35, 95% CI 0.20-0.61) lower odds of continued breastfeeding at 12 months, and 3.3 times (95% CI 2.31-4.78) higher odds of being bottlefed. Baby food assistance did not independently predict a minimum acceptable diet. High levels of optimal complementary feeding sustained since 2015 suggest protective factors for child nutrition in Ukraine, such as domestic agriculture and social safety nets. Additionally, maternal education was consistently linked to better IYCF outcomes, highlighting the need for targeted support for less-educated mothers. The negative association of formula assistance with EBF warrants further research alongside reinforcement of guidelines to prevent inappropriate formula targeting.

The Effect of the 2023 Turkey-Syria Earthquakes on the Sixth-Month Breastfeeding Rate of Infants: A Single-Centre Cohort Study

Background: We investigated the effect of earthquakes on the six-month breast milk intake rate in infants. Methods: In this single-centre prospective cohort study, 35 mother-baby dyads who were in the earthquake zone during the February 6, 2023, Turkey-Syria earthquakes were included as the study group, while 29 mother-baby dyads who were not in the earthquake zone were included as the control group. The physical, environmental, and social characteristics of the settlements after the earthquake, along with the nutritional characteristics of the infants, were evaluated through questionnaires during interviews and online assessments. The Breastfeeding Self-Efficacy Form and the Edinburgh Postnatal Depression Scale were administered to the mothers, and their scores were calculated. Results: No significant difference was found between the exclusive breastfeeding rates at six months in the study and control groups [18 (62.9%) vs. 22 (61.9%), n (%), P = 0.95]. The breastfeeding self-efficacy score was significantly higher in the study group [64 (33 - 70) vs. 54 (31 - 70), median (min-max), P = 0.02]. Although the Edinburgh Postpartum Depression Scale (EPDS) score was higher in the control group [10 (0 - 21) vs. 7 (0 - 26), median (min-max)], this difference was not statistically significant. Conclusions: In general, earthquakes do not affect breastfeeding rates in infants at six months. The continuation of breastfeeding, supported by increased resilience in difficult conditions, enhances breastfeeding self-efficacy and provides protection for the mother-baby dyad. Breastfeeding should be continued and supported during natural disasters.

OS EFEITOS DA LASERTERAPIA EM CICATRIZAÇÃO MAMILAR PARA MULHERES NO PROCESSO DE AMAMENTAÇÃO

INTRODUCTION: Breast milk is a great source of nutrients for the baby's immunological and psychological development, and has a strong impact on infant mortality. It all starts in the thirty-second week of gestation, as this is the time when the fetus begins to show sucking reflexes. The breastfeeding process can be very difficult, since if there is no monitoring, there may be cracks in the breasts, making the process very painful. METHODS: This is a descriptive and qualitative study, which took place in person and virtually in the city of Porto Velho/RO at the Physiotherapy School Clinic of the São Lucas University Center, with the objective of hearing reports from women/mothers who are or have been exclusively breastfeeding. Thirty-eight female women, aged 20 years and older, were selected to report their breastfeeding process as lactating women. RESULTS AND DISCUSSION: One of the reasons for this development is the incorrect breastfeeding process. The main risk factors identified were: the baby's latch on to the mother's breast, where there is incompatibility between mother and child, primary and race/color of the mother defined as white or yellow. Many lactating women end up thinking that all they have to do is let the baby latch on to the breast and perform the suction, since even the positioning of the child interferes in the process. It was also evident in the interviews that most of the women did not perform the procedure due to lack of knowledge, often not being instructed by the health professional, or for fear of the effects of the procedure, since most of the women interviewed are very young and from lower social classes, they end up having this transgression of low performance of the procedure. CONCLUSION: Laser therapy has been shown to be an effective and safe intervention in the treatment of breast fissures, a common complication during breastfeeding that can cause intense pain and difficulties in breastfeeding. By using low-level laser therapy, it is possible to promote healing of injured tissues, relieve pain and reduce inflammation, providing greater comfort to mothers and encouraging continued breastfeeding. The importance of this treatment lies in its rapid and non-invasive effect, offering an alternative to traditional therapies, such as ointments and dressings, which often do not provide immediate or complete relief. In addition, laser therapy helps to prevent early weaning, contributing to the well-being of the baby and the mother, since exclusive breastfeeding is essential in the first months of life.

Mothers’ perception of husband support during breastfeeding: A qualitative study in Indonesia

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted maternal and perinatal healthcare worldwide, including in Indonesia. Restrictions on access to health services have forced mothers to adapt to new challenges in breastfeeding during the pandemic. The aim of this study was to evaluate mothers’ breastfeeding experiences and the role of husbands in providing support during this period. This qualitative research used a phenomenological approach. Data were collected from August to October 2022 through a focus group discussion (FGD). Participants were selected using maximum variation sampling, with eight mothers participating in the FGD. Data were analyzed using qualitative content analysis, revealing four main themes: (1) not all husbands fully supported mothers’ efforts to provide exclusive breastfeeding; (2) supportive and inhibiting factors help to provide exclusive breastfeeding; (3) mothers understood the benefits and identified the causes of failure in providing exclusive breastfeeding and complementary food for breast milk; and (4) various stressors experienced by mothers did not impede breastfeeding efforts. In conclusion, the findings highlight the need for healthcare workers, especially maternity nurses, to encourage continued breastfeeding and emphasize the importance of husbands’ support in providing exclusive breastfeeding initiatives. Interventions should be designed to actively involve husbands in supporting exclusive breastfeeding practices.

Support for continued breastfeeding

Support for continued breastfeeding

Mothers' experiences of negative interactions with health professionals when breastfeeding beyond 1 year

This study explores women's negative interactions with health professionals when continuing to breastfeed beyond the first year. The research used a cross-sectional design, with an online questionnaire to gather responses from women worldwide who reported negative experiences with health professionals related to continued breastfeeding between the ages of 1 and less than 2 years. The study used content analysis to analyse responses from 1951 participants. Experiences of negative interactions with health professionals involved advising women to wean (74%), judging the women (18%), stigmatising the women (17%) or telling the women that breastfeeding would affect their healthcare (5%). The findings highlight the urgent need for widespread training programmes, advocating for evidence-based, supportive and non-judgemental care. Healthcare systems are urged to prioritise comprehensive training initiatives aligned with current recommendations, fostering environments where health professionals effectively support and empower women throughout their breastfeeding journey.

Predictors and Barriers to Breastfeeding Practices Among Jordanian Mothers: A Cross-Sectional Study

Breastfeeding, endorsed by religious, cultural, and scientific evidence, experiences divergent rates in Jordan due to substantial sociodemographic and cultural variations. Our aim is to explore the predictors and barriers that affect BF practices among mothers in Southern Jordan, in order to insight the healthcare providers to identify these barriers in order to increase awareness for the initiation and continuation of breastfeeding. A cross-sectional study was conducted among 380 mothers with infant 2 weeks to 6 months old. Data were analyzed using descriptive statistics and multinomial logistic regression. Findings revealed exclusive breastfeeding at 24%, mixed feeding at 57.63%, and artificial feeding at 18.42%. The study illuminated pronounced barriers in socio-environmental factors (1.65 ± 0.32), infant factors (1.63 ± 0.37), and maternal (1.59 ± 0.27). Predictors encompassed maternal age, education, employment, province, income, family member, delivery mode, and prior breastfeeding experience. In South Jordan, mixed feeding was the commonest way. Mothers’ work and lack of nursery at the workplace was the most noticeable factor. This study equips healthcare providers to recognize barriers hampering breastfeeding among Jordanian mothers, enabling informed strategies to enhance awareness and sustain breastfeeding initiation and continuation.

Role of proper postnatal care in continued exclusive breastfeeding among young Indonesian mothers.

Exclusive breastfeeding (EBF) provides numerous health benefits to children. However, the EBF rate is unsatisfactory among young mothers because they often experience difficulties. Thus, interventions during the postnatal period are imperative to encouraging EBF practices in these populations. Postnatal care (PNC) should be delivered appropriately to ensure a positive postnatal experience; however, there has been little discussion of evidence therein to date. This study investigated the association between proper PNC and EBF practices among young Indonesian mothers. This cross-sectional study analyzed data from the 2017 Indonesia Demographic Health Survey. All mothers aged 15-24 years who delivered an infant within the 2 years preceding the survey were included. Mothers were considered to be receiving proper PNC if they started breastfeeding soon after delivery, attended a PNC appointment within 2 days after giving birth, and received breastfeeding counseling and observation during the PNC visit. Approximately 51.6% of infants under 6 months of age born to young mothers (those aged 15-24 years) were exclusively breastfed. Appropriate PNC was received by approximately 24.3% of the total population. The correlation between proper PNC and EBF practices was significant among adolescent mothers aged 15-19 years after an age stratification analysis (odds ratio, 8.22; 95% confidence interval, 1.957-34.524). Maternal age became a noticeable confounder after a risk stratification analysis. Our findings imply the importance of breastfeeding service delivery during the early postnatal period in continuing EBF. Ensuring high PNC quality helps ensure positive postnatal experiences, particularly for adolescent mothers.

Evolutive Study of Dietary Aspects and Intestinal Microbiota of Pediatric Cohort with Cow's Milk Protein Allergy.

One of the most common food allergies in the pediatric population is allergy to cow's milk protein (CMPA). Treatment consists of avoiding cow's milk proteins in lactating mothers and/or using therapeutic formulas based on hydrolysates or vegetable formulas. In infants with CMPA at diagnosis, a different gut microbial profile has been found compared to healthy children, with a reduction in beneficial bacteria. The aim of this study was to evaluate changes in the gut microbiota profile and its metabolites, dietary patterns and anthropometric variables in a pediatric cohort with CMPA after six months on a restrictive diet compared to healthy controls. In total, 21 patients diagnosed with CMPA and a control group of 24 healthy infants participated in this study. The fecal microbiota of all participants were investigated by metataxonomic analysis of 16S rDNA amplicons, and fecal short-chain fatty acids were measured by gas chromatography. Epidemiological assessment and dietary questionnaires were carried out for both groups. Regarding growth, no significant differences were found, but differences in dietary intake of some macro- and micronutrients were observed. Patients who were breastfed at six months had higher bifidobacteria and lipid intakes than patients fed with hydrolyzed formulas. Although the growth of CMPA infants fed with therapeutic formula is similar to breastfed CMPA infants, there are differences in microbiota composition and macronutrient intake that underline the importance of continued breastfeeding in CMPA cases.

Knowledge, Attitude, and Practice of Health Care Professionals Toward Breastfeeding

Successful initiation and continuation of breastfeeding is proportionate to the attitude and knowledge of health care professionals toward breastfeeding; therefore, we conducted a study in Alkhoms district hospital, aimed to evaluate knowledge, attitude and practices of health care professionals toward breastfeeding. A well-structured questionnaire was designed to test their knowledge on Breastfeeding process, and their ability to deal with different problems and questions that may face during their practice. A total of 155 health care providers participates in this study [72 nurses, 25 midwives, and 58 junior doctors], all of them filled the questionnaire completely and each separately. The study has shown clearly deficiencies of health care providers in some aspects of their knowledge on and their abilities to deal with practical problems that may facing the lactating mother.

Impact of Flood on Breastfeeding Practices at Flood Relief Camps of Pakistan.

To explore impact of flood on breastfeeding practices and identify barriers in continuation of breastfeeding among mothers residing in flood relief camps. This exploratory observational study was conducted during visit of medical team of The University of Child Health Sciences, Children's Hospital at flood relief camps of Sindh (7th September to 12th September, 2022) and south-west of Punjab province (18th November to 20th November, 2022). The data was collected on structured questionnaire from 40 lactating mothers residing in flood relief camps. Purposive sampling technique was used in this regard. The mean age of breastfed children was 16.1±7.811 months. There was negative impact on breastfeeding practices (n=21, 52.5%) as frequency decreased in 18(45%) mothers and 3(7.5%) totally stopped breastfeeding. There was significant relation between pre-flood breastfeeding status and impact of flood on breastfeeding practices (p=0.001). The major barriers to appropriate breastfeeding were mother's perception of insufficient breast milk due to inadequate diet (n=6, 15%) or depression and anxiety (n=4, 10%), mother's illness (n=3, 7.5%), constant displacement (n=2, 5%) and provision of breast milk substitutes (n=2, 5%). There has been significant negative impact of flood on breastfeeding practices among lactating mothers residing in flood relief camps. Perception of decreased milk production due to inadequate diet and stress are major barriers in continuation of breastfeeding. Breastfeeding supportive services need to be integral component of flood crisis management.

The Stunting Determinants in Toddlers from Landak Regency, West Kalimantan: A Cross-Sectional Study

Background: Stunting is a nutrition problem that can slow down the growth. With prevalence at 32.5%, Landak Regency in West Kalimantan has been designated as a stunting hotspot. The lack of a maximum penalty for the stunting case in Landak Regency is not based on factors causing the stunting itself, because there is no identifiable factor causing the stunting in certain area due to narrow roads and sharp curves. Objectives: The objective of this study was to identify causes and distribution of the stunting case in Landak Regency. Methods: A total of 330 households in Meranti, Sebangki, and Senakin were included in this cross-sectional study because they were at a risk of the stunting. Toddlers, mothers, health care, and environmental factors were among the found variables. The researchers employed a basic random sampling strategy for the sampling and used the secondary health center data to find out whether or not toddlers were stunted. Researchers in this study collected data on the independent variables by observing and interviewing participants. Using the chi-square test, the data was analyzed. Results: The results showed that determinants of the stunting in Landak Regency were the history of early breastfeeding initiation (p-value=0.032), exclusive breastfeeding (p-value=0.042), frequency of exclusive breastfeeding (p-value=0.040), the continued breastfeeding (p-value=0.024), complementary feeding (p-value=0.042), immunization history (p-value=0.007), infectious disease history (p-value=0.000), maternal height (p-value=0.046), delivery assistance (p-value=0.000), access to health services (p-value=0.004), the role of health workers (p-value=0.002), and family latrine ownership (p-value=0.000). Conclusions: Several factors were found to be associated with incidence of the stunting among toddlers in Landak Regency.

LATCHES – a memory aide for the principles of attachment for effective breastfeeding: findings of a regional pilot in the Northeast of England and North Cumbria

BackgroundThis paper outlines a pilot of a new memory aide for breastfeeding conducted in the Northeast of England and North Cumbria between April and August 2023. The United Kingdom has some of the lowest rates of breastfeeding, particularly in the Northeast of England, and as such more needs to be done to support mothers to breastfeed for as long as they would like to. Good support from health professionals can be effective in influencing decisions to breastfeed as well as helping to ensure initiation and continuation of breastfeeding but there is evidence to suggest that professionals and students do not always feel adequately trained and it is here, where memory aides may have value.MethodsKey breastfeeding practitioners and educators were brought together to select one of two memory aides for principles of attachment for effective breastfeeding. The selected memory aide, LATCHS, was piloted with 57 participants with a key role in promotion and support of breastfeeding in the Northeast of England and North Cumbria.ResultsParticipants conveyed mixed views about the proposed memory aide with more experienced staff reporting more favourable opinions than student midwives and early years practitioners. Experienced staff felt the new memory aide would complement an early memory aide, CHINS, which focused on principles of positioning.DiscussionFindings of the pilot indicate there is a role for a mnemonic to help practitioners understand, recall, and retain theory around attachment for effective breastfeeding and that memory aides can play an important role in complementing existing approaches to education and practice. The participants felt the proposed memory aide had some limitations and suggested important ways for it to be improved, particularly in adding an E to reflect the expecting wording. This produced the final memory aide: LATCHES.ConclusionUsing data from the pilot, the memory aide was refined, and the final version LATCHES agreed for wider dissemination. Future research is needed to understand the value of LATCHES on the wider breastfeeding workforce and whether any future improvements can be made to enhance its utility.

The interplay between maternal employment dynamics and trends in breastfeeding practices over the past decade

BackgroundWorking mothers are in a situation where they have to manage both their job and maternal roles simultaneously. We aim to show the relationship between mothers' breastfeeding behavior and working status, as well as the effect of their working conditions on the continuation of breastfeeding.MethodsThis study examined 3557 (weighted 3490) child-mother pairs from Turkey's Demographic Health Survey data in 2008, 2013, and 2018 with a complex sample multiple logistic regression analysis to explore the relationship between breastfeeding and maternal employment.ResultsIn our study, 35.5% of the mothers had never worked, 18.6% were still working, and 45.9% had worked in the past but were not currently working. When breastfeeding percentages were examined based on maternal working status, mothers who worked in 2008 had significantly lower breastfeeding percentages than those who had never worked or had worked previously but not currently. In both 2013 and 2018, after legal regulations, maternal employment didn't affect breastfeeding. After adjusting for confounding factors, maternal employment in the industry sector had lower breastfeeding percentages [AOR:0.06 (95% CI: 0.01–0.48)] than those working in agriculture.ConclusionIt seems that adhering to legal regulations such as paid maternity leave and lactation leave can promote breastfeeding. It is necessary to raise awareness of mothers working in the industry about the continuation of breastfeeding and to monitor their legal rights.

Investigating the Start time and duration of skin-to-skin contact in the delivery or operating room in the hospitals of Khorasan Razavi Province, Iran

Background. Skin-to-skin contact (SSC) plays a significant role in the initiation and continuation of breastfeeding and maintaining and improving the health of infants. The goal of this research was to study the start time and duration of SSC in the labor rooms or operating rooms of the hospitals in Khorasan Razavi province. Methods. This descriptive study has been done on 714 newborn babies in labor rooms and ORs of governmental hospitals in Khorasan Razavi province from 1399 to 1401 through convenience sampling method. A midwife who did not have any role in the delivery process kept a record of the time of the SSC and its duration after the delivery. In the next stage, probable reasons for not having SSC, the connection of the start time of SSC and its duration with the start time and duration of breastfeeding were studied. Results. Based on the results of the study, 65% of the cases had SSC after the delivery in labor rooms under study . The mean start time of the SSC was 5.06±12.30 minutes, and the mean duration of the SSC after the birth was 9.28±13.66 minutes. Non-cooperation of the mother (61.38%), the fear of non-sterile environment (8.62%) and hastening the delivery process by the professionals involved (3.79%) were the most common reasons for not having SSC. Conclusion. In 35% of cases, there was no SSC after birth. Starting the contact early after birth can increase the success rate of breastfeeding. Practical Implications. According to the results of our study, skin-to-skin contact in our maternity hospitals is not done in one-third of the cases, which is necessary after the birth of babies. Babies who received skin-to-skin contact started breastfeeding earlier and held the breast longer, indicating that skin-to-skin contact facilitates the initiation of breastfeeding and increases its duration. The non-cooperation of the mother is the most common reason for not having skin-to-skin contact. Therefore, providing the necessary information and training to mothers about the importance of skin-to-skin contact in maintaining the health of babies, facilitating the initiation of breastfeeding, and changing the attitudes and behaviors of mothers seems necessary.

A Qualitative Study of Breastfeeding Mothers' Perspectives Regarding Lactation Support Services.

Although breastfeeding is widely accepted as beneficial, only half of U.S. mothers are breastfeeding at 6 months. This study aimed to learn whether a quality improvement project to embed lactation support services into the newborn visit at a primary pediatric practice met families' needs. Mothers who were aged 18+ years, had an infant born in October 2021 with a well-child visit to the study practice (urban, 85% Medicaid, and 90% African American), and planned to breastfeed were invited to participate in a semi-structured telephone interview about their experience with breastfeeding and lactation support. We interviewed 18 mothers and, using a descriptive qualitative approach (thematic analysis), found that early support was helpful in addressing initial challenges such as latching pain but did not adequately anticipate later barriers to continued breastfeeding. This suggests lactation support offered by pediatric primary care practices should extend beyond the newborn period and be tailored to families' evolving needs.

Infant feeding practices and associated factors during the COVID-19 pandemic: Findings from an online crosssectional study in Indonesia

Introduction: COVID-19 pandemic presents a challenge to ensuring optimal infant feeding practices. This study aimed to assess infant feeding practices and investigate potential factors associated with exclusive and continued breastfeeding practices during the COVID-19 pandemic in Indonesia. Methods: An online survey was conducted during December 2020 – August 2021. A total of 817 Indonesian mothers aged ≥18 years old with infants aged <18 months were obtained through convenience sampling. Exclusive breastfeeding was the practice at the time of the survey among infants <6 months old; continued breastfeeding was considered when infants aged >6 months received any type of breastfeeding in the previous day. Results: Most subjects were aged 25-34 years old (81.3%), had a high education level (85.7%), with middle household income level (40.5%), and lived in Java Island (81.6%). Infants’ age and sex were comparable between younger vs. older infants and boys vs. girls, respectively. Exclusive breastfeeding was 81.3%. Continued breastfeeding was 93.4%, with 74.3% meeting the minimum acceptable diet. Breastfeeding intention (92.9%) and husband’s support for infant feeding (67.2%) were reported during the COVID-19 pandemic. Multivariate analyses showed that breastfeeding intention was one of the factors associated with exclusive breastfeeding [aOR=12.6; 95%CI (4.1-39.1)] and continued breastfeeding [10.9 (4.4-27.0)]. Conclusion: The study suggested that mothers’ intention to breastfeed during the COVID-19 pandemic provided affirmation of good breastfeeding experiences by allowing mothers to have more time for childcare activities and more opportunities to develop meaningful coparenting practices while staying at home.

Complex intertwined association between breastfeeding practices and household food insecurity: Systematic review and meta-analysis.

Breastfeeding offers ideal food and nutrition for infants; however, structural barriers may amplify breastfeeding inequities. We aimed to identify whether household food insecurity (HFI) is associated with exclusive and continued breastfeeding (EBF and CBF) as recommended by the World Health Organization/United Nations Children's Fund (UNICEF) Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, literature searches using 'breastfeeding', 'food insecurity' and 'infant' terms were conducted in PubMed/MEDLINE, Embase, CINAHL, Global Health and LILACS from inception through November 2023, without language restrictions, yielding 1382 publications (PROSPERO:CRD42022329836). Predetermined eligibility criteria yielded the 12 included studies (nine cross-sectional and three cohorts). The risk of bias was assessed through the Effective Public Health Practice Project. Meta-analysis was performed for studies assessing EBF (n = 10), and metaregression was used to explore heterogeneity across studies. Prevalence of EBF ranged from 1.6% to 85.3%, with a lower prevalence among HFI. The pooled effect of the association between HFI and EBF presented an odds ratio (OR) of 0.61 (95% CI = 0.49-0.76) with consistent results across marginal (OR = 0.72, 95% CI = 0.55-0.94), moderate (OR = 0.59, 95% CI = 0.41-0.84) and severe HFI (OR = 0.49, 95% CI = 0.32-0.76). High heterogeneity was found only when HFI was dichotomized. The prevalence of CBF ranged from 35.4% to 78.0%, with inconsistent prevalence among HFI; a meta-analysis was not performed due to the low number of studies (n = 3). We concluded that HFI levels are associated with lower odds of EBF. Integrating service and policy-level strategies, such as screening, referrals, skilled breastfeeding counseling and access to comprehensive nutrition and social programs, could reduce structural inequities and promote adherence to the World Health Organization/UNICEF breastfeeding recommendations among food-insecure families.

Importance Assigned to Breastfeeding by Spanish Pregnant Women and Associated Factors: A Survey-Based Multivariate Linear Correlation Study.

Breastfeeding education, across all disciplines, is often inconsistent and lacking in expertise and confidence. However, recommendations from health professionals, the sociocultural environment, and previous knowledge and experiences significantly influence women's decision to breastfeed. This study aimed to identify factors that promote the assignment of greater importance to breastfeeding and associated practical benefits. This retrospective cross-sectional study included 276 participants who completed a self-administered questionnaire. Descriptive and bivariate analyses were performed, and multivariate linear models were applied to identify factors influencing the importance assigned to breastfeeding. Most participants were married or in a relationship, were native Spaniards, had secondary or higher education, and had an average age of 32.6 years. Seventy percent met the physical activity recommendations, and 91% felt comfortable with their body image during pregnancy. The importance assigned to breastfeeding was high across various aspects, except for postpartum weight loss and body image. Group prenatal care was only significantly associated with the importance assigned to the breastfeeding technique (how to breastfeed). The obesogenic environment and the importance assigned to nutritional aspects and physical activity also turned out to be predictors, although not for all models. In our region, the educational strategy of antenatal care groups could contain gaps regarding the mother's health, which should be addressed in the future to improve results regarding the initiation and continuation of breastfeeding.

Perception and Practice of Sub-Himalayan Region Mothers for Breastfeeding: A Cross-Sectional Survey

Abstract Background: Breast milk is an ideal food for neonates, which is also beneficial for mothers. Nowadays, modern mothers choose not to breastfeed their babies. The World Health Organization also recommends continuous breastfeeding of babies for up to 2 years. The present study focuses on assessing the perception and practice of mothers for exclusive breastfeeding in the sub-Himalayan region of India. Materials and Methods: A cross-sectional study was conducted among postnatal mothers who were attending pediatric outpatient departments (OPDs) and immunization clinics at All India Institute of Medical Sciences, Rishikesh, India. Interview schedules were conducted to assess knowledge and skills, and data related to breastfeeding were collected from 210 mothers. Purposive sampling techniques were used to select each participant. Results: The mean age of mothers was 26.8 years, 56% had previous experience of breastfeeding, 76% had a cesarean delivery, and 70% had started breastfeeding within 1 h. More than half (53%) of the mothers had inadequate knowledge of breastfeeding. On the Iowa Scale, only 8% of mothers reported a very positive attitude toward breastfeeding. On the Bristol scale, 81% of mothers reported that they were following good breastfeeding practices. Conclusions: The study concludes that sub-Himalayan mothers have inadequate knowledge of breastfeeding, but their practices are still suboptimal. We recommend more public health awareness programs to promote breastfeeding in this region.