Determinants Of Breastfeeding Practices Research Articles

The Effect of Self Leadership on Breastfeeding with Intention Mediation

Purpose: This study aims to investigate the influence of maternal self-leadership on breastfeeding practices, with a particular focus on examining the mediating role of intention. Recognizing the crucial role of maternal self-leadership in fostering successful exclusive breastfeeding, the research seeks to understand how maternal self-leadership impacts breastfeeding behavior, and whether intention serves as a mediator in this relationship. Methods: The research involves 118 breastfeeding mothers with infants aged 6-12 months as the study subjects. The independent variable under scrutiny is self-leadership, while breastfeeding serves as the dependent variable, with intention acting as the mediating variable. Structural equation modeling (SEM) is employed as the data analysis method to explore the relationships between these variables and assess the mediation effects. Results and Discussion: The findings reveal that maternal self-leadership exerts a positive and significant influence on both intention and breastfeeding practices. However, contrary to expectations, intention does not demonstrate a significant effect on breastfeeding behavior. Furthermore, the mediation analysis indicates that the relationship between self-leadership and breastfeeding is partially mediated by intention. This suggests that while intention plays a role in translating maternal self-leadership into breastfeeding practices, other factors may also contribute to this relationship, indicating potential avenues for further exploration. Implications of the Research: The research outcomes hold important implications for maternal and child health interventions aimed at promoting exclusive breastfeeding. By highlighting the significance of maternal self-leadership in influencing breastfeeding practices, the study underscores the importance of empowering mothers with self-leadership skills to enhance breastfeeding initiation and continuation. Additionally, the findings suggest that interventions targeting intention formation may not be sufficient on their own to promote breastfeeding behavior, emphasizing the need for multifaceted approaches that address various determinants of breastfeeding practices. Originality/Value: This study contributes to the existing literature by examining the interplay between maternal self-leadership, intention, and breastfeeding practices within the context of breastfeeding promotion. By employing structural equation modeling to assess mediation effects, the research provides a nuanced understanding of the mechanisms underlying the relationship between maternal self-leadership and breastfeeding behavior. The findings offer valuable insights for policymakers, healthcare practitioners, and breastfeeding support programs seeking to develop more effective strategies to support and encourage exclusive breastfeeding among mothers.

Current prevalence, changes, and determinants of breastfeeding practice in China: data from cross-sectional national household health services surveys in 2013 and 2018

BackgroundThe World Health Organization and the government of China have made many efforts to improve breastfeeding practices. The evidence of breastfeeding practices over the past decade in China is limited. The current study aimed to describe the current prevalence, variation trends, and determinants of breastfeeding practices in China using data from the National Household Health Service Surveys (NHHSS) in 2013 and 2018.MethodsWomen who had at least one live birth in the five years from the 2013 NHHSS numbered 10,544, and 12,766 women from the 2018 NHHSS were included in the current study. The rates of breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months since birth, and continued breastfeeding accompanied by adequate complementary feeding for over two years were measured. Logistic regressions were performed to study the associations between breastfeeding practices and maternal-based, healthcare-based, and infant-based characteristics.ResultsIn the 2018 survey, the rates of practiced any breastfeeding, early initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for at least six months, and continued breastfeeding for over two years were 91.50%, 28.16%, 47.90%, and 4.78%, respectively, showing significant improvements compared to the 2013 survey period. Women who received high education, were from a household with high incomes, had more than one child, and had more antenatal and postnatal visits, were more likely to practice breastfeeding and initiate it within the first hour, but they were less likely to breastfeed the infants for two years. Births by caesarean section and low birthweight were associated with worse breastfeeding practices.ConclusionsThe rates of practicing breastfeeding and exclusive breastfeeding for six months or more in China improved over the past decades, suggesting improved awareness and knowledge of breastfeeding among women. However, individual and social factors may impact practices of early initiation and continued breastfeeding. Strengthening breastfeeding support from family, community, and health professionals (e.g., family member engagement, friendly work environment, and professional consultation, etc.) during the postpartum and infant period may improve women’s confidence in breastfeeding practices.

Protecting both infant and mother: perceptions of infant feeding practices in rural Haiti

Background Global recommendations for optimal breastfeeding include early initiation, exclusivity for six months, and continued breastfeeding for two years and beyond. Although breastfeeding is near universal in Haiti, gaps in optimal practices persist. Determinants of breastfeeding practices are complex, and a contextualized understanding is needed to strengthen breastfeeding support interventions. We conducted a qualitative study to explore mothers’ perceptions of factors influencing breastfeeding practices in rural Haiti. Methods Focus group discussions were held in eight rural communes participating in a nutrition project. Study participants (n=86) were recruited from mothers’ support groups. A moderator facilitated the focus groups in Haitian Creole using a question guide to elicit observations about community breastfeeding practices related to early initiation, colostrum feeding, complementary foods and beverages, and breastfeeding cessation. Focus groups were recorded, and three observers took notes which were compiled into a single report of key points and validated by participants following each session. Quotes representing the key points were selected from the audio recordings, translated into English and analyzed to identify explanatory themes. Results Participants described breastfeeding for 12-18 months as the norm in study areas, with early and frequent use of additional foods and beverages. Three explanatory themes were identified, related to concerns for (i) infant well-being, including digestive health, nutritional needs and contentment; (ii) transmission of negative maternal emotional and physical states through breast milk; and (iii) maternal well-being, including effects on breastfeeding practices of maternal illness, hunger, stress, and competing time pressures. Underlying all these concerns is the context of rural poverty and the cultural meanings of breastfeeding. Conclusions Findings suggest that practices which compromise global breastfeeding recommendations may persist because of their perceived value in addressing concerns for infant and maternal well-being in the challenging context of rural poverty, food insecurity and poor health. Multi-sectoral interventions are needed to mitigate these underlying contributors and create an enabling environment for early, exclusive and continued breastfeeding.

Determinants of breastfeeding practice in Pujehun district, southern Sierra Leone: a mixed-method study

BackgroundIt is well established that exclusive breastfeeding can play a critical role in reducing child morbidity and mortality. Limited research has been done thus far on the practice and perceptions of breastfeeding in Sierra Leone, where more than 10 % of children die before the age of five. This study aimed to gain understanding into and explore both matters in order to develop recommendations for effective strategies to promote breastfeeding practice in Pujehun District, Southern Sierra Leone.MethodsThis exploratory mixed-method study included a cross-sectional survey of 194 mothers, semi-structured interviews and focus group discussions. Logistic regression analysis was used calculated odds ratios of factors associated with primarily breastfeeding practice, defined as ‘Children under six months of age who are fed with breast milk only and children older than six months of age that were exclusively breastfed up to six months’, based on recall from birth. Exclusive breastfeeding rate was based on breastfeeding practice 24 h prior to the survey. Qualitative data was analysed through a deductive approach, using a pre-determined framework on determinants of breastfeeding.ResultsThis study revealed an exclusive breastfeeding rate of 62.8% (95% CI 53.9, 71.7); dropping from 74% in the 0–1-month age group to 33% in the 4–5 months group. Triangulation of qualitative and quantitative data revealed enabling factors for primarily breastfeeding practice included mothers receiving support during their first breastfeed, pregnant women being provided with information on the benefits of the practice, counselling by nurses, support from husbands, and women’s awareness of how their friends and family members fed their own babies. The main barriers were a lack of encouragement by husbands, women’s perception that their infants’ stools were abnormal or that they were not producing enough breast milk.ConclusionsAlthough the exclusive breastfeeding may have risen over recent years, a gap remains compared to World Health Organization recommendations. According to the breastfeeding determinants identified in this study, promotion of counselling by a nurse, encouragement of husbands’ support, and improve knowledge of mothers on breastfeeding are recommended to be incorporated in the design of future health programs.

Determinants of breastfeeding practices in Myanmar: Results from the latest nationally representative survey.

Optimal breastfeeding practices can ensure healthy growth and development of infants, which in the long term can impact the country's economic development. Nevertheless, Myanmar has yet to achieve the WHO’s target of 70% for early initiation of breastfeeding, and the country’s target of 90% for exclusive breastfeeding. The purpose of this study was to assess the associations between early initiation of breastfeeding and exclusive breastfeeding and bio-demographic, socio-economic and behavioral factors in Myanmar. Using the 2015–2016 Myanmar Demographic and Health Survey, the analysis of early initiation of breastfeeding was based on a sample of 1,506 under-2 children and the analysis of exclusive breastfeeding was based on a sample of 376 children aged 0–5 months. Multiple logistic modeling, with heteroskedasticity-adjusted standard errors, was used. The prevalence rates of early initiation of breastfeeding and exclusive breastfeeding in the study were 67.9% and 52.2% respectively. Having a vaginal delivery (AOR = 2.5; 95% CI = 1.7–3.7) and having frequent (≥ 4) antenatal visits (AOR = 2.4; 95% CI = 1.5–3.8) were associated with higher odds of early initiation of breastfeeding. Having a postnatal checkup (AOR = 0.5; 95% CI = 0.3–0.9) and having an infant that was perceived to be small at birth (AOR = 2.5; 95% CI = 1.1–5.7, for infants perceived to be large at birth) were significantly associated with decreased odds of exclusive breastfeeding. In order to promote optimal breastfeeding practices, this study suggested that delivery and quality of health services during pregnancy need to be strengthened in Myanmar.

Time trends and determinants of breastfeeding practices among adolescents and young women in Nigeria, 2003–2018

IntroductionOptimal breastfeeding practices have far-reaching health and economic benefits. Evidence suggests disparities in breastfeeding practices by maternal age-groups, with younger mothers often having lower rates of breastfeeding initiation, continuation and...

The Determinants of Early Initiation of Breastfeeding Practice among Mothers Attending a Tertiary Hospital, Kathmandu

Introduction: Breastfeeding is the best way of providing ideal food for the optimal growth and development of an infant. Early initiation of breastfeeding (EIBF) within one hour of birth is one of the cost effective strategies to reduce neonatal mortality. The aim of the study was to find out the determinants of breastfeeding practice.
 Methods: This was a descriptive cross-sectional study conducted among 207 mothers who have child from birth to 12 months in Maternal and Child Health (MCH) Clinic of tertiary care referral hospital. The mothers for the study were selected using probability sampling technique. Variables were analysed using a multivariate logistic regression model to identify the determinants of EIBF.
 Results: The prevalence of EIBF in the study population was 47.3%. Caesarean delivery (AOR: 3.449, CI: 1.224-9.719, p = 0.019), mothers who have done more than one postnatal visit (AOR: 2.824, CI: 1.126-7.079, p = 0.027) and low birth weight babies (AOR: 7.973, CI: 1.571-40.465, p = 0.027) were more likely to delay initiation of breastfeeding.
 Conclusions: Less than half newborn receive breast milk within the first hour of birth. Mothers delivered by caesarean section, who have done more than two postnatal visit and low birth weight babies were more likely to delay initiation of breastfeeding. These are the major determinants of initiation of breastfeeding. Existing breastfeeding promotion program should be strengthened within the existing health care system.

Practice of exclusive breastfeeding and its associated factors in a suburban area in Angola: a cross-sectional study.

Exclusive breastfeeding for six months is one of the measures with highest impact on prevention of child deaths. The determinants of breastfeeding practices are complex and differ between populations. This study aimed to identify factors associated with the prevalence of exclusive breastfeeding in a suburban area in Angola. Population-based cross-sectional study in the municipality of Cacuaco, Luanda. A random sample of children under two years of age and their mothers was included. -Prevalence ratios (PR) were estimated using Poisson regression based on a hierarchical model. 749 children and their mothers were surveyed, including 274 children under six months. Theprevalence of exclusive breastfeeding among children under six months was 51.5% (95% confidence interval, CI, 46.3-56.6%). Four variables were positively associated with exclusive breastfeeding at ages of under six months: number of prenatal visits (PR 1.11 for each visit after the first one; 95% CI 1.04-1.18), maternal occupation (other occupations versus self-employed) (PR 1.54; 95% CI 1.05-2.26), younger child age (PR 0.77 for each month; 95% CI 0.71-0.84) and female child (PR 1.34; 95% CI 1.02-1.76). Our findings showed that the prevalence of exclusive breastfeeding at six months was satisfactory, according to international recommendations. Factors associated with exclusive breastfeeding practices that had never been surveyed before in Angola were identified through this study. These data are particularly relevant in the context of high infant mortality and may be useful in planning actions aimed at improving child health through promotion of exclusive breastfeeding, in Angola and other countries.

Socio-cultural determinants of breast feeding practices in Dharwad district of Karnataka

WHO recommends mothers worldwide to exclusively breastfeed infants for the child's first six months to achieve optimal growth, development and health. The infant mortality rate in India is 40/1000 live births and 31/1000 live births in Karnataka according to NFHS-4 report released in 2013. In India, breastfeeding is culturally well accepted but inadequately practiced, partly due to ignorance. Lack of knowledge, prevailing misconceptions and cultural taboos significantly contribute to undesirable breastfeeding practices such as delayed initiation and discarding of colostrum. In this context the present study was conducted to study the knowledge, attitude and breast feeding practices among the lactating mothers in Dharwad district of Northern Karnataka. A cross-sectional study was conducted in rural and urban areas of Dharwad district, Karnataka. The population of the study consisted of mother -infant dyads, where the infants were in the age group of 3 months to 24 months and their mothers from rural as well as urban area of the district. The sample comprised of 300 women of whom 200 were from rural area and 100 from urban area in the age range of 17-45 years. The tools used for the study were Socio - economic status scale developed by Aggarwal et al. (2005) and a self structured questionnaire to document the mother and child health characters, demographic profile, feeding practices, patterns and knowledge of mothers towards breast feeding. Iowa Infant Feeding Attitude Scale (1999) was used to assess maternal attitude towards infant feeding and information regarding feeding choice. The results indicated that 56.33 per cent breastfed the baby within 1hr and 26 per cent fed after 3 days. Majority of the mothers fed colostrum (71.67%) and 28.33 per cent discarded the colostrum. 51.33 per cent mothers gave prelacteal feeds. 48.7 per cent mothers practiced exclusive breast feeding. Majority of mothers both in urban and rural area had medium level knowledge and attitude towards breast feeding. Breast feeding knowledge had significant association with feeding practices while SES had no impact.

Determinants of early initiation, exclusiveness, and duration of breastfeeding in Uganda.

Breastfeeding practices in Uganda are contrary to the best practice recommended by World Health Organization (WHO). Only six in 10 Ugandan children below the age of six months are exclusively breastfed. This paper investigated the determinants of breastfeeding practices in Uganda. Using the Uganda Demographic and Health Survey (UDHS) of 2006, we employed probit and Cox's regression techniques as well as the Kaplan-Meier survival functions during the analysis. On average, 56% and 46% initiated breastfeeding in the first hour and practised exclusive breastfeeding respectively while 25%, 50%, and 75% terminated breastfeeding at 18, 24, and 26 months respectively. The mean number of months of breastfeeding was 14.1, and the maximum was 40. Hospital delivery increased the probability of early initiation and exclusive breastfeeding by 4-5% (p < 0.01) and 7-8% (p < 0.01) respectively. Prenatal care increased the probability of early initiation and exclusive breastfeeding by 6-7% (p < 0.05) and 5-7% (p < 0.05) respectively. Birth intervals less than 24 months increased the risk of early termination of breastfeeding by 19% (p < 0.01). Hospital delivery and prenatal care should be made a priority, and mothers should be encouraged to adopt higher birth intervals.

Determinants of exclusive breastfeeding in an urban population of primiparas in Lebanon: a cross-sectional study

BackgroundThe proportion of mothers who exclusively breastfeed their babies up to 6 months remains low. Determinants of breastfeeding practices have been largely documented in high-income countries. Little evidence exists on possible predictors of breastfeeding behaviors in the Middle East. Our aim was to assess the prevalence of breastfeeding in Beirut and determine the factors that impact breastfeeding behavior in this population.MethodsData for this longitudinal study is nested within a randomized controlled trial (RCT) assessing the impact of a 24-hour hotline and postpartum support film on postpartum stress. Healthy first-time mothers delivering in the capital Beirut between March and July 2009, were interviewed at 1–3 days and 8–12 weeks post delivery. A multiple logistic regression analysis was used to determine the factors associated with exclusive breastfeeding at 8–12 weeks postpartum.ResultsThe overall breastfeeding rate at 8–12 weeks postpartum was 67%. The exclusive breastfeeding rate was 27.4%. Factors associated with exclusive breastfeeding included maternal work (OR=3.92; p-value<0.001), planned pregnancy (OR=2.42, p-value=0.010), intention to breastfeed (OR=3.28; p-value=0.043), source of maternal emotional support (OR = 1.87, p-value=0.039) and the use the postpartum support video, the hotline service or both (OR=2.55, p-value=0.044; OR=3.87, p-value=0.004 and OR=4.13, p-value=0.003).ConclusionsThe proportion of healthy first-time mothers who exclusively breastfeed in Beirut is extremely low. Factors associated with breastfeeding behavior are diverse. Future research and interventions should target different levels of the maternal-child pair’s ecosystem.Trial registrationClinicalTrials.gov, NCT00857051

Patterns and Determinants of Breast Feeding Practices in Dodoma Municipality: A Cross Sectional Study

Promotion of proper breastfeeding practices for the first six months of life is the most cost-effective intervention for reducing childhood morbidity and mortality. The objective of the present study was to determine prevalence of EBF and understand the awareness of breast feeding practices among the women in Dodoma Municipality, central part of Tanzania. A cross-sectional study was conducted in Dodoma municipality, Tanzania in April to May 2011. Multiple sampling methods were applied in selection of a sample 200(women aged 15-42 years). A structured interview schedule was used to collect information of Mothers with infants aged 0 to 12 months on demographic characteristics, knowledge of EBF, and details regarding breast feeding practices since birth of their children to six months of life. The prevalence of EBF among women in Dodoma Municipality, Tanzania was 59%. Knowledge of EBF was relatively higher (89%) compared to the prevalence of EBF (59%). In total, majority(89%) of the women in study area had initiated breastfeeding in first one hour of delivery. Hospital deliveries (67.5%) higher than home deliveries in Dodoma municipality. Though exclusive breastfeeding prevalence rate found higher than at national level which was encouraging but not satisfactory according to world health organizations recommendations. Interventions and further research should address the low prevalence of exclusive breast feeding practices in study area.

Determinants of breastfeeding practices: An analysis of the Sri Lanka Demographic and Health Survey 2006–2007

Identification of factors that predict a woman's infant feeding choice is important for breastfeeding promotion programmes. We analysed a subsample of children under 2 years of age from the most recent Sri Lanka Demographic and Health Survey (SLDHS) to assess breastfeeding practices and factors associated with suboptimal practices. SLDHS 2006-2007 used a stratified two-stage cluster sample of ever-married women aged 15-49 years. Breastfeeding indicators were estimated for the last-born children (n = 2735). Selected indicators were examined against independent variables through cross-tabulations and multivariate analyses. Of the sample, 83.3% initiated breastfeeding within 1 h of birth. Continuation rates declined from 92.6% in first year to 83.5% in second year. Exclusive breastfeeding (EBF) rate under 6 months of age was 75.8%, with median duration being 4.8 months. Delayed initiation of breastfeeding was associated with low birthweight [odds ratio (OR) = 2.24] and caesarean delivery (OR = 3.30), but less likely among female infants (OR = 0.75), mothers from 'estate' sector (OR = 0.61) or richer wealth quintile (OR = 0.60). Non-EBF was associated with children from urban areas (OR = 1.72) and estate sector (OR = 4.48) and absence of post-natal visits by a public health midwife (OR = 1.89). A child was at risk for not currently breastfeeding if born in a private hospital (OR = 3.73), delivered by caesarean section (OR = 1.46) or lived in urban areas (OR = 2.80) or estate sector (OR = 3.23). Those living in estates (OR = 11.4) and not receiving post-natal home visits (OR = 2.62) were more likely to discontinue breastfeeding by 1 year. Breastfeeding indicators in Sri Lanka were higher compared with many countries and determined by socio-economic and health care system factors.