Infant Feeding Intentions Research Articles

Are breastfeeding intention and choice associated with contraceptive choice

Background: Both breastfeeding and child spacing benefit infant and maternal health, however there is overlap between risk factors for not exclusively breast feeding and for short interval pregnancy, including socioeconomic status, educational level, race and ethnicity, and younger age. Our aim was to determine if prenatal infant feeding and contraceptive intentions were predictive of postpartum choice, and to examine the relationship of breastfeeding to contraceptive choice. Methods: We previously surveyed expectant publicly-insured women about infant feeding and contraceptive intentions; this follow up study recorded their feeding and contraceptive choices postpartum in-hospital and at the postpartum …

To what extent does maternal body mass index predict intentions, attitudes, or practices of early infant feeding?

Public health guidelines recommend women establish and maintain exclusive breastfeeding to 6 months postpartum. Women with a body mass index (BMI, kg/m2 ) in the overweight or obese range are less likely to initiate and continue breastfeeding than healthy weight women. Evidence for psychological mechanisms of this association using validated methods of measurement is limited, but factors such as attitudes and intentions for infant feeding are implicated. This study aimed to investigate the associations between maternal BMI, antenatal attitudes and intentions for infant feeding, and subsequent breastfeeding practices. A total of N=128 women completed an online questionnaire antenatally, and n=48 were followed-up in the first month postpartum. Validated measures of intentions (Infant Feeding Intentions Scale) and attitudes (Iowa Infant Feeding Attitude Scale) for infant feeding were used. One-way analysis of variance and multivariate regression analyses assessed study objectives. Infant feeding attitudes (p=.327) and intentions (p=.254) were similar among healthy weight, overweight, and obese women and did not differ significantly. In adjusted regression models, only intentions significantly predicted early breastfeeding behaviour (p=.036; AR2 =.301). Missing data analysis revealed no significant differences in the profile of completing versus noncompleting women. Evidence suggests postnatal factors contribute significantly to lower breastfeeding rates in cohorts of women with overweight or obese BMIs. Further investigations should consider using theory and methods from behavioural science to longitudinally investigate modifiable mechanisms of action responsible for lower breastfeeding rates among overweight and obese women to inform practices that support prolonged breastfeeding.

Associations Between Prenatal Intention and Postpartum Choice: Infant Feeding and Contraception Decisions Among Inner-City Women.

Purpose: We sought to understand how women's prenatal infant feeding and contraception intentions were related to postpartum choices. Materials and Methods: Expectant women ≥14 years of age receiving care at MacDonald Women's Hospital, Cleveland Ohio were previously surveyed regarding feeding and contraceptive intentions. Here, we asked: (1) What were postpartum feeding choices, and did prenatal intention predict postpartum choice?, (2) What were postpartum contraceptive choices, and did prenatal intention predict postpartum choice?, and (3) What was the relationship of postpartum contraceptive choice to postpartum feeding choice? Results: Of 223 women interviewed prenatally, 214 (96%) were followed to postpartum in-hospital, and 119 out of 214 (56%) were followed to the postpartum visit. The mean age was 25 years, 185 out of 206 (89.8%) were African American, and 149 out of 200 (75.0%) were multiparous. Prenatal feeding and contraceptive intent were significantly associated with postpartum feeding and contraceptive choices, respectively (both p < 0.0001). More women who initiated breastfeeding chose no contraception (54.5% for any breastfeeding versus 32.2% for exclusive formula feeding) versus long-acting reversible contraception (LARC), tubal ligation, or other contraceptive types (χ2 = 9.28, p = 0.03). After adjusting for known confounders, only receipt of other contraceptive types (not LARC, not tubal ligation) was significantly associated with decreased odds of any breastfeeding (p = 0.02). Conclusions: Among low-income predominantly African American inner-city women, prenatal intentions were significantly associated with postnatal choices for infant feeding and contraception. After controlling for confounders, women receiving less effective types of contraception (not LARC and not tubal ligation) had reduced odds of any breastfeeding (p = 0.02).

Infant feeding by South African mothers living with HIV: implications for future training of health care workers and the need for consistent counseling

BackgroundSince 2010, the World Health Organization recommends lifelong antiretroviral treatment for all women living with HIV, and exclusive breastfeeding for six-months followed by breastfeeding until 24-months for all HIV positive mothers. Nevertheless, many mothers living with HIV do not initiate breastfeeding or stop prematurely, and many countries are still in the process of updating their national infant feeding guidelines to align with World Health Organization recommendations. We sought to understand uptake of breastfeeding and factors that influence decision-making regarding infant feeding in women living with and without HIV who receive ante- and postnatal care at a primary healthcare setting.MethodsProgrammatic data on infant feeding intentions and practices among women attending an ante-and postnatal clinic service at a primary care clinic in Johannesburg, South Africa were summarized using descriptive statistics. Qualitative interviews were conducted with 12 healthcare providers, 12 women living with HIV who were breastfeeding and 10 who were formula feeding. Interviews were analyzed using a content analysis approach.ResultsPregnant women living with HIV were less likely to express an intent to breastfeed (71% vs 99%). During the first 6 months postpartum, mothers living with HIV were also less likely to exclusively breastfeed compared to HIV-negative mothers. Mixed messages during infant feeding counselling, social and economic factors, and fear of HIV transmission influenced women’s choices to initiate and continue breastfeeding.ConclusionsAs infant feeding guidelines for women living with HIV have evolved rapidly in the past 10 years, uniform messages on the low risk of mother-to-child transmission of HIV associated with breastfeeding while on ART and on introduction of complementary foods after 6 months of age are needed.

Understanding health behaviour in pregnancy and infant feeding intentions in low-income women from the UK through qualitative visual methods and application to the COM-B (Capability, Opportunity, Motivation-Behaviour) model

BackgroundHealth behaviours during pregnancy and the early years of life have been proven to affect long term health, resulting in investment in interventions. However, interventions often have low levels of completion and limited effectiveness. Consequently, it is increasingly important for interventions to be based on both behaviour change theories and techniques, and the accounts of pregnant women. This study engaged with pregnant women from deprived communities, to understand their subjective experiences of health in pregnancy.MethodsThe study adopted a women-centred ethos and recruited a purposive sample of ten pregnant women, who lived in deprived areas and were on low incomes. Participants engaged with three creative techniques of visual data production (timelines, collaging and dyad sandboxing), followed by elicitation interviews. One participant only engaged in the initial activity and interview, resulting in a total of 28 elicitation interviews. This in-depth qualitative approach was designed to enable a nuanced account of the participants’ thoughts, everyday experiences and social relationships. Data were deductively coded for alcohol, smoking and infant feeding and then mapped to the COM-B model (Capability, Opportunity, Motivation – Behaviour).ResultsFive participants had experience of smoking during pregnancy, four had consumed alcohol during pregnancy, and all participants, except one who had exclusively formula fed her child, disclosed a range of infant feeding experiences and intentions for their current pregnancies. Considerable variation was identified between the drivers of behaviour around infant feeding and that related to abstinence from tobacco and alcohol during pregnancy. Overall, knowledge and confidence (psychological capability), the role of partners (social opportunity) and support from services to overcome physical challenges (environmental opportunity) were reported to impact on (reflective) motivation, and thus women’s behaviour. The role of the public in creating and reinforcing stigma (social opportunity) was also noted in relation to all three behaviours.ConclusionsWhen designing new interventions to improve maternal health behaviours it is important to consider the accounts of pregnant women. Acknowledging pregnant women’s subjective experiences and the challenges they face in negotiating acceptable forms of motherhood, can contribute to informed policy and practice, which can engage rather than isolate potential user groups.

Investigating the effectiveness of school-based breastfeeding education on breastfeeding knowledge, attitudes and intentions of adolescent females

Breastfeeding intentions are usually shaped prior to conception, often as early as adolescence. Secondary school reproductive curriculum may be an appropriate setting to provide breastfeeding information on a population level. The purpose of this pilot study was to investigate the impact of a school-based breastfeeding educational intervention on the breastfeeding knowledge, attitudes and future infant feeding intentions of secondary school adolescent females; as well as assess the acceptability and feasibility of the intervention among the target population. Participants consisted of a convenience sample of 77 adolescent female students from an Ontario secondary school. Participants received one 70 min breastfeeding educational session in health education class. Data were collected using self-administered questionnaire at baseline and one day after the intervention. A modified version of the Iowa Infant Feeding Attitude Scale (IIFAS) and a modified breastfeeding knowledge scale were used to measure breastfeeding attitudes and knowledge. Additional outcomes measured included future breastfeeding intentions and participants’ perceptions of the educational session. Breastfeeding knowledge (p < 0.001), attitudes (p < 0.001), and future intentions of participants to exclusively breastfeed increased significantly (p < 0.05) at post-test. The participant feedback indicated that they found the content useful, interesting and the information was presented in an engaging manner. These findings suggest that adolescent females are receptive to learning about breastfeeding in school and a single school-based breastfeeding educational intervention can positively impact breastfeeding knowledge, attitudes and future intentions of adolescent females. The secondary school setting may be an ideal setting for the inclusion of educational breastfeeding content to enable future informed decision making.

SEX DIFFERENCES IN THE SOCIAL ECOLOGY OF BREASTFEEDING: A MIXED METHODS ANALYSIS OF THE BREASTFEEDING VIEWS OF EXPECTANT MOTHERS AND FATHERS IN THE US EXPOSED TO ADVERSITY.

Despite the significant health benefits of breastfeeding for the mother and the infant, economic class and race disparities in breastfeeding rates persist. Support for breastfeeding from the father of the infant is associated with higher rates of breastfeeding initiation. However, little is known about the factors that may promote or deter father support of breastfeeding, especially in fathers exposed to contextual adversity such as poverty and violence. Using a mixed methods approach, the primary aims of the current work were to (1) elicit, using qualitative methodology, the worries, barriers and promotive factors for breastfeeding that expectant mothers and fathers identify as they prepare to parent a new infant, and (2) to examine factors that influence the parental breastfeeding intentions of both mothers and fathers using quantitative methodology. A sample (N=95) of expectant, third trimester mothers and fathers living in a low-income, urban environment in Midwestern USA, were interviewed from October 2013 to February 2015 about their infant feeding intentions. Compared with fathers, mothers more often identified the benefits of breastfeeding for the infant's health and the economic advantage of breastfeeding. Mothers also identified more personal and community breastfeeding support resources. Fathers viewed their own support of breastfeeding as important but expressed a lack of knowledge about the breastfeeding process and often excluded themselves from discussions about infant feeding. The results point to important targets for interventions that aim to increase breastfeeding initiation rates in vulnerable populations in the US by increasing father support for breastfeeding.

Analysis of selected determinants of intention to breastfeed

Aim: Breastfeeding and consumption of breast milk positively affect the health of children and mothers. The goal of this research was an analysis of intention to breastfeed in pregnant women and the impact of selected factors on intention to breastfeed. Design: Cross - sectional study. Methods: Research was conducted involving 176 women in the 5th-9th month of pregnancy. We analyzed their intention to breastfeed using the Infant Feeding Intentions Scale (IFI). Among the analyzed factors we included: socio-demographic variables, smoking during pregnancy, women's attitudes to breastfeeding, and the body image of pregnant women (the Body Image States Scale - BISS). Results: The intention to breastfeed in pregnant women was very high (M = 13.15; SD = 2.6). In the 1st month after birth, 85.2% of women plan to breastfeed to the fullest extent, falling to 77.2% in the 3rd month, and 62.5% in the 6th month. Variables included in linear regression explain 30% of the variation in intention to breastfeed. By hierarchic linear regression, we identified the attitude of husband/partner towards breastfeeding (β = 1.236; p = 0.001), and impact of breastfeeding on women's health (β = 0,354; p = 0,035) and body image (β = 0,497; p = 0,000) as significant independent variables determining the intention to breastfeed. Women's satisfaction with their pregnant body explains 11% of the variation in all analyzed variables. Conclusion: Promoting the health of mothers and their children requires midwives and nurses to perform a range of activities that will engage the husbands/partners of the women, and which will also take account of the body perceptions of pregnant women.

Agreement between Future Parents on Infant Feeding Intentions and Its Association with Breastfeeding Duration: Results from the Growing Up in New Zealand Cohort Study.

Maternal intentions are believed to have the strongest influence on infant feeding. However, what has rarely been studied, are the associations of maternal and partner intentions, and the influence these factors have on infant feeding. Our objective was to describe breastfeeding intentions of pregnant women and their partners, agreement about these intentions, and whether this agreement is associated with breastfeeding initiation and duration. This study was completed within the Growing Up in New Zealand study. Agreement between mothers and partners on intended initial infant feeding method was fair (κ = 0.21, 95% confidence interval (CI) 0.17–0.25) as was intended breastfeeding duration (κ = 0.25, 95% CI 0.22–0.28). Infants whose parents agreed antenatally on breastfeeding only were more likely to have been breastfed for >6 months, after adjustment for maternal (odds ratio (OR) = 6.3, 95% CI 3.9–10.2) and partner demographics (OR = 5.7, 95% CI 3.6–9.2). Likewise, infants whose parents agreed antenatally to breastfeed for >6 months were more likely to have been breastfed for >6 months, after adjustment for maternal (OR = 4.9, 95% CI 3.9–6.2) and partner demographics (OR = 5.0, 95% CI 4.0–6.3). Interventions that promote breastfeeding to both mothers and partners which enable parents to reach agreement about intended feeding methods have the potential to increase both breastfeeding initiation and duration.

The Influence of Breastfeeding Self-Efficacy and Breastfeeding Intention on Breastfeeding Behavior in Postpartum Women

World Health Organization (WHO) guidelines recommend that infants should be breastfed for six month after childbirth. The average duration of breastfeeding in Taiwan still falls short of this sixth-month timeline. In order to improve the duration of breastfeeding, it is crucial to understand the factors that affect related behavior. To explore the effects of breastfeeding self-efficacy and breastfeeding intention among exclusive-breastfeeding women during the initial six months after childbirth and to verify the reliability and validity of the infant feeding intentions scale (Chinese version). Purposive sampling was used to select and enroll a total of 167 breastfeeding women from a southern metropolitan medical-teaching hospital. Data were collected using a structured questionnaire and phone interviews. Data were analyzed using SPSS 18.0, LISREL8.7, and S-Plus package software to obtain scores for the independent-sample t test, Pearson's product-moment correlation coefficient, one-way analysis of variance, survival analysis, and reliability and validity. Breastfeeding self-efficacy scores ranged from 14 to 70, with a mean score of 44.80 (±11.56). Infant feeding intention scores ranged from 14 to 70, with a mean score of 12.20 (±3.14). Additionally, 29.9% of the participants breastfed exclusively for the entire six months after childbirth. Breastfeeding self-efficacy and breastfeeding intention were positively correlated (r = .45, p < .001). Education level, occupation, and breastfeeding intention were each identified as factors that significantly influenced the success of exclusive breastfeeding during the initial six months after childbirth. Breastfeeding self-efficacy and breastfeeding intention are correlated with breastfeeding behavior. Based on findings, medical staff should target promotion and education regarding the importance of breastfeeding particularly toward women who have lower levels of education, who are employed, and who express low initial intention to breastfeed.

Infant feeding decisions and behaviours among low-income smoke-exposed women: timing and change during pregnancy.

The present study aimed to describe change in feeding intentions and predictors of breast-feeding intentions during the course of pregnancy. Analysis of prospectively collected data from a larger randomized controlled trial of a health education intervention to reduce environmental smoke exposure among women during and after pregnancy. Participants were recruited from prenatal clinics, but all further communication occurred with participating women living in the community. Low-income, adult women (n 399) were interviewed during the 16th and 32nd week of pregnancy to ascertain prenatal feeding intentions and breast-feeding knowledge, attitudes and self-efficacy. Characteristics of women by infant feeding intention were assessed along with differences in intention from 16 to 32 weeks of pregnancy and feeding behaviours after delivery. Differences in psychosocial variables between women of different intention for infant feeding were measured. Women in each category of feeding intention were assessed for changes in psychosocial factors by eventual infant feeding behaviour. Feeding intention early in pregnancy was strongly, but not consistently, associated with feeding intention late in pregnancy, feeding initiation and later feeding patterns. Over one-third of women who were undecided at 16 weeks' gestation or earlier initiated breast-feeding. Increases in knowledge and improvement in time, social factors and social support barriers were found among those who exclusively breast-fed. Results indicate that feeding decisions may change during pregnancy. Determining when women make feeding decisions during their pregnancy warrants more research. Interventions to increase breast-feeding intentions should target knowledge, self-efficacy and barriers.

A prospective study of breastfeeding intentions of healthy weight and overweight women as predictors of breastfeeding outcomes

ObjectiveWomen with a higher BMI are at increased risk of breastfeeding for a shorter duration, however it is unclear if weight status itself or other factors such as feeding intentions are responsible for early breastfeeding cessation. The aim of this study was determine the influence of maternal pre-pregnancy weight status on infant feeding intentions during pregnancy using a validated scale and assess whether high intentions to exclusively breastfeed measured during pregnancy predicted feeding mode at discharge and at 4 months postpartum in both healthy weight (Hwt) (BMI< 25kg/m2) and overweight (Owt)(BMI > 25kg/m2) women. DesignThis prospective, observational study commenced when participants were <20 weeks gestation, continuing until four months post partum. Self-administered questionnaires assessed pre-pregnancy weight, infant feeding intentions at 36 weeks gestation, and breastfeeding practices at hospital discharge and 4 months postpartum. Hospital records provided details of delivery mode, gestation and breastfeeding during hospital stay. Binary logistic regression analyses were used to compare weight groups on the breastfeeding beliefs and practices adjusting for selected covariates Participants and settingA consecutive sample of pregnant women (n = 715) were recruited from an Australian metropolitan hospital between August 2010 and January 2011. All women <20 weeks gestation were eligible unless they had pre-existing Type 1 or 2 diabetes or insufficient English language skills to complete questionnaires. Measurements and findingsOf 715 women recruited, 402 had complete data at 4 months post-partum. There were no differences in high breastfeeding intentions (66% vs 53%, p = 0.10) or initiation (96% vs. 98%, p = 0.33) between Hwt and Owt women. Owt women were less likely to be exclusively breastfeeding at hospital discharge AOR [95%CI] 0.57 [0.33,0.98] and 4 months post-partum 0.62 [0.40,0.97]. High intention to breastfeed was positively associated with exclusively/fully breastfeeding at hospital discharge in Hwt 3.24 [1.52,6.89] but not Owt women 1.73 [0.75,4.00] and 4 months post partum in both weight groups (Hwt 4.1 [2.4–7.2], Owt 6.5 [2.9–14.3]). Key conclusionsHealthy and overweight women appear to have similar antenatal intentions for infant feeding but overweight mothers are less likely to be exclusive breastfeeding at hospital discharge. High antenatal intentions for breastfeeding are related to exclusively/fully breastfeeding at 4 months post partum in both healthy and overweight women. Implications for practiceInvestigation of early hospital practices that support and hinder the establishment of successful breastfeeding in overweight mothers may help to identify effective strategies to protect breastfeeding relationships between mother-infant dyads, particularly those who have experienced a caesarean delivery.

\u2018Both parents should care for babies\u2019: A cross-sectional, cross-cultural comparison of adolescents\u2019 breastfeeding intentions, and the influence of shared-parenting beliefs

BackgroundMany young men and women expect to co-parent their newborn infant. This may have a positive or negative impact on decisions to breastfeed, which is an important health behaviour, influenced by cultural and psycho-social norms. We investigated the relationship between shared parenting, infant feeding beliefs and intentions in male and female (non-parent) adolescents, comparing Nordic countries (Sweden, Norway, Finland) with high breastfeeding rates with others with low rates (Scotland, USA).MethodsWe utilised cross-sectional surveys of male and female adolescents (n = 1064, age 12–18) administered directly in schools or via the internet. We assessed attitudes to breast and formula feeding and shared parenting, using a Theory of Planned Behaviour framework, assessing beliefs, attitudes, norms and control as predictors of intention.ResultsMale and female adolescents’ breastfeeding intentions varied in line with national cultural norms. Young people from Nordic countries (high breastfeeding rates) were significantly more likely to intend to breastfeed than those from Scotland or the USA (low breastfeeding rates). Positive beliefs about breastfeeding, norms and ‘exposure’ to breastfeeding and feeding confidence were consistently stronger in Nordic countries, whereas young people in Scotland had more positive beliefs, norms and ‘exposure’ to formula feeding. Differences in parenting beliefs, norms and confidence were less consistent. In logistic regression, cultural group, positive breastfeeding beliefs and exposure, norms, and shared parenting beliefs were significant predictors of breastfeeding feeding intention.ConclusionsPositive beliefs about shared parenting and equal gender norms were related to future breastfeeding intentions for female and male adolescents. Health education programmes for young people could encourage positive breastfeeding choices by considering how this would fit with young people’s ideal parenting roles, and by emphasising benefits of complementary maternal and paternal roles in breastfeeding newborn infants.

Lactation Advice Through Texting Can Help (LATCH): An Analysis of Intensity of Engagement via Two‐Way Text Messaging

Rates of breastfeeding initiation and duration among women who attend the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are dramatically lower than non‐participants. Innovative solutions are needed to improve breastfeeding rates in this population. The LATCH study was one such approach, designed to augment and reinforce the WIC breastfeeding peer counseling process. The purpose of this study was to examine intensity of engagement via two‐way text messaging in a sample of women attending the WIC breastfeeding peer counseling program and enrolled in LATCH. The objectives were to: (1) Describe intensity of text message engagement in the context of LATCH; and (2) Assess the association between intensity of engagement and exclusive breastfeeding status. Text messaging data were first coded qualitatively by two independent researchers and intensity of engagement variables created. An analysis of intensity of engagement was conducted using descriptive statistics for normally distributed data and binary logistic regression.Participants (N = 70) were on average 26.8 years old (SD = 5.0; range: 18 – 41) with an average pre‐pregnancy weight of 158.1 pounds (SD = 46.8) and average body mass index of 28.0 (SD = 6.7), which falls in the overweight range. The average gestational age at recruitment was 23.4 weeks (SD = 3.2; range: 14 – 28). Nearly three‐quarters of the sample self‐identified as Hispanic, more than two‐thirds were single‐never married, more than three‐quarters were living with their partner, 65.7% had other children at home, 61.2% spoke English primarily, and 40.0% had more than a high school education. More than half of participants (55.2%) had previous breastfeeding experience and of those who had other children at home (n=46), just 8 had no previous breastfeeding experience.A larger volume of one‐ and two‐way SMS exchanges and MMS clicks occurred during the prenatal period. However, only post partum intensity of engagement was significantly associated with breastfeeding status at two weeks such that those who were exclusively breastfeeding averaged 1.26 more two‐way exchanges compared to the partial/no breastfeeding women (p = 0.037). The average number of breastfeeding issues addressed by BFPC's in the post partum period was significantly associated with breastfeeding status. Those who were exclusively breastfeeding had an average of 1.31 more breastfeeding issues addressed than partial/no breastfeeding women (p =0.008). In the multivariable model, controlling for baby's age at the time of the two week interview, onset of lactation, mother's age, parity, pre‐pregnancy BMI, and infant feeding intentions, the number of breastfeeding issues addressed during the first two weeks post partum was the single strongest predictor of exclusive breastfeeding status [OR = 1.69; 95% CI (1.12, 2.57)]. Pre pregnancy BMI also significantly predicted exclusive breastfeeding status [OR: 0.88; 95% CI (0.79, 0.98)]. LATCH is an innovative intervention designed to enhance the capacity of breastfeeding peer counselors and holds much potential for improving exclusive breastfeeding rates in this population.Support or Funding InformationThis project has been funded with Federal funds from the U.S. Department of Agriculture, Food and Nutrition Service through grant WIC NEI‐12‐TX to Baylor College of Medicine to Dr. Rafael Pérez‐Escamilla at Yale University. The contents of this publication do not necessarily reflect the view or policies of the U.S. Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

DOES BREASTFEEDING INTENTION AMONG PREGNANT MOTHERS ASSOCIATED WITH EARLY INITIATION OF BREASTFEEDING

Background: Early initiation of breastfeeding is defined as breastfeed started immediately after birth delivery up to one hour , and it will lead to successfull exclusive breastfeeding. Skin-to-skin contact during early initiation of breastfeeding gives positive health impact to both mother dan baby. However, national coverage of early initiation of breasfeeding in Indonesia was 34,5% in 2014 which was lower than global coverage (50%). Objective: To examine the relationship of of breastfeeding intention among pregnant mothers towards early initiation of breastfeeding in two Mother and Child Hospitals, in South Tangerang. Methods: A prospective study conducted in August-November 2016. A sample of 152 third trimester pregnant mothers were from the 2 selected hospitals, taken by purposive sampling. Early breastfeeding initiation (EBI) was measured by interview based structured questionnaire and breastfeeding intention measured by The Infant Feeding Intention scale (IFI). Results : A total of 56.6% of mothers breastfeed during 1 hour after delivery. EBI was done by 71.1% of mothers with high breastfeeding intention. It was the most dominant variable related to early breastfeeding (p = 0.000; OR=5.249;95%CI:2.321-11.870) after controlling other variables. Conclusion: Mother with high breastfeeding intention 5 times more likely to initiate breastfeeding, than those having the low ones. Early promotive, preventive and intervention can be done by measuring breastfeeding intentions during pregnancy. Further research is needed to analyze breastfeeding initiation towards exclusive breastfeeding.

Validation of the Arabic Version of the Infant Feeding Intentions Scale Among Lebanese Women.

The Infant Feeding Intentions (IFI) scale was shown to reliably measure maternal intentions to initiate breastfeeding and continue exclusive breastfeeding until 1, 3, or 6 months in English and Spanish but not in Arab contexts. Research aim: This study aimed to validate an Arabic version of the IFI scale (IFI-A) and examine its ability to predict exclusive breastfeeding at 1, 3, or 6 months in pregnant Lebanese women. The internal consistency reliability and construct validity of the IFI-A scale were tested on 50 pregnant women (Group 1), whereas its predictive ability was tested on 196 pregnant women (Group 2), who were surveyed monthly about their infants' nutrition method until 6 months. The IFI-A scale's Cronbach's alpha internal consistency reliability is .82. Its corrected item-total correlations ranged from .26 for Item 2 ("at least give breastfeeding a try") to .86 for Item 4 ("will be exclusively breastfeeding at 3 months"). Exploratory factor analysis revealed that it is unidimensional. IFI-A scores correlated significantly with exclusive breastfeeding duration in Group 1 ( r = .624; p = .001) and with participants' breastfeeding attitude ( r = .390; p < .001) and previous breastfeeding duration ( r = .237; p = .011) in Group 2, thus confirming its external construct validity. In adjusted analysis, the IFI-A scale predicted exclusive breastfeeding at 3 months, albeit weakly (odds ratio = 1.16; 95% confidence interval [0.99, 1.36]), but not at 1 or 6 months. The IFI-A scale is a reliable and valid tool to assess maternal feeding intentions and predict exclusive breastfeeding at 3 months in the Arab context. Further studies are needed in other Arab contexts to confirm our findings.

Intentions and barriers toward breastfeeding among Jordanian mothers-A cross sectional descriptive study using quantitative method.

Breastfeeding is very important for both mother and infant. Within Jordanian hospitals, intentions and barriers to breastfeeding have not been addressed effectively during preparing policies in routine antenatal care or in maternal and child health care. To identify the intentions and barriers toward breastfeeding among Jordanian mothers with a specific focus on women from low income circumstances. A cross-sectional descriptive study using quantitative methods was adopted in this study. Data was collected via the Modified Infant Feeding Intention Scale (MIFIS). Women reported that for the most part their intention to feed their babies was using formula milk. However, they reported a desire to breastfeed but this intention could be hindered due to limited social support and challenges related to work arrangements. Further, participants also reported concerns regarding perceived pain that breastfeeding may cause and concerns regarding changes in their body shape and weight as a result of breastfeeding. Views toward breastfeeding among Jordanian women are not homogeneous. Policymakers and nurse educators should be cognizant of findings from this study and use them as guidelines for decision making. Efforts to improve intention toward breastfeeding can be achieved through structured and targeted educational programs for women from low income circumstances, and by modifying policies concerning work conditions for mothers to enable them to breastfeed their babies.

The Infant Feeding Genogram: a tool for exploring family infant feeding history and identifying support needs.

BackgroundFamily culture and beliefs are passed through the generations within families and influence what constitutes appropriate infant care. This includes infant feeding decisions where a family history and support network congruent with women’s infant feeding intentions has been shown to be important to women’s breastfeeding experience. This is reflected in breastfeeding rates where women who were not breastfed themselves are less likely to initiate and continue with breastfeeding. Given the importance of family infant feeding history in the initiation and duration of breastfeeding, and the limited ability of some families to provide support; it is unclear why infant feeding family history and support networks are not explored during pregnancy.MethodsThe Infant Feeding Genogram was adapted from a simple pictorial device that is widely used in psychotherapy and genetic counselling. This tool was developed as part of a study investigating the experience of women when they were the first to breastfeed in their family. Fourteen Scottish participants completed their Infant Feeding Genogram as part of a semi-structured interview. The tool was adapted alongside their narratives to give a visual representation of each participant’s family infant feeding history.ResultsThe utility of the genogram is illustrated through two contrasting case examples with very different family feeding histories. The genogram showed family structures, patterns of infant feeding over time, and supportive or conflicting relationships. In the research setting it assisted women to explore their infant feeding history, identify challenges and sources of support and build rapport with the interviewer.ConclusionsThe infant feeding genogram is proposed as a time efficient tool that could assist health professionals and other breastfeeding workers to support women and their families and by stimulating discussion around breastfeeding, Bby identifying strengths or possible deficits in social support for each individual, the tool could inform tailored support and care interventions. The effectiveness and acceptability of the Infant Feeding Genogram requires testing in the clinical environment. However, its successful application in other clinical contexts, combined with the interest in genealogy in popular culture, mean this is likely to be an acceptable, family friendly way to develop more effective breastfeeding conversations.

Infant feeding intentions of pregnant women in Plateau State, Nigeria

Background: Nigeria has a low rate of exclusive breastfeeding, at 13–17%. Antenatal intention to breastfeed is an important modifiable factor that influences breastfeeding. Aims: This study describes infant feeding intentions of women in Plateau State, Nigeria, and identifies the determinants of infant feeding intentions. Methods: Adopting a cross-sectional design, the study involved 763 pregnant women attending antenatal clinics in the three senatorial zones of Plateau State, Nigeria, who completed a validated questionnaire. Findings: Of the 749 pregnant women who responded, 596 (79.6%) intended to breastfeed, 22 (2.9%) intended to formula-feed while 131 (17.5%) intended to practise mixed feeding. Respondents intended to breastfeed exclusively for 5.9 months (SD ± 2.4) and to continue breastfeeding up to 16 months (SD ± 4). Marital status, antenatal attendance in the previous pregnancy, knowledge about how the woman herself was fed as a baby, and previous breastfeeding experience were significant determinants of breastfeeding intention in this setting. Conclusions: Promoting antenatal attendance, recognising women who are less likely to continue breastfeeding, and providing lactation support by health-care workers, especially for breastfeeding problems, could contribute to higher rates of breastfeeding.

Antenatal breastfeeding intention, confidence and comfort in obese and non-obese primiparous Australian women: associations with breastfeeding duration.

Maternal adiposity is known to affect breastfeeding initiation and duration via both antenatal and postnatal factors. This study investigates associations between maternal pregravid body mass index (BMI), breastfeeding duration and antenatal breastfeeding confidence, intention and social comfort among primiparous Australian women. Women in their first pregnancy (n=462) were recruited by convenience sampling in Queensland, Australia. Participants responded to an antenatal and six postnatal questionnaires during their infants' first year between June 2010 and March 2012. Maternal pregravid BMI was examined against breastfeeding duration, participants' antenatal infant feeding intentions and measures of breastfeeding confidence and social comfort. Breastfeeding initiation in this cohort was 97%, but 46% of mothers had ceased breastfeeding at 52 weeks postpartum. Breastfeeding duration differed significantly (χ(2) (2)=7.21, P=0.007) between normal, overweight and obese women. No differences were found in antenatal intention for feeding type nor intended breastfeeding duration by one-way ANOVA (F(2,178)=1.77, P=0.17). More than half of the pregnant respondents anticipated social discomfort breastfeeding in public, with obese women significantly more likely to anticipate discomfort breastfeeding in the presence of close female friends, (χ(2) (1)=5.53, P=0.019). This study confirmed the risk of premature cessation of breastfeeding for obese mothers. Interventions during pregnancy that address body image issues in relation to breastfeeding may facilitate breastfeeding success for obese mothers and their infants and accrue short- and long-term health benefits for both.