Infant Feeding Knowledge Research Articles

Maternal perceptions of breastfeeding and infant nutrition among a select group of Maasai women

BackgroundAdverse health outcomes are higher among Maasai children in the Ngorongoro Conservation Area compared to other co-located ethnic groups and regions of Tanzania. The Mama Kwanza Socioeconomic Health Initiative, a Canadian-Tanzanian partnership delivering healthcare at clinics in this region, gathered perceptions of mothers regarding breastfeeding and infant nutrition in order to inform culturally sensitive, realistic, and effective health promotion efforts.MethodsA qualitative description approach was used in interviewing 30 Maasai mothers of infants zero to six months of age to explore their infant feeding practices, beliefs, knowledge, and recommendations to support breastfeeding. A local research team was trained to conduct and transcribe the interviews and assist with data interpretation. Qualitative content analysis was used in analyzing the interview transcripts.ResultsLactation is universal in this culture with all the mothers planning to breastfeed for at least one year and most having initiated breastfeeding within one hour of birth. Lactation skills and knowledge are passed down intergenerationally from the elder women. None of the infants less than six months were exclusively breastfed, with a variety of liquid and semi-solid supplements given. Mothers perceived their milk alone was nutritionally insufficient with maternal dietary deficiencies cited as a factor.ConclusionsWhile there is a strong breastfeeding culture among the Maasai in Ngorongoro, intersectoral efforts are required to provide culturally respectful health education on the benefits of exclusive breastfeeding and to ensure the maternal dietary adequacy required to achieve this goal. The findings reinforce the importance of international health projects adapting health promotion initiatives to local realities and beliefs in efforts to improve maternal child health.

Age-appropriate feeding practices of mothers and nutritional status of infants in an urban community in Kano State, North West Nigeria

BACKGROUND: Age-appropriate infant feeding practice, a major determinant of child growth, development, and survival, remains suboptimal in many developing countries. OBJECTIVES: This study determined the mother's nutritional knowledge, infant feeding practices, nutritional status of their infant, and factors associated with infant feeding practice in an urban community in Kano State. MATERIALS AND METHODS: A cross-sectional study was conducted in selected communities in Kano Municipal, one of the urban local government areas in Kano State. Using mixed method of data collection, a semi-structured questionnaire was administered to 440 mothers and their infants, and three focus group discussions (FGDs) with ten participants in each group were conducted for mothers of infants. Anthropometric indices were used to determine the children's nutritional status. Data were analyzed using the Statistical Package for the Social Sciences statistical software (version 21), while thematic analysis was used to summarize data from the FGDs. RESULTS: Majority of the mothers (87.5%) had adequate knowledge of infant feeding practices. Few (16.8%) of the mothers breastfed exclusively, and many (82.5%) of the mothers introduced complementary foods to their infants before 6 months of age. The prevalence of wasting and stunting among infants was 38.9% and 36.4%, respectively. Educational status and antenatal care were associated with good infant feeding practices. CONCLUSION: Although majority of the caregivers had adequate knowledge of infant feeding, it was not translated to good practice, and thus, nutritional status was poor. Mothers with secondary /tertiary level of education were two times more likely to have good infant feeding practice while mothers that had ANC are four times more likely to have good infant feeding practices Efforts should be made to improve girl child education and develop sustainable strategies to improve feeding practices and nutritional status of children.

Knowledge, Attitude, Prior Exposure and Intention to Breastfeed among Undergraduate University Students

Introduction: The Theory of Planned Behaviour by Ajzen (1985) states that breastfeeding intention which is made prior to pregnancy predicted future breastfeeding outcomes and also influenced by factors including attitude, knowledge and exposure. The goal of this study was to investigate the level of breastfeeding knowledge, attitude, prior exposure and intention to breastfeed and the relationship between these factors among non-pregnant, single undergraduates. There are limited studies in Malaysia involving young adults who will be future parents. Methods: This cross-sectional study involved 377 students in UiTM Puncak Alam, Selangor. Self- administered questionnaires adapted from Infant Feeding Knowledge Test and Iowa Infant Feeding Attitude Score (IIFAS) were included as research instruments. Results: Overall study population had a low level of knowledge (10.61±2.10) and attitude (60.64± 5.02) towards breastfeeding, high exposure (2.7±0.52) and intention (4.74±0.64) to breastfeed especially in females. Breastfeeding knowledge is significantly associated with breastfeeding attitude and prior breastfeeding exposure. Breastfeeding intention also established an association with breastfeeding attitude and prior breastfeeding exposure. Subsequent predictive analysis found that breastfeeding attitude impacts breastfeeding intention. Conclusion: Breastfeeding intervention should target undergraduate university students in preparing these future parents with adequate and accurate knowledge and positive attitudes towards breastfeeding thus, resulting in higher breastfeeding intention and greater efforts of initiation and sustenance of breastfeeding. KEYWORDS: Breastfeeding knowledge, breastfeeding attitude, breastfeeding exposure, breastfeeding intention, university undergraduates

Evaluating effects of prenatal web-based breastfeeding education for pregnant mothers in their third trimester of pregnancy: Prospective randomized control trial

BackgroundEducation is the cornerstone supporting breastfeeding practices. However, the traditional oral education method cannot always satisfy the learning needs of mothers. Objectiveto measure the effectiveness of prenatal web-based breastfeeding education program for Jordanian pregnant mothers in their third trimester of pregnancy on enhancing knowledge, attitude, and self-efficacy of breastfeeding after giving birth. Methodsprospective randomized control trial design was used with sample consisted of 112 pregnant mothers who were recruited from one antenatal clinic in Irbid Governorate. Data collection instruments were the infant feeding knowledge and attitudes (IIFAS) and Breastfeeding Self-Efficacy Scale (BSES) were used to measure self efficacy, knowledge and attitudes regarding breastfeeding. ResultsParticipants of the experimental group were at moderate level of BSES in pre and post intervention with increasing the number of mothers in the same level post intervention. Participants were at a neutral level of IIFAS in both groups generally, they were neither positive to breastfeeding nor to bottle feeding. There was no significant difference between the experimental and control groups on post- intervention scores on BSES and IIFAS. ConclusionThis study is considered the first trial to use new teaching methodologies as internet and website in teaching mothers about breastfeeding. Despite that there were not differences between intervention and control groups, web-based breastfeeding education program may contribute in improving breastfeeding self efficacy. ImplicationsInclusion prenatal web-based breastfeeding education in antenatal clinics at MCHC centers of Ministry of Health. Further research is needed to replicate this study in other Jordanian health settings.

Large-Scale Social and Behavior Change Communication Interventions Have Sustained Impacts on Infant and Young Child Feeding Knowledge and Practices: Results of a 2-Year Follow-Up Study in Bangladesh

BackgroundSustained improvements in infant and young child feeding (IYCF) require continued implementation of effective interventions. From 2010–2014, Alive & Thrive (A&T) provided intensive interpersonal counseling (IPC), community mobilization (CM), and mass media (MM) in Bangladesh, demonstrating impact on IYCF practices. Since 2014, implementation has been continued and scaled up by national partners with support from other donors and with modifications such as added focus on maternal nutrition and reduced program intensity.ObjectiveWe assessed changes in intervention exposure and IYCF knowledge and practices in the intensive (IPC + CM + MM) compared with nonintensive areas (standard nutrition counseling + less intensive CM and MM) 2 y after termination of initial external donor support.MethodsWe used a cluster-randomized design with repeated cross-sectional surveys at baseline (2010, n = 2188), endline (2014, n = 2001), and follow-up (2016, n = 2400) in the same communities, among households with children 0–23.9 mo of age. Within-group differences over time and differences between groups in changes were tested.ResultsIn intensive areas, exposure to IPC decreased slightly between endline and follow-up (88.9% to 77.2%); exposure to CM activities decreased significantly (29.3% to 3.6%); and MM exposure was mostly unchanged (28.1–69.1% across 7 TV spots). Exposure to interventions did not expand in nonintensive areas. Most IYCF indicators in intensive areas declined from endline to follow-up, but remained higher than at baseline. Large differential improvements of 12–17 percentage points in intensive, compared with nonintensive areas, between baseline and follow-up remained for early initiation of and exclusive breastfeeding, timely introduction of foods, and consumption of iron-rich foods. Differential impact in breastfeeding knowledge remained between baseline and follow-up; complementary feeding knowledge increased similarly in both groups.ConclusionsContinued IPC exposure and sustained impacts on IYCF knowledge and practices in intensive areas indicated lasting benefits from A&T's interventions as they underwent major scale-up with reduced intensity. This trial was registered at clinicaltrials.gov as NCT02740842.

Hindering factors of infant feeding practices among the mothers of mid western part of Nepal

Background and Objectives: This study was aimed to provide baseline information on infant feeding knowledge, practices and hindering factors for proper feedings.Material and Methods: Among the 185 women with less than one year child coming on immunization clinic of health post of Chisapani Village Development Committee, infant feeding knowledge, practices were assessed by interviewing with semi structured questionnaire and focus group discussion.Results: Male children were more exclusively breastfed (33%) than female (27%) and exclusive breast feeding was lower in fifth and sixth month of age. All of them were aware that the baby should be fed only breast milk for 6 months, but the exclusive breastfeeding practice was found only in a very few mothers. Most of them had fed solid food after 3 months.Conclusion: Knowledge and practices on infant feeding do not go along despite the adequacy of knowledge due to the hindering factors like poverty, working mother, lack of support from family members and lack of support from the government infant. The gap between knowledge and practice can be lessened via informative activities on lactation management, endorsing policies and rights for mothers-infants relationship.

What it takes: evidence from a nutrition- and gender-sensitive agriculture intervention in rural Zambia

ABSTRACTThe Realigning Agriculture for Improved Nutrition (RAIN) project was designed to address child undernutrition through a multisectoral approach which integrated agricultural diversification to improve access to nutritious foods, the promotion of gender equality and women’s empowerment and nutrition behaviour change communication to improve infant and young child feeding (IYCF) knowledge and practices. This paper presents the intention-to-treat impacts of the RAIN project on women’s empowerment, IYCF knowledge and practices and child anthropometry. Findings on programme impacts on agricultural production, household food security and dietary diversity and maternal and child dietary diversity are reported elsewhere. The RAIN project had positive effects on women’s empowerment, IYCF knowledge, child morbidity and weight-for-height z-scores, but had little impacts on IYCF practices, and no impact on stunting. Strengthening programme implementation and fostering higher participation rates could support greater impacts on child nutrition outcomes.

Knowledge, attitude and practice of infant feeding in the first 6 months among HIV-positive mothers at the Queen Mamohato Memorial hospital clinics, Maseru, Lesotho.

BackgroundThe balance between the risks of transmission of human immunodeficiency virus (HIV) through breastfeeding and its life-saving benefits complicates decisions about infant feeding among HIV-positive mothers in the first 6 months.ObjectiveThe aim of this study was to assess the knowledge, attitude and practice of infant feeding among HIV-positive mothers attending the prevention of mother-to-child transmission services in Maseru, Lesotho.Method and settingThis observational cross-sectional study was done by collecting data from HIV-positive mothers attending the filter clinics of Queen Mamohato Memorial hospital in Maseru, Lesotho. HIV-positive mothers with infants below the age of 6 months attending the clinics at the time of the study were interviewed using a standardised questionnaire. We described the sociodemographic profile of the mothers, the information and education received on prevention of mother-to-child transmission (PMTCT) infant feeding options, the mothers’ knowledge, attitudes and practices of infant feeding, and assessed risk factors for improved knowledge, attitudes and practices.ResultsThe majority (96%) of the 191 HIV-positive mothers who participated in the survey knew about the PMTCT programme and related breastfeeding services. Most of the participants chose to breastfeed (89%), while only 8% formula-fed their infants. Knowledge received during the PMTCT programme was significantly associated with the decision to exclusively breastfeed their infants. Earlier infant feeding counselling and education was associated with more exclusively breastfeeding as compared to late infant feeding counselling (p < 0.001).ConclusionThe study found that HIV-positive mothers attending health clinics in Maseru, Lesotho, had high knowledge, and appropriate attitudes and practices with respect to infant feeding; and that early counselling and education improved infant feeding methods among these mothers.

Men's views and experiences of infant feeding: A qualitative systematic review.

Although the advantages of breastfeeding are well documented, rates for breastfeeding often fall short of international and national targets. Increasing attention has been paid to the role of men in infant feeding, but a lot of the research about men has been elicited from women, rather than from men themselves. To explore these issues further, a systematic review of the qualitative research on infant feeding was carried out, focusing specifically on men's own views and experiences. Evidence was identified by searching electronic databases (CINAL, Cochrane, PubMed, and Scopus), manually searching citations, and by searching the grey literature. Studies were included in the review if they discussed men's views and experiences of infant feeding and if they reported primary qualitative data. Twenty research papers were included in the review, and each study was summarised and then analysed thematically to produce a synthesis. Five major analytical themes were identified: men's knowledge of infant feeding; men's perceptions of their role in infant feeding; positive views on breastfeeding; negative views on breastfeeding; and men's experiences of health promotion and support. The review concludes by highlighting that although men can play an important role in supporting women, they do not have a significant role in infant feeding decisions.

Infant Feeding Beliefs, Attitudes, Knowledge and Practices of Chinese Immigrant Mothers: An Integrative Review of the Literature.

Chinese are a fast-growing immigrant population group in several parts of the world (e.g., Australia, Canada, Europe, Southeast Asia, United States). Research evidence suggests that compared to non-Hispanic whites, individuals of Asian-origin including Chinese are at higher risk of developing cardiovascular disease and type 2 diabetes at a lower body mass index (BMI). These risks may be possibly due to genetic differences in body composition and metabolic responses. Despite the increasing numbers of Chinese children growing up in immigrant families and the increasing prevalence of obesity among Chinese, little research has been focused on children of Chinese immigrant families. This integrative review synthesizes the evidence on infant feeding beliefs, attitudes, knowledge and practices of Chinese immigrant mothers; highlights limitations of available research; and offers suggestions for future research. Using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we searched four electronic academic/research databases (CINAHL, Medline, PsycINFO, and PubMed) to identify peer-reviewed, full-text papers published in English between January 2000 and September 2017. Only studies with mothers 18+ years old of normally developing infants were included. Of the 797 citations identified, 15 full-text papers were retrieved and 11 studies (8 cross-sectional studies, 3 qualitative studies) met the inclusion criteria and were included in this review. Reviewed studies revealed high initiation rates of breastfeeding, but sharp declines in breastfeeding rates by six months of age. In addition, reviewed studies revealed that the concomitantly use of breast milk and formula, and the early introduction of solid foods were common. Finally, reviewed studies identified several familial and socio-cultural influences on infant feeding beliefs and practices that may increase risk of overweight and obesity during infancy and early childhood among Chinese children of immigrant families. Nonetheless, as only 11 studies were identified and because the majority of studies (n = 8) were conducted in Australia, additional research including longitudinal studies, and studies conducted in countries with large Chinese immigrant population are needed to further identify and understand influences on Chinese immigrant mothers’ beliefs, attitudes, and practices related to infant feeding that may increase risk of child overweight and obesity. This information is needed to develop interventions tailored to the beliefs and needs of this fast-growing immigrant group and aimed at promoting healthy infant feeding practices to prevent childhood overweight and obesity.

Only half of the mothers practiced early initiation of breastfeeding in Northwest Ethiopia, 2015

BackgroundEarly initiation of breastfeeding has been well-recognized in reducing neonatal mortality; however, it remains sub-optimal in Ethiopia. This study therefore assessed the prevalence of early initiation of breastfeeding and associated factors among mothers with children aged 6–24 months in Dabat Health and Demographic Surveillance System (HDSS) site, northwest Ethiopia, where literature on the issue is markedly scarce.MethodsThis community-based cross-sectional survey was carried out from May to June, 2015, at Dabat HDSS site, Dabat District. Eight hundred twenty-two mother–child pairs were included in the study. A multivariable logistic regression model was employed to identify factors associated with early initiation of breastfeeding.ResultsThis study demonstrated that the prevalence of early initiation of breastfeeding was 53.3%. Institutional delivery (AOR = 4.9; 95% CI 3.2, 7.4), higher Infant and Young Child Feeding (IYCF) knowledge (AOR = 2.3; 95% CI 1.6, 3.3), higher wealth status (AOR = 4.1, 95% CI 2.8, 6.0) and low fathers’ education (AOR = 0.3, 95% CI 0.2, 0.6) were significantly associated with early initiation of breastfeeding in the multivariate analysis.ConclusionIn summary, the coverage of early initiation of breastfeeding in Dabat HDSS site was low, considerably below the national target. Therefore, efforts should be intensified to step-up early initiation of breastfeeding by focusing on the identified determinants.

Perceptions of breast milk expression practices among working mothers

Background: Working women often feel unable to practise exclusive breastfeeding if they return to work early. Expressing breast milk is an option to ensure exclusive breastfeeding. Aims: The aim of this study was to explore the working mothers' knowledge, perceptions and breast milk expression practices. Methods: A descriptive cross-sectional study design was used to administer a structured questionnaire to 217 working breastfeeding mothers attending the postnatal clinic at Mulago Hospital, Uganda. Simple random sampling was used to select women who consented before completing the questionnaire. Data was analysed using descriptive statistics. Findings: The respondents (79.3%) were knowledgeable about breast milk expression but only a few knew about the storage and use of expressed breast milk. Breast milk expression was not practised by most of the mothers (73.7%), and the majority (64.5%) did not like to express breast milk, raising doubts on acceptability, hygiene and safety. Chi-square (χ2) tests showed an association between breast milk expression and level of education (χ2=5.595; P=0.018), occupation (χ2=4.678, P=0.031), infant feeding practices (χ2=9.617; P=0.002), knowledge (χ2=16.97; P&lt;0.00), and perception (χ2=13.772; P&lt;0.00) of breast milk expression. Conclusions: The results highlighted important knowledge gaps about breast milk expression. There is a need to design and implement interventions to sensitise and support women to express breast milk for continued exclusive breastfeeding.

Influences on Infant Feeding: Perceptions of Mother-Father Parent Dyads.

The purpose of this study was to examine interrelational-, organizational-, and community-level influences on how coparents collaborate about infant and toddler feeding. Using qualitative methods, we interviewed mother-father parent dyads to explore the potential influences on infant and toddler feeding. Participants were purposively recruited from two Midwest, rural, university-system pediatric clinics. Thematic analysis was used to code the data. Mother-father dyadic interviews were conducted using a semistructured interview schedule. Twenty-four mother-father dyads who had a child between the ages of 6 and 36 months were interviewed together. Major themes include interpersonal factors (peer behavior reinforcement, dyad and important others infant feeding conflict, conflict resolution proactiveness), organizational factors (healthcare provider infant-feeding support, workplace flexibility), and community factors (public perception on breastfeeding and social media influence). Community-based collaboration can be a platform for mother-father dyads, researchers, public health nurses, and other healthcare providers to proactively create interventions that include opportunity for building coparenting skills and infant-feeding knowledge that promote team management of common early childhood feeding challenges.

Predictors of exclusive breastfeeding and consumption of soft, semi-solid or solid food among infants in Boucle du Mouhoun, Burkina Faso: A cross-sectional survey.

IntroductionExclusive breastfeeding is among the most effective interventions for preventing child mortality. The objectives of this paper are to describe infant feeding knowledge and practices in Boucle du Mouhoun, Burkina Faso; to identify predictors of exclusive breastfeeding among infants <6 months, and consumption of soft, semi-solid or solid food among infants 6–11 months; to describe mothers’ sources of information regarding breastfeeding.MethodsA cross-sectional survey (n = 2288) of a representative sample of women aged 15–49 years with at least one live birth in past year took place during June and July 2015. Crude and multivariable random-effects logistic regressions were used to identify factors predictive of exclusive breastfeeding and consumption of soft, semi-solid or solid food.Results30% of infants <6 months were exclusively breastfed; 67% of infants age 6–11 months consumed soft, semi-solid or solid food the day and night before the interview. 2% of infants age 6–11 months had a minimum acceptable diet. There was strong evidence of a positive association between knowledge and practice of exclusive breastfeeding, nonetheless 60% of mothers who correctly identified that an infant should be exclusively breastfed for 6 months did not breastfeed their infant exclusively. Only 42% of mothers reported receiving advice on breastfeeding from a health worker, despite all mothers having contact with a health worker at least once during pregnancy or postpartum.ConclusionGiven poor practices and low levels of knowledge, targeted interventions are needed to improve infant nutrition in Boucle du Mouhoun during antenatal, delivery and postnatal care. Most women now deliver in a facility in Burkina Faso; increased attention should be paid to ensuring that existing guidelines relating to support and counselling for infant feeding are adhered to. Factors such as social norms are also important and these should be investigated in more detail using qualitative methods.

Infant feeding counseling and knowledge are the key determinants of prelacteal feeding among HIV exposed infants attending public hospitals in Ethiopia

BackgroundDespite the fact that breastfeeding promotes optimal health and growth for infants and young children, inappropriate feeding practice, such as prelacteal feeding increases the risk of neonatal death and illness and remains a public health problem in Ethiopia. Therefore, this study assessed the prevalence of prelacteal feeding and associated factors among HIV positive mothers with children aged 7–20 months attending government hospitals in North Gondar zone, northwest Ethiopia.MethodsAn institution based cross-sectional study was conducted from February to March, 2016, at public hospitals of North Gondar Zone. Three hundred sixty-seven HIV positive mothers attending PMTCT clinics in government hospitals during the study period were included in the study. A multivariate logistic regression analysis was used to investigate factors associated with prelacteal feeding. The Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was used to show the strength of association, and variables with a P-value of <0.05 were considered statistically significant.ResultsIn this study, the overall prevalence of prelacteal feeding was 19.1% (95% CI: 15–23). According to the multivariate analysis, prelacteal feeding was associated with fathers with no formal education (AOR = 5.85; 95% CI: 2.02, 16.92), lack of infant feeding counseling (AOR = 3.36; 95% CI: 1.27, 8.85), discarding the colostrum (AOR = 5.16; 95% CI: 2.32, 11.45), inadequacy of antenatal care visit (AOR = 0.07; 95% CI: 0.03, 0.15), and high IYCF knowledge (AOR = 0.10; 95% CI: 0.03, 0.30).ConclusionIn this study, the prevalence of prelacteal feeding was high. Furthermore, father’s education, colostrum feeding, infant feeding counseling, ANC visit, and IYCF knowledge were significantly associated with prelacteal feeding. As a result, strengthening maternal health care utilization, breastfeeding counseling, and IYCF knowledge are essential to address the high burden of prelacteal feeding.

Maternal participation in a nutrition education program in Uganda is associated with improved infant and young child feeding practices and feeding knowledge: a post-program comparison study

Maternal participation in a nutrition education program in Uganda is associated with improved infant and young child feeding practices and feeding knowledge: a post-program comparison study

Maternal participation in a nutrition education program in Uganda is associated with improved infant and young child feeding practices and feeding knowledge: a post-program comparison study

BackgroundCost-effective approaches to improve feeding practices and to reduce undernutrition are needed in low-income countries. Strategies such as nutritional counseling, food supplements, and cash transfers can substantially reduce undernutrition among food-insecure populations. Lipid-based nutrient supplements (LNS) are an increasingly popular strategy for treating and preventing undernutrition and are often delivered with nutrition education. The post-program effects of participation in a LNS-supported supplemental feeding program on Infant and Young Child Feeding (IYCF) practices and caregiver child feeding knowledge are not well understood. The objective of this study was to understand whether children’s diet quality and caregiver nutrition knowledge was improved after participation in such a program.MethodsWe conducted a post-program comparison group study to compare feeding practices and caregiver nutrition knowledge among mother-child dyads who completed a nutrition education program and a community comparison group in western Uganda. We administered a feeding practices survey and two 24-h dietary recalls to 61 Post-Program (PP) caregivers and children ages 6 to 59 months (mean age = 25.1 months) who participated in a supplemental feeding program (which included growth monitoring, caregiver nutrition education, and LNS) and a Comparison Group (CG) of 61 children and caregivers. PP caregivers were recruited 4 to 8 weeks after program participation ended. We hypothesized that PP caregivers would report better IYCF practices and greater knowledge of key nutrition education messages related to IYCF.ResultsPP children had higher dietary diversity scores (3.0 vs 2.1, p =0.001) than CG children, and were more fed more frequently (3.0 vs 2.1 times per day, p = 0.001). IYCF indicators were higher in the PP group for minimum meal frequency (44.8% vs. 37.9%), minimum dietary diversity (10.3 vs. 3.4%), iron-rich complementary foods (17.2 vs. 20.7%), and minimally acceptable diet (10.3% vs 3.6%), but differences were non-significant. Caregivers in the PP group demonstrated greater knowledge of healthful IYCF practices.ConclusionsNutrition education can be effective to improve caregiver feeding practices and children’s dietary diversity and the frequency by which they are fed. A 10-week nutrition education and supplemental feeding program appears to provide some benefit to children in terms of dietary diversity and frequency of meals, and caregiver knowledge of feeding 1 to 2 months after program completion. However, children in this rural Ugandan region have diets that are still largely inadequate, highlighting the need for enhanced interventions and policies to promote diverse and appropriate diets for young children in this region. Future follow-up work in LNS-supported programs is recommended to understand how other similar approaches influence children's diet quality after program completion in other contexts.

Understanding the Effect of Community‐Based Health and Nutrition Program on Uptake of Iron and Folic Acid Supplementation and Breastfeeding Practices in a Pastoralist Community in Rural Ethiopia

Maternal and child health and nutrition are important issues to address in Ethiopia. Poor socioeconomic context and inadequate healthcare affects availability, access, and utilization of health services. The Community‐Based Maternal and Neonatal Health and Nutrition (CBMNH‐N) project by the Micronutrient Initiative aimed at strengthening the health system capacity to improve access and quality of maternal and newborn health and nutrition services by increasing the knowledge and skill of community health workers, traditional birth attendants, and health care providers. We undertook a qualitative inquiry from the endline data from four intervention and six comparison woredas to understand the effect of CBMNH‐N project on iron and folic acid supplementation and breastfeeding practices in the Afar community in Ethiopia. We used open coding to identifying themes and analyzed 46 key informant interviews from fathers, health extension workers, midwives, traditional birth attendants, and clan leaders, and 11 focus‐group discussions with pregnant and lactating mothers. Overall, mothers, health workers, and community members in the intervention woredas were more knowledgeable about the use of iron and folic acid supplementation and showed improvement in early initiation and exclusively breastfeeding practices as compared to the comparison woredas. Mothers noted that health extension workers were instrumental in increasing knowledge and awareness of iron and folic acid supplements, and trained traditional birth attendants helped with follow‐up and compliance in taking the supplements. Program efforts helped the community, including clan leaders to be more aware and supportive of the importance of iron and folic acid supplementation during pregnancy and the post‐partum period. Community members and clan leaders also noted the importance of early initiation and exclusive breastfeeding. Most respondents also discussed the change from traditional feeding practices such as providing the baby with goat milk to putting the baby to the breast immediately after birth and exclusively breastfeeding. Mothers, health extension workers, and traditional birth attendants were aware of the health benefits of exclusively breastfeeding. Several respondents attributed their knowledge of infant feeding to health education provided by the health extension workers and traditional birth attendants. Our findings suggest that community‐based programs can build capacity, increase knowledge, and improve health practices that can ultimately promote maternal and child health and nutrition.Support or Funding InformationFunding: Micronutrient Initiative

The Relationship of Knowledge and Breastfeeding Practice to Maternal BMI

ABSTRACTThis study aimed to investigate the effect of breastfeeding on maternal BMI and evaluate mothers’ knowledge of infant feeding in Samsun, Turkey. A total of 289 mothers who had children ranging from 0 to 2 years of age and applied to the Family Health Centers were included in the study. The mothers filled out a questionnaire covering sociodemographic characteristics and knowledge on infant feeding. The data was evaluated using the SPSS with the descriptive statistics, the Student t-test, the chi-square test, and multiple linear regression analyses. Most of the mothers, who did never breastfeed their children, were either overweight or obese. As a result of the multiple linear regression analysis, we concluded that maternal age, number of pregnancies, time of first breastfeeding ≥ 12 hours, and early introduction of complementary foods positively affect maternal BMI. Increased maternal BMI is thought to be negatively correlated with decreased breastfeeding of babies immediately after birth.

Infant feeding knowledge and practices among lactating mothers in Kwale County, Kenya

Background: Lactating mother’s knowledge on infant feeding and its practices are key determinants of children’s nutritional status and future food habits. In Kenya, stunting rates among children below five years is 26 %. Objective: To assess infant feeding knowledge and practices among lactating mothers in Kwale County where stunting stands at 29%. Design: A cohort study. Setting: Maternal and Child Health clinics or respective households. Subjects: Lactating mothers who were part of the baseline survey. Results: One hundred and ninety-seven lactating mothers were interviewed. Most mothers (65.3%) had knowledge of breastfeeding within the first hour and majority (91.8%), gave colostrum to the newly born. Majority (84%) had no knowledge on expressing a mother’s milk for later use. Complementary feeds had been introduced by 48.2% of which more than a quarter gave before six months. Maize meal porridge was the common weaning food in addition to mother’s milk. There was a significant relationship between: breast feeding advice given during antenatal care and use of colostrum (r = 0.165, N = 197, p = 0.021); breastfeeding initiation and pre-lacteal feeding (r = - 0.264, N = 197, p = 0.0001); parity and place of birth (r = 0.184, N = 197, p = 0.001) as well as pre- lacteal feeding and use of colostrum (r = - 0.289, N = 197, p = 0.0001). Conclusion: There was poor knowledge of preservation of mother’s milk and dietary diversity during complementary feeding. There is need for an intervention to empower mothers on best practices for optimal growth and development of infants.