Iowa Infant Feeding Attitude Scale Research Articles

The Relationship between Maternal Factors and the Timely Initiation of Complementary Feeding for Infants, in West Sumatera Province, Indonesia

Objective − This study looked into the relationship between maternal factors and the timely initiation of complementary feeding for infants. Material and Methods − A cross-sectional study was conducted from September to December 2022 on 196 mothers and their children aged 6-23 months. This study collected data through a questionnaire that included sociodemographic informa- tion, the Infant and Young Child Feeding Questionnaire for Child Care Providers (IYCF-CCPQ), the Iowa Infant Feeding At- titude Scale (IIFAS), and the time of initiation of complementary feeding.Results − This study included 196 mothers, with 128 (55.1%) having adequate knowledge of complementary feeding and 112 mothers (59.7%) had a negative view of infant feeding. The rate of timely initiation of complementary feeding was 71.4%. The mothers’ knowledge of infant feeding did not predict the timely initiation of complementary feeding (OR=1.18; 95% CI=0.62-2.26). However, maternal attitudes toward infant feeding were linked to the timely initiation of complementary feeding (OR=2.14; 95% CI=1.14-4.02).  Conclusions − Mothers with positive attitudes toward infant feeding were twice as likely to start complementary feeding on time as those with negative at- titudes. Counseling mothers on the importance of timely initiation of complementary feeding is therefore required to improve mothers’ attitudes toward providing complementary foods to their infants in accordance with health recommendations.

The effect of birth memory, recall level, and related factors on breastfeeding attitude of mothers in the postpartum period: a prospective study

AbstractThis study was conducted to examine the effect of birth memory, recall level, and related factors on postpartum mothers’ breastfeeding attitudes. This is a correlational prospective study. The study was conducted in the postpartum clinic of a city hospital in a province located in the Central Anatolia Region of Turkey. The study included a total of 248 mothers in the early postpartum period. Data were obtained via a Personal Information Form, a Labor Monitoring Form, the Birth Memories and Recall Questionnaire (BirthMARQ), the Birth Satisfaction Scale (BSS), and the Iowa Infant Feeding Attitude Scale (IOWA). A positive correlation was found between mothers’ level of birth memory and recall and breastfeeding attitude on postpartum day 1, month 1, and month 3. In the regression analysis, emotional memory and coherence and reliving, which are the sub-dimensions of the birth memory and recall scale affecting breastfeeding attitude, were found to be significant associated risk factors for the 1st postpartum day, consistency and reliving for the 1st month, and birth memory and recall for the 3rd month. No relationship was found between mothers’ breastfeeding attitude and birth satisfaction on postpartum day 1, month 1, and month 3. Positive birth memory and recall positively affected mothers’ breastfeeding attitude. No relationship was found between mothers’ labor satisfaction and breastfeeding attitude. Supporting women for the formation of positive birth memory and recall for the labor process may positively improve breastfeeding attitudes of mothers in the postpartum period.

Determinants and Prevalence of Exclusive Breastfeeding Among Thai Muslim Mothers: A Cross-sectional Analysis

Exclusive breastfeeding is pivotal for the health and development of infants and offers numerous benefits to mothers. However, unique cultural beliefs and practices, particularly among Muslim communities, can significantly influence breastfeeding behaviors. This study sought to elucidate the factors influencing exclusive breastfeeding among Thai Muslim mothers. The sample was 168 postpartum Muslim mothers from well-baby clinics in southern Thailand, selected through multi-stage random sampling. Data were collected from June to December 2022 employing the Demographic Data Form, Infant Feeding Intentions Scale, Breastfeeding Knowledge Questionnaire, Iowa Infant Feeding Attitude Scale, Breastfeeding Self-Efficacy Scale -Short Form, Maternal Health Literacy Scale, Islamic Belief Scale, Exclusive Breastfeeding Social Support, and Breastfeeding Practices Questionnaire. Data were analyzed using descriptive statistics, Spearman rank’s correlation, and binary logistic regression analysis. The study found that the rate of exclusive breastfeeding among Thai Muslim mothers at six months postpartum was 54.8%. Notably, breastfeeding self-efficacy emerged as the sole predictor of exclusive breastfeeding, accounting for 11% of the variance in this practice. These findings underscore the critical role of breastfeeding self-efficacy in promoting exclusive breastfeeding. It is recommended that nurses and healthcare professionals develop culturally tailored support programs that enhance breastfeeding self-efficacy, aligned with Islamic beliefs, to improve breastfeeding practices among Muslim mothers.

Attitudes and barriers to breastfeeding among women at high-risk for not breastfeeding: a prospective observational study

BackgroundRates of breastfeeding are lower among minority and underserved populations in the United States. Our study objective was to assess pregnant persons attitudes and barriers to breastfeeding among a cohort at high risk for not breastfeeding.MethodsWe disseminated the Iowa Infant Feeding Attitude Scale (IIFAS) to 100 pregnant persons at least 18 years of age attending a prenatal visit in a low-resource, academic practice in south-central Louisiana (Woman’s Hospital). The IIFAS, as well as questions collecting information on breastfeeding experience and sociodemographic characteristics, were administered via interview. Medical records were reviewed to investigate associations between attitudes about breastfeeding in pregnancy and patient’s feeding choices during the delivery hospital stay. Fisher exact tests and Wilcoxon rank-sum tests were used to assess associations between categorical and continuous variables respectively.ResultsOf the 98 participants who completed the study, 8% were Hispanic, 63% were Black, 95% were Medicaid eligible, and 50% were unemployed. 59% (n = 58) went on to breastfeed/combination breast-formula feed (called “Any-Breastfeeding Group”) during the delivery stay. Total IIFAS score during pregnancy was significantly higher among those who went on to breastfeed during delivery hospital stay (Any-Breastfeeding Group vs. Formula-Feeding-Only Group: 58.9 ± 5.5 vs. 53.7 ± 6.2 respectively, p < 0.001). In the group that went on to only formula feed (Formula-Feeding-Only Group), only 4% agreed breastfeeding was more convenient when surveyed during pregnancy, compared to 45% of the Any-Breastfeeding Group. 60% of Formula-Feeding-Only Group agreed formula is as healthy as breast milk.ConclusionThe three major themes that coincided with favorability toward breastfeeding in the study, and can be addressed during prenatal counseling, are: mother-infant bonding, convenience, and health benefits. By identifying attitudes and barriers to breastfeeding for patients during pregnancy who went on to not breastfeed, directed educational opportunities can be developed to address these specific attitudes to ultimately increase breastfeeding initiation and continuation.

The effectiveness of online breastfeeding education and support program on mothers of preterm infants: A quasi-experimental study

ObjectiveTo develop a WeChat-mini-program-based Online breastfeeding education and support program and explore its impacts on promoting mothers of preterm infants’ breastfeeding knowledge, attitudes, self-efficacy, and rates. Design, setting, and participantsThis was a quasi-experimentation with two-group comparisons. The eligible preterm mother-infant pairs were recruited from the NICU within seven days postpartum. The first 25 mothers admitted to the NICU during the study period were included in the control group, and the following 25 mothers were in the intervention group according to the admission order of their preterm infants. A generalized linear mixed model was used to detect the effects of the online intervention program and the interaction effects of group and time. InterventionsThe participants received a 3-month online breastfeeding intervention from a WeChat mini program for the intervention group. MeasurementsMothers of preterm infants’ breastfeeding knowledge, attitudes, self-efficacy, and breastfeeding rates of different patterns were respectively evaluated by the Breastfeeding Knowledge Questionnaire (BKQ), Iowa Infant Feeding Attitude Scale (IIFAS), and Breastfeeding Self-Efficacy Scale (BSES) at three different points of times including before intervention (T0), at one month postpartum (T1) and three months postpartum (T2). FindingsThe breastfeeding knowledge significantly differed between the two groups but without differences between different time points and in the grouping*time interaction. Within the intervention group, significant improvements were observed from T0 to T2 and T1 to T2. No significant differences in breastfeeding attitudes, self-efficacy, and breastfeeding rates were found between and within groups. Key conclusionsThe WeChat-mini-program-based online breastfeeding intervention may improve the breastfeeding knowledge level of mothers of preterm infants but has no significant impact on mothers’ breastfeeding attitudes, breastfeeding self-efficacy, and breastfeeding rates. Implications for practiceThe WeChat mini program can be used to improve the breastfeeding knowledge level of mothers of preterm infants. Future interventions need to target both mothers of preterm infants and their family members by combing online and offline approaches.

Understanding the attitudes towards breastfeeding amongst staff and students in a UK higher institutional setting – a mixed-method cross-sectional study

ABSTRACT Breastfeeding is recognised as a human right and in the UK, it is a legal requirement for employers to provide a space where breastfeeding mothers can rest. Despite this, breastfeeding rates in the UK are amongst the lowest in the world and breastfeeding mothers suffer prolonged loss of earnings compared to those who do not. In response, this study aimed to measure the attitudes to infant feeding among staff and students in a UK higher education institution and understand the experiences of those who have breastfed and/or expressed on campus. A convenience sampling technique was used to recruit 72 staff members and 99 students at the same UK university. Respondents completed an online questionnaire which first presented the Iowa Infant Feeding Attitude Scale and then provided an open text box where people who had experience of feeding on campus could share their experiences. Female respondents were more likely to prefer breastfeeding than men. Students were more likely to prefer breastfeeding than staff. However, raising breastfeeding awareness among both staff and students is required. A realist thematic analysis of the comments made by 17 staff members about their feeding experiences on campus identified a lack of consistency in terms of management and access to suitable facilities to either express milk or breastfeed. It is argued that a combination of education around breastfeeding, visual cues that breastfeeding is welcome, provision of suitable facilities and a clear breastfeeding policy that is consistently implemented is required to support breastfeeding on campus.

Evaluation of Mothers’ Sociodemographic Characteristics and Infant Feeding Attitudes During Pregnancy According to the Iowa Feeding Attitude Scale and Examining the Scale’s Role in Determining Breastfeeding Duration

Introduction: The World Health Organization recommends exclusive breastfeeding for the initial 6 months of life, followed by the introduction of supplementary foods together with breast milk after 6 months, and then continuing to breastfeed until the child reaches 2 years of age. Iowa Infant Feeding Attitude Scale (IIFAS) was developed to identify which infant feeding methods pregnant women are more inclined towards during the early stages of pregnancy. In our study, we aimed to assess the feeding practices of mothers using the IIFAS. Material and methods: The study was planned with consenting pregnant women who applied to the gynaecology clinic, pregnancy outpatient clinic and pediatric outpatient clinic of our hospital. Those who had problems such as drug use, chronic disease, psychological disorder, anatomical disorder that would prevent breastfeeding, syndromic condition, indication for hospitalisation were excluded from the study. A questionnaire regarding the demographic profile of the mothers and the IIFAS was filled out. Subsequently, face-to-face interviews were conducted with the mothers on the seventh day, third month, and sixth month to gather information. Results: The study was completed with 96 mothers. According to the IOWA infant feeding scale scores of the mothers, there were 26 (27.1%) mothers in the breastfeeding-prone group with a score of 70 and above and 70 (72.9%) mothers in the undecided group with a score between 49-69. Since none of the pregnant women scored between 17-48, the group predisposed to formula feeding was not formed. There were no significant variations observed between the groups with regard to age, family type, and mode of delivery; however, there was a notable disparity in the educational and informational statuses of the mothers. Conclusions: The fact that mothers were mostly undecided about the recommendations related to the IIFAS indicates the need for information about breast milk.

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

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

Associated Factors of Exclusive Breastfeeding Intention among Pregnant Women in Najran, Saudi Arabia.

The exclusive breastfeeding (EBF) intention conceived by pregnant women is the most important predictor of breastfeeding (BF) initiation, duration, and continuation. This study explores the associated factors of EBF intention among pregnant women. This was a descriptive cross-sectional study conducted from November 2022 to January 2023 with 382 pregnant women who came to the outpatient clinic in the Maternal and Children Hospital (MCH). Four instruments were used for data collection: the Infant Feeding Intention scale, the Gender-Friendly BF Knowledge scale (GFBKS), the Iowa Infant Feeding Attitude scale (IIFAS), and the basic data questionnaire. The study findings indicated that 51.8% and 75.9% of gravida women had adequate knowledge and a positive attitude regarding BF. Furthermore, 56.3% of the participants had a high intention for EBF. Binary logistic regression illustrated that occupational status, antenatal care, plan for the current pregnancy, BF practice, last child delivery mode, medical disorder during the current pregnancy, age, BF knowledge, and attitude are potential predictors. The goodness of fit test revealed that 46.8% of the EBF intention could be anticipated through the positive pre-mentioned factors. The low EBF intention is modifiable by addressing the previously positive predictors. BF educational interventions should be tailored based on EBF intention predictors in order to be effective and lead to behavior change.

Psychometric Properties of the Spanish Version of the Iowa Infant Feeding Attitude Scale in Fathers.

Research gaps exist with regard to paternal attitudes towards breastfeeding and the association between fathers' attitudes and the type of breastfeeding. To analyze the psychometric properties of the Spanish version of the Iowa Infant Feeding Attitude Scale in fathers, and (2) to examine the association between fathers' attitudes and type of breastfeeding. We used a cross-sectional study design to analyze the scale's psychometric properties and performance. A total of 639 fathers participated in the study. The mean age was 35.83 years (SD = 4.65) and 67.3% (n = 430) were married or in a civil partnership. We observed an adequate fit in the confirmatory factor analysis: TLI = 0.96, CFI = 0.97 and RMSEA = 0.05. The overall internal consistency was 0.76. Between 1-6 months, 48% (n = 307) of participants' babies were exclusively breastfed, 35.2% (n = 225) were partially breastfed, and 16.7% (n = 107) were exclusively formula fed. Statistically significant differences were shown in attitudes towards breastfeeding, depending on the type of breastfeeding, between 1 and 6 months (F = 54.67; p < .001). Fathers who reported that their baby had been exclusively breastfed scored higher on attitudes towards breastfeeding. Statistically significant differences were also found between partial breastfeeding and formula feeding. The Spanish version of the Iowa Infant Feeding Attitude Scale is a valid and reliable instrument for measuring paternal attitudes towards breastfeeding.

University campus breastfeeding, knowledge, and perceptions of support: An exploratory study.

Breastfeeding is often considered principally a biological issue but success is impacted by the socio-ecological environment of the lactating parent. Identifying current attitudes towards breastfeeding is essential in the effort toward normalizing breastfeeding in communities, including university campuses. The study explored campus community knowledge, awareness, and attitudes about breastfeeding, including available resources and applicable laws on two university campuses in the southern United States. This cross-sectional, self-reporting study utilized the Iowa Infant Feeding Attitude Scale and an adaptation of the Breastfeeding Behavior Questionnaire to survey a convenience sample. Results revealed decreased awareness of protective laws, availability of private lactation space, and insufficient public appreciation of breastfeeding's unique advantages to both lactating parent and infant as barriers to breastfeeding. These findings will help develop additional breastfeeding strategies to improve university campus community breastfeeding initiatives.

Prevalence and Factors Influencing Exclusive Breastfeeding Practice among Breastfeeding Mothers in Kathmandu, Nepal

Introduction: Exclusive breastfeeding (EBF) for up to six months has several benefits for children in reducing their morbidity and mortality. The objective of this study was to find out the prevalence of EBF practice and its influencing factors.&#x0D; Methods: A cross-sectional survey was conducted with 362 breastfeeding mothers attending selected health facilities in the Kathmandu district. Data were collected using structured questionnaires through a face-to-face interview. The knowledge, attitudes, self-efficacy and social support of breastfeeding were assessed by Iowa Infant Feeding Attitude Scale (IIFAS), Breastfeeding Self-efficacy Scale Short Form (BSES-SF) and Exclusive Breastfeeding Social Support Scale (EBSSS) scales respectively. Data were analyzed using descriptive and inferential statistics, through SPSS.&#x0D; Results: The prevalence of EBF practices for the six months was 64.1%. The higher proportion (99.2%) of the respondents had high self-efficacy for breastfeeding, 95.3% of the respondents had positive attitudes toward EBF, and 89.8% had high social support for EBF practices. The determinant of the Iowa Infant Feeding Attitude Scale was being a Hindu religion (aOR 6.1, 95% CI, 2.23-16.58). The determinants of the exclusive breastfeeding social support scale were being a mother who did colostrum feeding (aOR 11.8, 95% CI, 2.29-61.14), had institutional delivery (aOR 7.4, 95% CI, 2.21-24.54), and had school level education (aOR 3.6, 95% CI, 1.54-8.53). The determinants of EBF practices were of being an unemployed mother (aOR 2.7, 95%CI, 1.40-5.07) and mothers aged 26 year-old and below (aOR 1.7, 95%CI, 1.08-2.64).&#x0D; Conclusion: Findings reveal that high level of knowledge, attitude, self-efficacy and social support towards exclusive breastfeeding, but the prevalence of EBF practice is still low, so it should be promoted by having targeted intervention programs for mothers who are at-risk groups. Breastfeeding awareness programs should be integrated into the existing immunization clinics and give information to mothers about its long-term benefits.

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

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

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

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

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

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

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

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

Effectiveness of an optional breastfeeding course for multidisciplinary undergraduate healthcare students: A quasi-experimental study

AimsThis study aimed to examine and quantify the effectiveness of an optional breastfeeding course for multidisciplinary undergraduate healthcare students and to provide advice for education improvement based on students’ characteristics and learning feedback. BackgroundBreastfeeding has received global awareness and educating undergraduate healthcare students is a prospective way to promote breastfeeding. This is the first report from mainland China to verify the education effects and formulate a proposal for improvement. DesignA quasi-experimental study with a one-group pretest-posttest design. MethodsAn optional breastfeeding course covering eight topics based on the Health Belief Model was conducted for multidisciplinary students in a medical college. The Breastfeeding Knowledge Questionnaire, Iowa Infant Feeding Attitude Scale and Breastfeeding Promotion Intention Scale were completed for pre- and post-education comparison. The Wilcoxon signed-rank test, MannWhitney U test, KruskalWallis test and chi-square test were used for statistical analysis. The class average normalized gain and individual students’ normalized gain were calculated to quantify the effectiveness from the perspective of learning gain. ResultsFrom March to November 2021, 102 students specialized mainly in nursing, clinical medicine, medical imaging technology and midwifery took the course. Knowledge, attitudes and intention scores improved significantly (Z = 8.70, 8.72, 7.64, respectively, p < .001) and the class average normalized gains were 81.0%, 52.3% and 70.6%, respectively. Insignificant differences were found for students of different genders and categories of specialties (p > .05). Students of first year had significantly higher individual normalized gains (p < .05). In learning feedback, the top-ranked advice for course improvement was to increase practice and experience (75.5%). ConclusionsThis optional breastfeeding course produced medium to high learning gains for multidisciplinary healthcare undergraduates. Independent breastfeeding education based on behavioral theory for multidisciplinary students is recommended to be conducted in medical colleges. The addition of practice and experience may add value to such education.

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

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

Newborn Feeding Knowledge and Attitudes among Medical Students.

This study sought to assess newborn feeding knowledge and attitudes among medical students. A sample of 649 Portuguese medical students completed an online survey containing a sociodemographic questionnaire, the Newborn Feeding Ability Questionnaire (NFA), and the Iowa Infant Feeding Attitudes Scale (IIFAS). The overall sample showed moderate scores for all variables. Gender analysis identified significant differences only for the dimension related to the benefits of skin-to-skin contact between mother and newborn where women scored higher. Analysis by year of training found that students with more years of training scored higher on all variables of newborn feeding knowledge that were positively correlated and were positive predictors of newborn feeding attitudes. Students with fewer years of training scored higher on work practices interfering with newborn feeding ability, which were negatively correlated and were negative predictors of newborn feeding attitudes. These results demonstrate that medical students with more years of training are the most prepared, however, the moderate results of the sample raise concerns. Our results point to the importance of providing medical students with adequate knowledge in order to influence their attitudes toward newborn feeding and contribute to better working practices for future health professionals.

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

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