Iowa Infant Feeding Attitude Scale Research Articles

COGNITIVE INTERVENTION TO THE WOMEN WHO ATTEND THE "BREASTFEEDING SUPPORT GROUP"

Introduction: Breast milk is the best food to meet the nutritional needs of the child, exclusively for the first 6 months and up to two years of age, favoring the establishment of the mother-child bond. Objective: To carry out a cognitive intervention to the women who attend the “breastfeeding support group”. Method: Quantitative research, with a quasi-experimental design, in a census sample made up of 11 pregnant women and 19 breastfeeding women. The Iowa Infant Feeding Attitudes Scale (IIFAS) was used. Results: 33.30% (10) are between 33-35 years old, 63% (19) in the puerperium, 56% (17) with primary education, 60% (18) carry out agricultural / cattle raising activities, 53% (16) in free union. In the pre-intervention, the women had a positive attitude with a score of 17-48 towards artificial breastfeeding 83% (25), in the post-intervention the positive attitude towards breastfeeding changed 87% (26), with a significant difference of p <0.01, in the items of the IIFAS instrument in the pre-intervention a mean and standard deviation of 2.07 ± 1.16, with an increase in the post-intervention of 4.48±0.65, a significance difference <0.05 in the total of questions in the pre-intervention from 35.23, increased after the intervention to 76.13, their attitude changed to exclusive breastfeeding. Conclusions: the cognitive intervention increased the positive attitude towards exclusive breastfeeding, highlighting that a timely educational intervention of promotion, support and accompaniment during pregnancy and postpartum guarantees the duration and exclusivity of breastfeeding.
 
 Keywords: breastfeeding, breastfeeding behavior, breastfeeding, knowledge, attitudes and health practice

Atitudes e aplicações de mães turcas sobre a nutrição do bebê entre 0-24 meses: Iowa Nutrição do Bebê Atitude

ABSTRACT Objective This study aims to evaluate the behaviors and attitudes of mothers with 0-24-month-old babies towards infant feeding, depending on their sociodemographic characteristics. Methods This is a cross-sectional study, which was carried out with 300 mothers. Demographic characteristics of the mothers, breastfeeding and complementary feeding practices, and the Iowa Infant Feeding Attitude Scale were collected. As for the statistical evaluation, Statistical Package for the Social Sciences version 22 statistical package program was used. For the statistical analysis; percentages, mean values, Independent T-Test, One-Way ANOVA, Chi-Square test, and multinomial regression models analysis were used. Results 79.7% of the mothers gave human milk to their infants as the first food after delivery, 36.9% gave only human milk for the first 6 months, 52.0% started complementary feeding at 4-6 months. Of the mothers with a mean The Iowa Infant Feeding Attitude Scale score of 64.38±8.43, 54.0% were positive towards breastfeeding. A significant relationship was found between education and income levels and Iowa Infant Feeding Attitude Scale scores level of the mothers, respectively (χ2=10.001, χ2=10.421, p<0.05). The mothers with a postgraduate degree as educational status (AOR=1.27, 95%CI:1.06-1.53) and mothers who had more income than expenditures (AOR=1.19, 95%CI:1.03-1.63) were associated with a higher positive towards of breastfeeding. Conclusion Although most of the mothers say that they have a positive attitude towards breastfeeding, the rate of those who only breastfeed for the first 6 months is low. As the education and income level of mothers increase, their positive attitude towards breastfeeding increases. Mothers should be informed to initiate and maintain successful breastfeeding.

Refakatçi Anne Ünitesinde Kalan Annelere Verilen Eğitimin Annelerin Beslenme Tutumu ve Bilgisi Üzerine Etkisi

Background: In this study, we examined the breastfeeding attitudes of mothers whose babies are in intensive care unit and the change of thought, after breastfeeding training given to mothers during they were staying as accompanying mothers. Methods: This study was conducted on the mothers whose babies were hospitalized in the neonatal intensive care unit between May and July 2019. Before the training entitled “The Importance of Breastmilk and Breastfeeding” was given to mothers during their babies were intensive care unit, a face-to-face interview questionnaire and the IOWA Infant Feeding Attitude Scale (IIFAS) were applied. After the training, IIFAS was applied to the mothers again. Results: A total of 51 mothers participated in our study. The mean age of the mothers was 27.77 ± 5.8 years. The mean IIFAS score of the mothers was 66.35 ± 5.11 before the training and 74.5 ± 5.55 after the training. While only 15 (31.3%) of the mothers had an intention of breastfeeding before the training, 40 mothers (83.3%) had an intention of breastfeeding, after the training. We observed a significant increase in the mean IIFAS score after the training. Conclusion: When we compare the attitudes of mothers, regarding breastfeeding their babies before and after breastfeeding training, it was observed that the trainings positively affected their attitudes. Growing healthy generations can only be achieved by feeding with breast milk and increasing the rate of breastfeeding can be achieved by increasing the awareness in the society.

Infant Feeding Practices and Analysis Of Factors Affecting Exclusive Breastfeeding

<p>The coverage rate of exclusive breastfeeding in Indonesia is still low despite its ability to affect a baby's health status and ability to survive. In 2017, only 35.73% of babies in Indonesia received exclusive breastfeeding for up to 6 months. This study aims to determine infant feeding practices and identify the factors that influence the practice of exclusive breastfeeding in Yogyakarta. This is a descriptive analysis study with a cross-sectional approach. The instruments that have been used in this study were the demographic data questionnaire, the Iowa Infant Feeding Attitude Scale (IIFAS) questionnaire, and the Breastfeeding Self Efficacy Scale-Short Form (BSES-SF) questionnaire. A total of 421 mothers were involved in this study and the research was conducted between June 2019 to April 2020 in Sleman Regency, Yogyakarta, Indonesia. Correlation data analysis was performed using chi-square and point biserial correlation and the multivariate analysis used logistic regression. Infant feeding practice was high with 82.4% of infants receiving exclusive breastfeeding. It was found that employment status, knowledge, mothers’ attitudes, and self-efficacy about breastfeeding have significant correlations with exclusive breastfeeding. Employment status, knowledge, mothers’ attitudes, and self-efficacy about breastfeeding are factors that can encourage exclusive breastfeeding. <strong></strong></p>

Breastfeeding knowledge and attitudes of Nigerian mothers assessed by the Iowa infant feeding attitudes scale

Background: Excusive breastfeeding practice in Nigeria is reportedly dwindling, yet the current breastfeeding practices and challenges remain largely unknown. To use the Iowa infant feeding attitude scale (IIFAS) to assess the breastfeeding knowledge and attitude of recently delivered mothers in Lagos Nigeria.Methods: A community-based survey. Study-related data were obtained from 636 mothers selected through multistage sampling, using IIFAS. The scale was validated for our environment before use in the study. The study data were managed with SPSS version 22.0.Results: The prevalence of any breastfeeding, exclusive breastfeeding at 6 months and timely initiation of breastfeeding was 99.5%, 22.2% and 47.4% respectively. While the mothers had some knowledge of breastfeeding, their overall knowledge and attitudes about breastfeeding were positive towards infant formula than breastfeeding. More than half of the mothers in our study stated that infant formula was as healthy for infants as breastmilk (62.3%), formula feeding is the better choice if the mother plans to go back to work (80.7%), and that formula feeding was more convenient than breastfeeding (56.9%). Previous exclusive breastfeeding experience (OR 2.7, 95% CI: 1.15, 8.41), being a housewife (OR 1.6, 95% CI: 1.14, 10.9), and having a positive attitude to breastfeeding (OR 1.9, 95% CI: 1.3, 11.6) were found to be associated with exclusive breastfeeding.Conclusions: Although breastfeeding was almost universal in the study area (99.5%), the knowledge and attitude to exclusive breastfeeding (EBF) were suboptimal. Public health education on breastfeeding should be intensified before, during and after pregnancy to improve mother’s EBF knowledge and attitude.

Midwifery Students’ Attitudes towards Infant Feeding: A Sample from Turkey

Background & aim: Midwives are the main healthcare professionals who play a critical role in supporting mothers for initiating and maintaining breastfeeding. Due to the importance of midwifery students having sufficient breastfeeding knowledge and non‐judgmental attitudes prior to graduation, this study aimed to examine the attitudes towards infant feeding of midwifery students.Methods: This survey was conducted at Health Sciences University in Ankara, Turkey in June 2021. The study was carried out on 212 midwifery students in total who agreed to take part in the study. Data was collected using the Student Information Form and IOWA Infant Feeding Attitude Scale, which were completed electronically through WhatsApp messenger and analyzed using SPSS Version 22.00.Results: The mean age of the students was 20.40±1.25. The mean score of IOWA Infant Feeding Attitude Scale was 66.18±5.52 out of 87. There was a statistically significant difference found between the mean scores of the students in the infant feeding attitude scale and their grade in school (p<0.001), receiving information in related classes (p<0.005), attending courses in the related subject (p=0.044), taking additional classes (p<0.001), and feeling themselves sufficient in terms of knowledge (p=0.009). There was no statistically significant difference with the status to give counseling.Conclusion: Midwifery students had positive attitudes towards infant feeding. It is, therefore, suggested to present an educational curriculum that supports and encourages breastfeeding in midwifery programs and to evaluate students' attitudes towards infant feeding in order to train professional midwives who will encourage families to breastfeed in the future.

A Mixed-Methods Feasibility Study of Breastfeeding Attitudes among Southern African Americans.

We assessed the feasibility and acceptability of examining breast/chest feeding attitudes among African Americans in South Carolina using an explanatory sequential, mixed methods approach. We surveyed 50 pregnant African American women during their ob-gyn appointment (Phase I), followed by qualitative interviews with four African American couples (N = 8) (Phase II), and integrating quantitative-qualitative data through joint display (Phase III). Phase I supported the feasibility of recruiting pregnant African American women for our study. However, for Phase II, more research is needed to support the feasibility of recruiting couples from the quantitative phase. The Iowa Infant Feeding Attitude Scale demonstrated moderate reliability (α = 0.68). Participants intending to exclusively breastfeed (M = 65, SD = 5.79) had higher scores than those intending to exclusively use formula (M = 50, SD = 4.37, p < .001). The six qualitative themes (Phase II) and data integration (Phase III) identified cultural considerations for future research.

Influence of maternal age and mode of conception on infant feeding attitudes of the mothers and its impact on breastfeeding practices: a hospital based cross sectional study

Background: Despite multiple proven benefits of exclusive breastfeeding, its practice remains elusive.The aim of this study was to detect the influence of maternal age and mode of conception on breastfeeding practices. Questionnaire based observational study performed in the out-patient department of the Calcutta medical research institute, India.Methods: Cross sectional survey of maternal knowledge and attitude about breastfeeding, using the translated version of the Iowa infant feeding attitude scale and to analyze their breastfeeding practice.Results: A total 100 naturally conceived non-elderly (&lt;35 years) mothers had significantly more (p&lt;0.0001) mean IIFAS score in comparison to both groups of elderly (&gt;35 years) counterparts [46 naturally conceived (NC) and 56 artificially conceived (ART)]. This difference is statistically insignificant when comparing the two groups of elderly mothers (NC and ART). While the approaches of majority of mothers were neutral towards breastfeeding, only a handful of them were exclusively breastfeeding at 6 months.Conclusions: Elderly mothers have significantly less positive approach towards breastfeeding that do not depend on mode of conception.

Determinants of Knowledge and Attitude towards Breastfeeding in Rural Pregnant Women Using Validated Instruments in Ethiopia.

Understanding the underlying determinants of maternal knowledge and attitude towards breastfeeding guides the development of context-specific interventions to improve breastfeeding practices. This study aimed to assess the level and determinants of breastfeeding knowledge and attitude using validated instruments in pregnant women in rural Ethiopia. In total, 468 pregnant women were interviewed using the Afan Oromo versions of the Breastfeeding Knowledge Questionnaire (BFKQ-AO) and the Iowa Infant Feeding Attitude Scale (IIFAS-AO). We standardized the breastfeeding knowledge and attitude scores and fitted multiple linear regression models to identify the determinants of knowledge and attitude. 52.4% of the women had adequate knowledge, while 60.9% of the women had a neutral attitude towards breastfeeding. In a multiple linear regression model, maternal occupation was the only predictor of the BFKQ-AO score (0.56SD; 95%CI, 1.28, 4.59SD; p = 0.009). Age (0.57SD; 95%CI, 0.24, 0.90SD; p = 0.001), parity (−0.24SD; 95%CI, −0.47, −0.02SD; p = 0.034), antenatal care visits (0.41SD; 95%CI, 0.07, 0.74SD; p = 0.017) and the BFKQ-AO score (0.08SD; 95% CI, 0.06, 0.09SD; p < 0.000) were predictors of the IIFAS-AO score. Nearly half of the respondents had inadequate knowledge and most women had a neutral attitude towards breastfeeding. Policymakers and managers could address these factors when planning educational interventions to improve breastfeeding practices.

Psychometric properties of the original and short Hungarian version of the Iowa infant feeding attitude scale

BackgroundThe Iowa Infant Feeding Attitude Scale (IIFAS) is a widely used tool to assess attitudes towards infant feeding. Attitudes towards breastfeeding are one of the main influencing factors of feeding choice and breastfeeding duration. Adaptation of the IIFAS to the Hungarian context provides an opportunity for cross-cultural comparisons and helps to target breastfeeding support interventions. The growing number of shortened scales in various fields of research, demonstrates the necessity to adapt to a changing context of data collection to avoid fatigue and dropout among respondents. However, international comparisons are difficult due to the lack of a consensual shortened form of the scale.The aim of our study was to examine the psychometric properties of the Hungarian version of the IIFAS (IIFAS-H) and propose an 8-item short version that has appropriate construct validity.MethodsThe original IIFAS was translated into Hungarian and then translated back to English. A cross-sectional study based on an internet survey in 2019 was conducted among 553 mothers whose most recent child’s age was between 6 and 36 months. Psychometric properties of the Hungarian IIFAS were determined and compared with international results. In order to obtain a shorter version of the Hungarian scale, we preferably kept those items that are common with other international abbreviated IIFAS versions and deleted items with a corrected item-total correlation or factor loading of less than 0.3, where factor loadings came from a principal component analysis forcing the extraction of one principal component (factor).ResultsThe 17-item IIFAS-H showed good psychometric properties with a Cronbach’s alpha of0.73. Further analyses proved that the examined three shortened versions of the IIFAS consisting of 11, 9, and 8 items also showed good properties (Cronbach’s alpha = 0.79, 0.79, 0.76, respectively).ConclusionsThe Hungarian version of the original 17-item long IIFAS proved to be a good measurement tool with good psychometric properties. Based on our analyses, we suggest the use of the 8-item short version (IIFAS-H8) of the scale.

Experience predicts the duration of exclusive breastfeeding: The serial mediating roles of attitude and self-efficacy.

The relationship between prior breastfeeding experience and the duration of exclusive breastfeeding is of significant interest, but few studies have explored the mechanisms underlying this relationship. The purpose of this study is to address two hypotheses: (a) that attitude and self-efficacy mediate the relationship between previous breastfeeding experience and the duration of exclusive breastfeeding; and (b) that attitude and self-efficacy have serial mediation functions in this relationship. The data collection process was divided into two stages. The original stage included 394 women hospitalized after delivery who completed socio-demographic questionnaires (including previous breastfeeding experience), the Iowa Infant Feeding Attitude Scale (IIFAS), and the Breastfeeding Self-efficacy Short-Form Scale (BSES-SF). Follow-up data about duration of exclusive breastfeeding were obtained at six months postpartum. Mediation analysis indicated that previous breastfeeding experience directly affected the duration of exclusive breastfeeding and that the rate of the total indirect effect was 22.878%. Self-efficacy mediated previous breastfeeding experience and duration of exclusive breastfeeding, whereas attitude and self-efficacy played the series mediational role between previous breastfeeding experience and duration of exclusive breastfeeding. Cluster analysis supported these results. The duration of exclusive breastfeeding can be promoted by improving breastfeeding attitude and self-efficacy in women without breastfeeding experience.

Fomento de la lactancia materna en la universidad

Objetivo: evaluar el impacto de una intervención educativa que se llevó a cabo durante el segundo trimestre de 2018 con alumnos universitarios de distintas licenciaturas para mejorar su actitud respecto a la lactancia materna (LM).Diseño metodológico: es un estudio exploratorio transversal que busca comparar las actitudes hacia la LM determinadas por la Escala de Actitudes hacia la Alimentación Infantil Iowa (IIFAS, por sus siglas en inglés) entre 2 grupos, uno de ellos expuesto a una intervención educativa. Esta escala ha sido validada previamente para la población mexicana.Resultados: los alumnos que participaron en la intervención educativa mostraron una actitud más positiva hacia la LM que los alumnos que no participaron.Limitaciones de la investigación: el número de estudiantes que respondieron el cuestionario es relativamente bajo comparado con la población universitaria por lo que los resultados pueden no ser ampliamente generalizables. Pueden existir sesgos no identificables en los estudiantes que respondieron. El tipo de estudio no permite identificar cambios en las actitudes, ni identificar causa y efecto.Hallazgos: la participación de los estudiantes en intervenciones educativas que incorporan explícitamente el tema de LM puede modificar sus actitudes hacia la misma. Esto podría tener repercusiones en las decisiones que tomen al respecto a lo largo de su vida.

Differences in maternal characteristics and their associations with breastfeeding attitudes among primiparous mothers

BackgroundThe benefits of breastfeeding are well documented, yet substantially below half of all mothers globally meet the recommendation to exclusively breast-feed for 6 months. ObjectiveThis study aimed to examine whether there were differences in maternal factors, including maternal characteristics and breastfeeding attitudes, between those who were eligible versus non-eligible to be included in a randomised trial, as exclusive breastfeeding was the eligibility criteria for the trial. It also aimed to investigate associations between maternal factors and breastfeeding attitudes. MethodPrimiparous pregnant mothers (n=88) completed questionnaires on demographic factors including maternity care and breastfeeding attitude using self-administered questionnaire and Iowa Infant Feeding Attitude Scale (IIFAS). Two weeks post-birth, mothers were screened for eligibility to be included in a randomised trial including assessing for exclusive breastfeeding (EBF). Findings were compared between inclusion (all EBF mothers) and exclusion groups (non-EBF). ResultsInclusion group mothers were significantly younger than those in the exclusion group (26.7±2.8 v 28.5±2.5, p=0.007) and the majority had their husband as the primary maternity care person after birth (X2=12.8, p=0.01). Inclusion group mothers had a more positive perception toward breastfeeding in public and at work on the IIFAS scale (p<0.05). The overall IIFAS score was positively associated with higher breastfeeding confidence (r=0.285, p=0.008), education levels (r=0.31, p=0.003), household income (r=0.32, p=0.003), and age (r=0.28, p=0.008). ConclusionEBF mothers (inclusion group) tend to be younger, had husband as primary care, and have more positive perception towards breastfeeding outside home. Overall, maternal characteristics and paternal support could influence breastfeeding practices and should be targeted for future intervention. Maternal attitude and perceptions about breastfeeding in public could be improved to encourage exclusive breastfeeding.

The effects of training in breastfeeding counseling on breastfeeding knowledge and attitudes of midwifery students

Context: Training in breastfeeding counseling has positive effects on breastfeeding knowledge and attitudes of health professionals.Aims: This study aims to determine the breastfeeding knowledge and attitudes of midwifery students who received breastfeeding counseling training.Settings and Design: This study was carried out as a pretest-posttest semi-experimental study with a single group of students in the Midwifery Department of University of Health Science, Istanbul, Turkey, between February and May 2019.Materials and Methods: The sample consisted of all students (58 students) who agreed to participate in the study in the 2nd year of studies in the Midwifery Department. At first, all students were trained about breastfeeding counseling by the researcher. Then, the students were divided into 14 groups and the educational content was shared through peer-assisted learning for 2 h/week during 14 weeks. A “Personal Information Form,” “Breastfeeding Knowledge Evaluation Form,” and the Iowa Infant Feeding Attitudes Scale (IIFAS) were used as data collection tools.Statistical Analysis Used: Data were analyzed using descriptive statistics, a dependent-groups t-test, and a McNemar's test.Results: The students' knowledge of the benefits of colostrum, breast milk, and breastfeeding in maternal health increased after the training (P < 0.05). A significant difference was found between the mean scores of the students on the IIFAS before (65.6 ± 9.7) and after (69.7 ± 7.8) the training (P = 0.008).Conclusion: Breastfeeding counseling training improves students' understanding of basic physiological processes related to breastfeeding and as well as knowledge of and attitudes toward breastfeeding.

Relationship between factors affecting the willingness to breastfeed in late pregnancy and IIFAS-J (Japanese version Iowa Infant Feeding Attitude Scale)

Relationship between factors affecting the willingness to breastfeed in late pregnancy and IIFAS-J (Japanese version Iowa Infant Feeding Attitude Scale)

Awareness, Commitment, and Attitude Toward Breastfeeding in Pregnant Women

To assess the benefits of 1-hour classes that focus on breastfeeding education, information, and demonstrations of appropriate breastfeeding techniques through presentations, visual aids, and question-and-answer sessions at two federally qualified community health centers in coastal Georgia. This project was approved by the Institutional Review Board of Troy University. This project will measure the effect of prenatal breastfeeding education on breastfeeding rates, knowledge, awareness, and attitudes among pregnant women ages 19 to 45 years who are in their third semester at community prenatal clinics. The level of evidence for this quasi-experimental pretest–posttest research design is 2. Pender’s health promotion model served as the guiding conceptual framework for this study. Through the use of flyers, a convenience sample consisting of 52 pregnant women, ages 19–45 years and 34–36 weeks gestation, was recruited from two federally qualified, nonprofit community health clinics in a coastal Georgian city. The intervention spanned 4 weeks, consisting of weekly 1-hour classes of breastfeeding education, informational sessions by a certified lactation counselor, demonstrations of appropriate breastfeeding techniques, presentations, visual aids, and question-and-answer sessions. Data were collected using the Iowa Infant Feeding Attitude Scale (IIFAS) with Cronbach alpha scores of .85 to .86. Chi-square analysis revealed significant differences in intent to breastfeed and breastfeeding initiation after delivery. Forty participants initiated breastfeeding postintervention, 10 of whom had planned to formula feed in preintervention. Descriptive statistics indicated increased knowledge of breastfeeding; participants who disagreed or strongly disagreed to the statement, “Breast milk is lacking in iron,” increased from preintervention to postintervention by greater than 30%. The paired t test revealed statistically significant differences in the attitude toward breastfeeding between preintervention and postintervention time periods, indicating an increased positive attitude overall toward breastfeeding. Findings of this study are consistent with research demonstrating benefits of educational interventions on breastfeeding rates, knowledge, and attitude toward breastfeeding. Community prenatal clinics should implement prenatal breastfeeding education to enhance awareness, positive commitment, and attitudes among pregnant women. Evidence-based findings in this project can change practice to sustain, improve, and strengthen health care systems in the global market.

Effect of Nursing Intervention on Prevention of Exclusive Breastfeeding Discontinuation

Introduction: Planned nursing intervention and health education regarding exclusive breastfeeding (EBF)improved knowledge, practice and attitude of mothers and contributed to prevention of EBF discontinuationwhich can consequently reduce the worldwide infants’ morbidity and mortality rates. Aim of theStudy: The present study aimed to investigate the effect of nursing intervention on prevention of EBFdiscontinuation. Study Design: A quasi-experimental design was utilized. Setting: Obstetric OutpatientClinic, Breast Feeding Room in NICU of Children’s Hospital affiliated to Ain Shams University hospitalsand MCH center in Abassia sector/Cairo/Egypt. Subject: A purposive sample of 100 mothers of infantsaged from birth up to 6 months. Tools of the Study: Predesigned questionnaire to assess: mothers andinfants characteristics, knowledge regarding factors affecting EBF discontinuation and its prevention,Iowa Infant Feeding Attitude Scale and observational checklists to assess mothers? breastfeeding practice.Results: It was clear that the majority of the studied mothers had good knowledge, positive attitude towardsprevention of EBF discontinuation and improved practice of breastfeeding post implementation of nursingintervention. There was statistical significant difference between total knowledge of the studied mothersregarding factors affecting EBF discontinuation and its preventionand total practice of breastfeeding pre/post nursing intervention. Conclusion: Nursing intervention had a positive effect on prevention of EBFdiscontinuation. Recommendation: Developing initiatives,pre and postnatal health education programs forprotecting, promoting and supporting breastfeeding which aid in the prevention of EBF discontinuation.

The Relationship of Previous Breastfeeding Experiences and Factors Affecting Breastfeeding Rates: A Follow-Up Study.

Background/Objective: Many studies have focused on the effects of previous breastfeeding experience (PBE) on subsequent breastfeeding, but few have explored their specific relationships. To explain the relationship between PBE and subsequent breastfeeding behavior based on a follow-up study. Materials and Methods: After delivery, 394 participants who had no PBE completed a demographic questionnaire, breastfeeding knowledge questionnaire, the breastfeeding self-efficacy short-form scale (BSES-SF), and the Iowa infant feeding attitudes scale (IIFAS). Multiparas with PBE also completed the maternal breastfeeding evaluation scale (MBFES) in addition to the aforementioned four questionnaires. On the 42nd day after delivery, participants completed the breastfeeding experience scale (BES) through social networking platforms (QQ, WeChat: both are Chinese social medias). At 4 and 6 months postpartum, researchers contacted participants by phone or a social network regarding their exclusive and partial breastfeeding experiences. Results: In this study, exclusive breastfeeding rates were 58.6% and 30.5% at 4 and 6 months. PBE affected breastfeeding attitudes (p < 0.05), self-efficacy (p < 0.01), and difficulties (p < 0.05). Breastfeeding knowledge, attitude, self-efficacy, and difficulties were relevant to exclusive and partial breastfeeding at 4 and 6 months (p < 0.05). Multivariate logistic regression analysis showed that compared with women without PBE, the probability of exclusive breastfeeding of multiparas with PBE at 4 and 6 months increased by 275% and 369%, respectively. Conclusions: The rate of breastfeeding remains low among Chinese women, but PBE is associated with a higher probability of breastfeeding at 4 and 6 months postpartum. Multiparas, especially those having PBE were more likely to breastfeed for an extended period based on their knowledge, attitude, self-efficacy, and ability to manage difficulties.

Effectiveness of an integrated breastfeeding education program to improve self-efficacy and exclusive breastfeeding rate: A single-blind, randomised controlled study

BackgroundLow self-efficacy affects new mothers’ ability to sustain breastfeeding. Interventions that increase self-efficacy could improve sustained breastfeeding. ObjectivesTo develop an integrated breastfeeding education program based on self-efficacy theory, and evaluate the effect of the intervention on first-time mothers’ breastfeeding self-efficacy and attitudes. DesignA single-blind, randomised controlled trial. SettingA prenatal clinic of a teaching hospital. ParticipantsFirst-time mothers with a singleton pregnancy (12–32 weeks’ gestation) and their support partners were selected by convenience sampling (N = 104) and allocated by block-randomization to an intervention or control group. MethodsA 3-week breastfeeding intervention program was developed based on self-efficacy theory. The intervention group received the breastfeeding program; the control group received standard care. Data between groups were compared for scores on breastfeeding self-efficacy, infant feeding attitude, and breastfeeding practice, which were assessed using the Breastfeeding Self-Efficacy Scale-Short Form, the Iowa Infant Feeding Attitude Scale, and a structured questionnaire, respectively. Repeated data measurements were collected at baseline, 36-weeks’ gestation, and postpartum at 1-week, and 1-, 3-, and 6-months. ResultsNinety-three mothers completed the study. Data were compared for the self-efficacy intervention group (n = 50) with the control group (n = 43). Baseline measures did not differ between groups. The intervention group had significantly higher breastfeeding self-efficacy at 36 weeks’ gestation (mean difference (MD): 7.3, p < .001), and postpartum at 1-week (p < .001), 1-month (p < .001) and 3-months (p < .01) with MD: 6.7, 7.9, and 8.1, respectively; differences in scores from baseline were also significantly greater from 36 weeks’ gestation to 3-months (MD from 9.1~9.9, p < .001) and 6-months postpartum (MD: 7.0, p < .05). Infant feeding attitude scores significantly improved from 36 weeks’ gestation to 6-months postpartum for the intervention group (MD from 3.5~7.4, p < .05). Rates for exclusive and predominant breastfeeding postpartum were significantly higher for the intervention group vs control (p < .02) at 1-week (98% vs. 86%), 1-month (100% vs. 90.7%), and 3-months (94% vs. 76.7%). Odds ratio (OR) postpartum for exclusive and predominant breastfeeding was greater for the intervention group at 3-months (OR = 4.7, 95% Confidence interval (CI), 1.2 -18.6; p = .05) and for exclusive breastfeeding at 6-months (OR: 2.82, 95% CI 1.0–8.1; p = .05). ConclusionsThe breastfeeding education intervention improved breastfeeding self-efficacy, infant feeding attitudes, and exclusive breastfeeding rates. The breastfeeding education program could be effective for sustaining breastfeeding in new mothers.Trial registration: Registered with www.clinicaltrials.gov (NCT03807726)

Maternal knowledge of effective breastfeeding and its benefits, as potential determinant of attitudes to infant feeding: A survey in Calabar, Nigeria.

Appropriate breastfeeding is a cost-effective child survival strategy. This study assessed relationship between knowledge of breastfeeding and attitude towards infant feeding among pregnant women in Calabar, Nigeria. By convenience sampling, consenting antenatal clinic attendees were recruited from secondary health centers in Calabar. Pre-tested questionnaire was used to assess knowledge of different aspects of breastfeeding, while the Iowa Infant Feeding Attitude Scale (IIFAS) was used to assess attitude towards infant feeding. Data was analyzed using SPSS version 21.0, with p-value of less than 0.05 considered statistically significant. Two hundred and fifty (250) pregnant women were surveyed with mean age of 29.7 ± 6.1 years. One hundred and eight respondents (43.2%) had unsatisfactory levels of knowledge. Common areas of misconception were oral thrush effect of breastfeeding (47.2%), frequency of breast milk expression (47.6%), and effects of inverted nipples (45.6%). Most respondents (92.0%) had neutral attitude to infant feeding, and there was no significant relationship between overall knowledge of breastfeeding and infant feeding attitude (p <0.05). Of all the knowledge areas assessed, only benefits to mothers (r=0.11, p=0.08) and effective breastfeeding (r=0.17, p=0.01), had knowledge scores that correlated positively with infant feeding attitude scores. These findings contribute to existing literature required for improvement in policies and strategies, for breastfeeding education and child survival, especially in resource-poor settings. There is need for further research towards improving priority content of maternal health education during the time-constrained ANC visits.