Exclusive Breastfeeding Mothers Research Articles

Optimization of Lactation Room Management for Vulnerable Groups to Provide Excellent Service at the Mahkamah Syar'iyah Blangkejeren: A Literature Review

The state is obliged to ensure that health services are provided for women, especially family planning (KB) services,pregnancy, childbirth, postpartum or exclusive breastfeeding. It cannot be denied that until now there are still many offices /companies that ignore the existence of lactation rooms. Whereas the obligation of work organizers to provide lactation space has been regulated in the Republic of Indonesia Minister of Health Regulation Number 15 of 2013. The regulation of procedures for providing breastfeeding space aims to provide protection to mothers in exclusive breastfeeding and fulfill children's rights to receive exclusive breastfeeding. The provision of this breastfeeding corner facility is devoted to meeting the needs of mothers and babies who still have to breastfeed, and at the same time aims to increase exclusive breastfeeding for babies as one of the main nutrients. This research discussed about how to optimize the lactation room for vulnerable groups to provide excellent service in Mahkamah Syar’iyah Blangkejeren.

Determinants of cessation of exclusive breastfeeding in the early postnatal period in Indonesia

Breast milk is the main source of nutrients in infants under six months of age. The causes of low exclusive breastfeeding coverage vary from region to region. Lack of husband’s support is one of the factors contributing to exclusive breastfeeding failure. This study aimed to determine the determinants of exclusive breastfeeding failure, designed as a cross-sectional study, conducted in Sawangan District, Depok City, in February 2023. Subjects were selected using the total sampling method, namely all mothers who had babies aged 0-6 months who conducted antenatal checks at Health Center and private midwife clinics who were available to be interviewed and filled out a questionnaire with as many as 224 people and analyzed using the Chi-square test at 95% CI. Results: During antenatal care, the father's role in buying formula/instant porridge/bananas (p= 0,0000 and applying honey or mashed dates to the newborn (p= 0,000) was associated with failure of exclusive breastfeeding in the early postnatal period. Both variables were associated with a 3,7 times higher risk of discontinuing exclusive breastfeeding in the early postnatal period. In conclusion, the determinants of exclusive breastfeeding failure in the early postnatal period were fathers who bought formula/instant porridge/bananas and applied honey or mashed dates to newborns. Socialization and education of fathers regarding the importance of fathers’ involvement in exclusive breastfeeding for mothers is needed.

Fathers' Attitudes Toward Mothers with Infants and its Association with Exclusive Breastfeeding in a Rural Community of Karnataka.

Male participation in reproductive and child health improves breastfeeding rates. The role of fathers in breastfeeding may be crucial in improving exclusive breastfeeding (EBF) rates. This study explored the fathers' attitudes and support and its association with EBF in mothers with infants attending a rural primary health center in Karnataka. A cross-sectional descriptive study was conducted on mothers with infants visiting a rural primary health center between December 2020 and February 2021. A pretested semi-structured questionnaire was used to collect data to ascertain the exclusivity of breastfeeding and other sociodemographic factors. The fathers' attitudes and support toward mothers during and after pregnancy were measured on a 5-point Likert scale. Quantitative variables were expressed in median and interquartile ranges, and qualitative variables were expressed using percentages and proportions. The association was determined using the Chi-square test and Spearman's correlation test. The data were collected using Epi Data and analyzed using Epi info v 3. A total of 169 mothers participated in the study. The self-reported EBF was 148 (87.1%). The fathers' attitudes and support to the mothers were found to be more favorable during the antenatal period in 97% of the women. The fathers' attitudes and support in the antenatal period and after delivery were not associated with the mothers' exclusivity in breastfeeding. The present study concluded that there is no association between the fathers' attitudes and support before and after the delivery of the infant and mothers' exclusivity in breastfeeding.

Undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia: A community-based study.

An exclusive breastfeeding period is a time when the infant's feeding depends on only breast milk. Inadequate maternal nutrition during this period could lead to insufficient infant feeding, which can further lead to childhood undernutrition and developmental restrictions. Evidently, the burden of maternal undernutrition was higher in resource-limited countries, including Ethiopia. This study aimed to assess the proportion of undernutrition among exclusive breastfeeding mothers and its associated factors in Southwest Ethiopia. The study used a community-based cross-sectional design. The study was conducted among 442 nursing mothers from 10 to 30 June 2022. The participants were selected using multistage sampling techniques. An interviewer-administered structured questionnaire was used to collect information. Statistical software EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. The factors associated with undernutrition were identified using a binary logistic regression analysis. In the bivariable analysis, a p-value of less than 0.25 was used to include the variable in the multivariable analysis, whereas p-value less than 0.05 was an odds ratio used to declare an independent association at a 95% confidence interval. The proportion of undernutrition among the participants was found to be 24.8% in the study area. Poor intake of extra meals (adjusted odds ratio = 2.104; 95% confidence interval: 1.208, 3.664), poor dietary diversity habits (adjusted odds ratio = 3.605; 95% confidence interval: 2.112, 6.153), a lack of nutrition information (adjusted odds ratio = 1.853; 95% confidence interval: 1.070, 3.212), and household food insecurity (adjusted odds ratio = 4.424; 95% confidence interval: 2.639, 7.417) were identified as factors enhancing undernutrition among exclusive breastfeeding mothers in the area. A quarter of exclusive breastfeeding mothers were undernourished in the area. Poor dietary diversity habits, poor intake of extra meals, a lack of nutrition information, and household food insecurity were found to be the factors determining undernutrition. Hence, it is important to reinforce nutrition intervention programs, including maternal nutrition education and counseling.

Pemberdayaan Kelompok Pendukung ASI di Wilayah Kerja Puskesmas

Abstract 
 The first two years of human life are critical to form the foundation of optimal growth, development and health in the long term. It is therefore very important to ensure that children aged 0-2 years get optimal nutritional care.
 The lack of exclusive breastfeeding coverage is influenced by several things, especially the very limited number of breastfeeding counselors, the lack of optimal educational activities, socialization, advocacy and campaigns related to breastfeeding and the lack of optimal development of breastfeeding support groups (Astika, 2012). Therefore, to increase the scope of exclusive breastfeeding in the working area of the Taman Baca Health Center, a Breastfeeding Support Group (KP-ASI) was formed by empowering the surrounding community. The lowest exclusive breastfeeding coverage in Palembang city is still low, to increase exclusive breastfeeding coverage can be done by changing the knowledge and attitudes of mothers in exclusive breastfeeding for breastfeeding mothers. KP-ASI is a form of community empowerment in this case cadres who assist health workers (nutritionists) in delivering information related to exclusive breastfeeding and motivating pregnant women and lactating mothers to breastfeed their babies up to a minimum of 6-24 months.
 The Breastfeeding Support Group (KP-ASI) is a group formed by health care facilities and the community to support pregnant women, new mothers and breastfeeding mothers. The implementation of training for ASI support groups (posyandu cadres) has not been implemented so that training activities are needed to assist posyandu cadres in providing skills and seeing changes in cadres' attitudes to do their duties to help the community related to health information, understanding in mentoring breastfeeding mothers so that the exclusive breastfeeding target is achieved.
 
 Keywords: Breastfeeding, support groups, babies

Factors affecting breastfeeding mothers self-leadership in exclusive breastfeeding

Introduction: One of the leading factors of exclusive breastfeeding success in motherhood is self-leadership. Previous studies found that the role of external factors also has an impact on exclusive breastfeeding. Yet, until this day the level of exclusive breastfeeding in Indonesia and worldwide has not achieved its goal. The aim of this study was to analyze the factors that influence the self-leadership of breastfeeding mothers in exclusive breastfeeding. Methods: The analytic study with a cross-sectional design was conducted in this study. The population was all breastfeeding mothers who had babies aged 7-12 months. This study used simple random sampling which required 125 respondents. The independent variables are knowledge, attitudes, self-efficacy, and social support. The dependent variable is self-leadership. Data analysis used a logistic regression test to find out which variable had the most influence with a p-value < 0.05. Results: The multivariate analysis revealed a significant influence between knowledge on self-leadership (p=0.001), attitudes (p=0.005), self-efficacy (p=0.013), and social support (p=0.000). While the results of multivariate analysis showed that the most influential on breastfeeding mothers’ self-leadership was social support. Conclusion: There is a significant association between knowledge of self-leadership, attitudes, self-efficacy, and social support.

Hubungan Jenis Persalinan dan Dukungan Tenaga Kesehatan dengan Keberhasilan ASI Eksklusif

The Ministry of Health of the Republic of Indonesia has set a target to increase exclusive breastfeeding up to 80%. However, this policy has not yet obtained optimal results. Based on data from the Indonesian Health Profile, the coverage of babies who receive exclusive breastfeeding in 2020 is only 66.1%. This is due to several obstacles in exclusive breastfeeding, namely: lack of socialization of the lack of exclusive breastfeeding and the support of health workers, especially midwives, is still considered lacking. This type of research is descriptive quantitative using a cross sectional approach. The population of this study were postpartum mothers in Jember Regency. The number of samples studied was 30 respondents using a purposive sampling technique that met the inclusive criteria, namely: postpartum mothers 1 to 6 weeks, and able to operate android mobile phones. For the exclusion criteria, namely; Postpartum mothers who experience breast problems/abnormalities; and mothers who live in difficult signal areas. The data obtained were analyzed using SPSS statistics and Fisher's Exact Test with an alpha value of 5%. The results obtained for the type of delivery were that there was no significant relationship between the type of delivery and the success of exclusive breastfeeding mothers with a value of p = 0.140 (OR = 3.5; 95% CI 0.43-28.13). While the results for the support of health workers who carried out the Fisher's exact test showed that there was a significant relationship between the support of health workers and the success of mothers in exclusive breastfeeding with a value of p = 0.007 (OR = 0.83; 95% CI 0.12 - 5.5). Based on the results of the study it can be concluded that the need for understanding for mothers regardless of the type of delivery does not affect the success of breastfeeding and the need for support from health workers, especially midwives in helping mothers to successfully breastfeed their babies.

PERSPECTIVES OF TRADITIONAL MARKET WOMEN ON EXCLUSIVE BREASTFEEDING IN THE WORKING AREA OF DELI TUA HEALTH CENTER WORK AREA YEAR 2023

Abstract
 One of the fundamental steps toward a healthy and productive life is breastfeeding, which is in line with the Sustainable Development Goals (SDGs) or Sustainable Development Goals 2030 (Bennett et al., 2020). Low rates of exclusive breastfeeding lead to various infant health problems. The North Sumatra Provincial Government has recorded 299 cases of infant mortality until July 2021. Records from the Ministry of Health of the Republic of Indonesia, as many as 31.36% of 37.94% of children are sick, because they do not receive exclusive breastfeeding. The prevalence of stunting in Indonesia is currently at 27.67%. The low coverage of exclusive breastfeeding is influenced by various obstacles to optimal breastfeeding, one of the biggest obstacles is working women, especially those who work in the informal sector. The purpose of this study was to determine "The perspective of women informal workers in exclusive breastfeeding in the working area of the Deli Tua Health Center. This research is a qualitative study with a descriptive phenomenological approach. The participants in this study were mothers of traditional market traders as many as 7 participants who were obtained using nonprobality sampling technique with purposive sampling type. The instrument used in this research is an interview guide. In collecting data, this study used the in-depth interview method to collect data. The location of this research is Deli Tua Tax in the working area of the Deli Tua Health Center. The results of the research conducted obtained the results of a description of the factors that influence the perspective of traditional market trader mothers in exclusive breastfeeding, namely knowledge, work, husband support and socio-culture.

Working Mother’s Breastfeeding Experience: A Phenomenology Qualitative Approach

<p>Breast milk is a diet that satisfies all of a baby’s physical, psychological, social and spiritual needs because it contains nutrients, hormones, immunological components and growth factors. Unfortunately, many working mothers choose to stop breastfeeding due to various factors. The purpose of this study was to explore the experiences of working mothers in exclusive breastfeeding. This study used a qualitative research design with a phenomenological descriptive approach. Data were collected using in-depth interviews and then analyzed using the Colaizzi method. The study results show that children who receive exclusive breastfeeding are healthier and have adequate nutrition. However, working mothers have difficulty in breastfeeding. So, support from partners, family members, supervisors and colleagues influences a mother’s decision to breastfeed. In addition, leave regulations and child care facilities at work affect breastfeeding ability of working mothers. This study provides information about breastfeeding challenges and the support needed by breastfeeding mothers working to formulate better policies that support breastfeeding. Policies covering employee rights and privileges, such as extended maternity leave, support facilities and child care services, are critical to the success of exclusive breastfeeding by working mothers.</p>

The Effect Of Consumption Of Green Bean Juice On Exclusive Breastfeeding Mothers On Infant Weight Gain

The prevalence of exclusive breastfeeding tends to decrease in general due to the desire of parents for rapid growth of their baby's weight, especially the promotion of formula milk which is increasingly intensive. Breast milk is the single best source of nutrition for babies because it contains Fats, Carbohydrates, proteins, Vitamins, Minerals, Water and natural protective substances that can protect babies against various diseases. Green beans are one of the lagtogogum plants that contain vitamin tiamin and polyphenols that can increase breast milk production. The purpose of this study was to determine the effect of giving green bean juice on infant weight gain in breastfeeding mothers exclusively breastfed. Quasy experimental type of research with pretest and post test design with nonequivalent control group design. The study was conducted from September to November 2020 in the Working Area of UPT Puskesmas Sebangar Bengkalis Regency with a population of 189 mothers having babies aged (0-6) months with a total sample of 32 people, purposive sampling technique. Giving green bean juice is done once a day as much as 300 ml for 14 consecutive days. Data processing using an independent sample t test. From the results of the study, the average weight gain of babies in the experimental group was 468.74 grams while the average weight gain of the control group babies was only 290.62 grams. In the independent test of the t-test sample, a p value = 0.021 was obtained, where the p value of ≤ 0.05 Ha was received, meaning that there was an effect of giving mung bean juice on infant weight gain in breastfeeding mothers exclusively in the Working Area of UPT Sebangar Health Center, Bengkalis Regency. It is recommended that breastfeeding mothers can consume Green Bean Juice to help smooth milk production, so as to increase baby weight gain in exclusive breastfeeding mothers.

Relationship between Family Support and Attitude of Postpartum Mothers in Exclusive Breastfeeding at Clinic Hj. Tarpianie A.Md. Keb. Prambon Sidoarjo

Mother's Milk (ASI) is the best and most suitable food for babies to ensure the growth of babies into human quality. The substances contained in breast milk contain almost all the nutrients needed by babies with concentrations that suit the needs of the baby. (MOH RI, 2014). Based on preliminary studies conducted by researchers at Clinic Hj. Tapianie Prambon Sidoarjo in January 2020 from 15 respondents showed that the attitude of the mother in giving exclusive breast milk is very good. This is because of the large amount of family support in motivating mothers to want to breastfeed exclusively. The purpose of this study was to determine the relationship between family support and attitude of postpartum mother in giving exclusive ASI at clinic Hj. Tarpianie Prambon Sidoarjo year 2020. The design of this study included a cross sectional analytic study with a survey approach.

Pengaruh Pendidikan Kesehatan Terhadap Pengetahuan dan Sikap Ibu dalam Pemberian ASI Ekslusif di Wilayah Kerja UPT Puskesmas Marina Permai Kota Palangka Raya Tahun 2022

Exclusive breast milk (ASI) is the first and foremost food for babies from 0-6 months of age, in fact there are still many mothers who choose to give formula milk with the assumption that formula milk is better than exclusive breastfeeding. Lack of knowledge from the community and support from families that the benefits of exclusive breastfeeding are very important for babies. To anticipate this, it is necessary to provide health education to increase knowledge and attitudes of mothers. The purpose of this study was to determine the effect of health education on knowledge and attitudes of mothers in exclusive breastfeeding. The design of this study uses an experimental with a one-group pre-posttest design. The population in this study were all breastfeeding mothers, with a total sample of 42 respondents. The sampling method used is purposive sampling. Data for this study were collected twice, once before and once after the intervention, using a questionnaire. The existing data were tabulated and then analyzed using the Mc nemar test analysis test and marginal homogeneity. The results showed that there was an effect of health education on knowledge (p 0.000 a 0.05) and attitudes (p 0.001 a 0.05) of mothers in exclusive breastfeeding. For the puskesmas, they should increase socialization and outreach to the community, especially for mothers to breastfeed their babies immediately after giving birth for 6 months or to give exclusive breastfeeding without other additional food for 6 months.

Media Promosi Kesehatan Ular Tangga VS Leaflet ASI Eksklusif terhadap Pengetahuan dan Kesiapan Ibu Menyusui

Introduction: Currently exclusive breastfeeding promotion media uses written media such as leaflets, whereas snake and ladder promotion media are easier to digest and more interesting so that it is expected to increase the knowledge and readiness of exclusively breastfeeding mothers. Objectives: to measure the difference in the effect of exclusive breastfeeding version of the snake and ladder health promotion media with leaflets on the knowledge and readiness of mothers in exclusive breastfeeding. Methods: This study used a quasi-experimental pretest posttest design on 70 pregnant women in the third trimester from March to June 2022. The analysis used frequency distribution, Wilcoxon test and unpaired T test. Result: the average knowledge (9.1) and readiness (14.7) of the group with snakes and ladders media was higher than the knowledge (6.1) and readiness (12.1) group with leaflet media with p=0.000 (<0.05) Conclusion: the effect of health promotion media using exclusive breastfeeding version of snake and ladder is better than exclusive breastfeeding leaflet on mother's knowledge and readiness regarding exclusive breastfeeding. Thus, it is recommended that the exclusive breastfeeding version of the snake and ladder health promotion media should be used instead of leaflets.

EDUKASI HOLISTIK PADA IBU POSTPARTUM TERHADAP PEMBERIAN ASI

Introduction : Breast milk is the best food for infants because it contains many substances and protective factors that are impotant for the growth and development of infants so as to reduce infant morbidity and mortality. This contens is very complete and complex, there are hunderds of bioactive molecules that can protect babies from infectione and help in the formation of a strong immune system. Objective : This study aimsto determine whether there is an effect of holistic education on post partum mother on the success of breastfeeding at the Watampone Health Center. Research Methods : Based on the results of the research that researchers have done, the average value of knowledge in the interventioan group before being given education was 4,88, the lowest score was 3 and the highest score was 7 (total score 10), while the average score in the intervention group after education was 9.00. while the average value of knowledge in the pre test control group was 4,82, while the average value of knowledge in the post test control group was 6,29. This shows that there is an effect of providing education on changes in knowledge of post partum mothers in exclusive breastfeeding. Conclution : This study concludes that there is an increase in post pratum mother’s knowledge of exclusive breastfeeding at UPT Puskesmas Watampone after education.

Barriers to Exclusive Breastfeeding in Mothers Belonging to Low, Middle, and High Socio-Economic Families in Pakistan

Introduction: Exclusive breastfeeding (EBF) for the first six months of life improves health and increases infant survival. In Asia, Pakistan ranks second in child mortality. Socioeconomic status (SES) is an important predictor of healthy behaviors. The study aims to understand the barriers to exclusive breastfeeding faced by mothers from different socioeconomic classes in Pakistan.
 Method: The cross-sectional study was done in the Pediatric outpatient department (OPD) of Shifa International hospital and community health center from November 2020 to 1 March 2021. Mothers and their children 1 to 3 years of age were included in the study.
 Results: A total of 175 mothers and their children were included. EBF for the first six months was done by 120 (68.6%). However, by one year of age, only 99 (56%) continued breastfeeding. Out of these 175 mothers, 79 (45%) were from the lower class, 69 (39.4%) were from the middle class, and 27 (15.4%) were from upper SES. Among the lower, middle, and high socioeconomic classes frequency of EBF practiced by mothers was 51, 54, and 15 (p 0.03), respectively. Pre-lacteals were given to 102 (58.2%). This practice was more frequent in lower SES families (0.03). The majority of working women belonged to upper SES (0.04). Mothers in the upper class are least likely to EBF their children (OR 0.5 CI 0.2-1.3). The adjusted odds ratio for EBF is highest for lower SES mothers, followed by the middle class.
 Conclusion: Support from family, place and mode of delivery, working mothers, and high socioeconomic class are important factors affecting exclusive breastfeeding in Pakistan.

FACTORS RELATED TO EXCLUSIVE BREAST FEEDING TO MOTHERS WHO HAVE BABIES IN THE WORKING AREA OF SEMERAP PUBLIC HEALTH CENTER KERINCI DISTRICT 2022

The type of research used is cross-sectoral research, research conducted over a long period of time where this study is designed to study the correlation between exposure and consequences or effects at the same time. The sample size in this study is 65 people, the technique used in sampling is This study uses simple random sampling, which is a technique that has the same opportunity according to the proportion (regardless of the size of the population) in sampling. This study found that there is a relationship between knowledge, attitude and support of health workers towards exclusive breastfeeding for mothers who have babies and there is no relationship between exposure to information media and culture towards exclusive breastfeeding for mothers who have babies, P-Value knowledge < 0.05 (0.002), Attitude P-Value < 0.05 (0.028), statistical health worker support (P-Value=0.019), The factors related to exclusive breastfeeding are knowledge, attitudes and health workers and there is no relationship between exposure to information media and culture.
 

Comparison of mothers’ perceptions of hunger cues in 3-month-old infant under different feeding methods

BackgroundMothers’ perception of infant hunger cues is a critical content of responsive feeding, which is central to the promotion of early childhood development. However, only a few studies have examined responsive feeding in China, especially lacking the studies on perceptions of infant hunger cues. Consider the cultural differences, the aim of this study was to describe the perceptions of infant hunger cues of Chinese mothers for infants aged 3 months, and explore the relationship between maternal perceptions of infant hunger cues and different feeding methods.MethodsA cross-sectional study was conducted with a sample of 326 mothers of healthy 3-month-old infants, including 188 exclusive breastfeeding (EBF) mothers and 138 formula feeding (FF) mothers. It was implemented in four provincial and municipal maternal and child health hospitals. The mothers’ perceptions of infant hunger cues were surveyed by self-reporting questionnaires. Chi-square tests and logistic analysis were applied to analyze the differences in maternal perceptions of infant hunger cues, including the number of hunger cues and the specific cues, between EBF group and FF group by controlling sociodemographic variables and the daily nursing indicators.ResultsWe found that a higher proportion of EBF mothers could perceive multiple hunger cues (≥ 2) than FF mothers (66.5% vs.55.1%). For specific cues, the EBF mothers had higher perceptions of infant’s “hand sucking” (67.6% vs. 53.6%) and “moving head frantically from side to side” (34.6% vs. 23.9%), all p < 0.05. Regression analysis revealed that EBF might support mothers to perceive infant hunger cues than FF mothers, with the number of infant hunger cues (OR = 1.70, 95% CI: 1.01–2.85), “hand sucking” (OR = 1.72, 95% CI: 1.04–2.87), “moving head frantically from side to side” (OR = 2.07, 95% CI: 1.19–3.62). The number of infant hunger cues perceived by mothers was also associated with their educational level and family structure.ConclusionEBF mothers of 3-month-old infants may be more likely to perceive infant hunger cues than FF mothers in China. It is necessary to increase the health education about infant hunger and satiety cues to caregivers in China, especially among mothers with lower education levels, mothers living in nuclear families, and FF mothers.

The Experience Of Breastfeeding Exclusively In Primapara Mothers In The District Of Lintang Kanan, Empat Lawang South Sumatra

Breastfeeding is a scientific process of providing breast milk (ASI) to babies optimally from at least six months to two years. Breastfeeding is a decision that is instinctively realized by a mother for the benefit of the child's growth and development in the future. The aim of the study was to obtain in-depth information about the exclusive breastfeeding experience for primiparous mothers in Lintang Kanan District, Empat Lawang Regency, South Sumatra. The research method used in this study uses a qualitative descriptive method. The sample in this study were primiparous mothers who had babies aged more than 6 months and gave exclusive breastfeeding to their babies as many as 5 participants. The results of this study can provide an overview to the public regarding the experiences of primiparous mothers in exclusive breastfeeding. Further research is needed regarding in-depth exploration of cultural aspects in exclusive breastfeeding because the behavior inherent in the mother is influenced by the cultural aspects owned and the application of the theory of maternal role attainment-becoming a mother to primiparous mothers in exclusive breastfeeding.

A training curriculum for an mHealth supported peer counseling program to promote exclusive breastfeeding in rural India

BackgroundDespite strong evidence about the benefits of exclusive breastfeeding, that is the baby receiving only breast milk, no other foods or liquids, rates have remained relatively unchanged over the past two decades in low- and middle-income countries. One strategy for increasing exclusive breastfeeding is through community-based programs that use peer counselors for education and support. The use of mobile health applications is also gaining increasing applicability in these countries. Minimal information is available about training peer counselors in the use of mobile technologies to support exclusive breastfeeding. The present article describes our curriculum in the state of Karnataka, India for supporting new mothers to exclusively breastfeed using a mobile health application in rural India.MethodsTwenty-five women from the community surrounding the city of Belgavi, Karnataka, India were trained to be peer counselors and to use a mobile health application to conduct a structured curriculum to support new mothers in exclusive breastfeeding. The three-day interactive training, conducted in March 2018, was based on the WHO breastfeeding course, translated, and adapted to the local culture The curriculum, which included information collected during a formative research process, consisted of eight visits, two during the antenatal period and continuing for six months postpartum. Twelve nursing and obstetric experts validated curriculum content. Pre-post-evaluation of the training focused on breastfeeding knowledge, self-efficacy, skills, and app usability.ResultsWe observed a significant increase in the mean scores for knowledge (P < 0.0001) and skills (P = 0.0006) from pre- to post-training. Age of the peer counselors and their own breastfeeding experience correlated significantly with the acquisition of knowledge and skills. The mobile health app showed high usability scores.ConclusionsThe culturally adapted curriculum presented here, combined with an mHealth app, can be an important educational strategy for training rural women in the acquisition of exclusive breastfeeding knowledge and skills.

Beliefs and Norms Influencing Initiation and Sustenance of Exclusive Breastfeeding: Experiences of Mothers in Primary Health Care Facilities in Ermelo, South Africa.

Exclusive breastfeeding (EBF) is not a norm in many communities in South Africa despite the World Health Organizations' recommendations for EBF in the first six months of infant's life. Thus, South Africa continues to observe suboptimal and poor practices of EBF. The purpose of the study was to explore the experiences of mothers who are HIV-positive and negative on EBF and examine the extent to which initiation and sustenance of EBF is influenced by cultural beliefs, societal norms, and family norms and practices in Mpumalanga Province. Three focus group discussions and twelve in-depth interviews were conducted among thirty mothers who were purposively selected during their visits to the facilities for childcare services. Interviews were audiotaped, transcribed verbatim, and transcripts were analysed through thematic analysis using NVivo version 10. Mothers were aged between 18 and 42 years, most were unemployed and were living in poor sociodemographic backgrounds in extended family households. We found evidence of factors that influence the decision to EBF and mix feed infants among mothers. Traditional and cultural beliefs and norms that exist within their communities informed decisions mothers took to EBF. These beliefs existed alongside mothers' opinions on breastfeeding (BF) and HIV infection, as well as the fears of harming the baby through HIV infection, leading to early cessation of BF. Mothers were also advised by family members, friends, and even some healthcare workers to use traditional medicines while BF. The association of EBF with sagging breasts and weight loss as well as discomfort with public BF are personal beliefs that influenced initiation and early cessation of EBF. Breastfeeding messages ought to be context specific to improve the knowledge, understanding, acceptance and practice of EBF among HIV-positive and negative mothers. Culturally appropriate counselling messages that address the known cultural practices of the populations affected are essential to changing the beliefs and norms of the communities including extended families of EBF mothers.