Optimal Breastfeeding Practices Research Articles

An Assessment of Knowledge of Health Workers in Hospitals of Southern Province of Zambia, Towards Marketing of Breastmilk Substitutes Regulations

Background: Optimal breastfeeding practices have been undermined by unregulated marketing of breastmilk substitutes worldwide, resulting in about 820, 000 preventable deaths per year among children under five years globally. The International Code (thereafter called the Code) of Marketing Breastmilk Substitutes was developed by the World Health Organization, the United Nations Children's Emergency Fund and stakeholders to protect, promote and support breastfeeding. Member states are expected to domesticate the Code. Zambia enacted Statutory Instrument No. 48 of 2006, Regulations on marketing of breastmilk substitutes. Successful implementation calls for a good level of knowledge among health workers. However, we found no study, in Zambia on the marketing of breastmilk substitutes Regulations. Objective: To assess the level of knowledge of health workers on Zambia’s Regulations on marketing breastmilk substitutes. Study design and methods: A mixed-method cross-sectional study. Data was collected online and in person. Probability proportional to size calculation yielded an estimated sample size of 384. A sample size of 410 after adjusting upwards assumed non-response rate, 401 participants responded. Quantitative data were analyzed using the Social Statistical Package for Social Sciences. Knowledge results were described by frequencies and percentages. Tests were conducted using univariable linear and multivariable regression analysis. A p-value of <0.05 was considered statistically significant. Thematic analysis was used for qualitative data analysis. Results: The mean overall level of good knowledge of health workers was 0.339 or 34% [SE: 0.0221; 95%CI: (0.2959, 0.3828)]. Conclusion: The level of knowledge among health workers in hospitals of Southern Province, Zambia was poor.

An Assessment of Knowledge of Health Workers in Hospitals of Southern Province of Zambia, towards Marketing of Breastmilk Substitutes Regulations

Background: Optimal breastfeeding practices have been undermined by unregulated marketing of breastmilk substitutes worldwide, resulting in about 820, 000 preventable deaths per year among children under five years globally. The International Code (thereafter called the Code) of Marketing breastmilk substitutes was developed by the World Health Organization, the United Nations Children's Emergency Fund, and stakeholders to protect, promote and support breastfeeding. Member states are expected to domesticate the Code. Zambia enacted Statutory Instrument No. 48 of 2006, Regulations on marketing of breastmilk substitutes. Successful implementation calls for a good level of knowledge among health workers. However, we found no study, in Zambia on marketing of breastmilk substitutes Regulations. Objective: To assess the level of knowledge of health workers on Zambia’s Regulations on marketing breastmilk substitutes. Study design and methods: A mixed-method cross-sectional study. Data was collected online and in person. Probability proportional to size calculation yielded an estimated sample size of 384. A sample size of 410 after adjusting upwards assumed non-response rate, 401 participants responded. Quantitative data were analyzed using the Social Statistical Package for Social Sciences. Knowledge results were described by frequencies and percentages. Tests were conducted using univariable linear and multivariable regression analysis. A p-value of <0.05 was considered statistically significant. Thematic analysis was used for qualitative data analysis. Results: The mean overall level of good knowledge of health workers was 0.339 or 34% [SE: 0.0221; 95%CI: (0.2959, 0.3828)]. Conclusion: The level of knowledge among health workers in hospitals of Southern Province, Zambia was poor. Keywords: Breastmilk substitute Regulations, Health worker, Knowledge.

Optimization of Breast Milk Production with Breastfeeding

Optimal breastfeeding practices are the key to reducing stunting in children under the age of five. Breastfeeding mothers in carrying out their roles are often faced with various challenges. Lack of confidence in breastfeeding mothers can affect breast production. Hypnobreastfeeding is a natural method of using subconscious energy so that the breastfeeding process runs comfortably, smoothly and can produce sufficient milk for the needs of the baby's growth and development. Objective : Determine the effectiveness of hypnobreastfeeding on breast milk production. Method : This type of research is Pre experimental Design with One Group Pretest-Postest Design, namely by comparing 1 group with 2 treatment namely observing the volume of breast milk in nursing mothers before and after being given hypnobreastfeeding. The sample in this study were 20 breastfeeding mothers who met the inclusion criteria. Results : The results of the statistical test obtained a p-value of 0.000 so that it can be concluded that hypnobreastfeeding is effective for overcoming the problem of breast milk production in breastfeeding mothers. Conclusions : There is a significant effect between hypnobreastfeeding on breast milk production. The volume of breast milk in breastfeeding mothers increases after hypnobreastfeeding 2 times a day for 3 days. For health care providers, hypnobreastfeeding can be applied to postpartum mothers as a method of lactation management to prepare mothers physically and mentally to be able to breastfeed and believe that breast milk production is sufficient according to baby needs.

The relationship between national cultural dimensions, maternal anxiety and depression, and national breastfeeding rates: An analysis of data from 122 countries

IntroductionBreastfeeding is a natural and universal practice across countries and cultures. It is estimated that several thousand lives could be saved per year if optimal breastfeeding practices were adopted across countries. In addition, breastfeeding has numerous health, emotional and developmental benefits for both the mother and her infant. Despite widespread awareness of these benefits, rates of breastfeeding initiation and maintenance remain suboptimal, both in high- and in low- and middle-income countries. Unfavorable breastfeeding outcomes are related to several factors, including variations in cultural values and the occurrence of common mental disorders in women during pregnancy and in the postnatal period. However, the relative contributions of culture and mental health to variations in national breastfeeding rates have not been examined to date.MethodsIn the current study, recent United Nations International Children's Emergency Fund (UNICEF) data on lifetime breastfeeding rates is analyzed in two stages, to first explore and then confirm the impact of cultural values and maternal mental health status at a cross-national level.ResultsIt was found that the estimated prevalence of both depression and anxiety disorders in women of childbearing age was negatively correlated with breastfeeding rates. Significant associations were also observed for the cultural dimensions of individualism-collectivism and masculinity-femininity. The association between anxiety disorders and breastfeeding outcomes remained significant in multivariate analysis incorporating demographic and health variables that could exert a confounding effect.DiscussionThese results suggest that both cultural values and the assessment and treatment of maternal mental illness should be components of any programme aimed at communicating the benefits of breastfeeding or at improving breastfeeding outcomes. The inclusion of these components could help promote the values of cultural sensitivity, inclusiveness and equity in breastfeeding from a global perspective.

HUBUNGAN DUKUNGAN SUAMI DENGAN BREASTFEEDING SELF EFFICACY DALAM PEMBERIAN ASI DI WILAYAH KERJA PUSKESMAS BANDA RAYA KOTA BANDA ACEH

Self-efficacy is one of the factors associated with low coverage of exclusive breastfeeding, while a husband’s support is known to positively influence a mother’s breastfeeding self-efficacy. This study examined the correlation between husband’s support and Breastfeeding Self-efficacy (BSE) in providing exclusive breastfeeding among mothers in the working area of the Community Health Center (Puskesmas) of Banda Raya in Banda Aceh city. This study was a quantitative study with a cross-sectional design. The population of this study includes 243 mothers who have children aged 6 months or less. The sampling was performed through stratified random sampling which resulted 78 respondents. Husband support and Breastfeeding Self-efficacy Scale- Short From (BSES-SF) questionnaires were used as the research instruments. The data were analyzed using bivariate and analysis Chi-Square test. The result showed a correlation between husband support (p-value 0,01), informational support (p-value 0,03), appraisal support (p-value 0,01), emotional support (p-value 0,03) and instrumental support (p-value 0,04) with BSE. The Health Community Center is urged to provide mothers with more information regarding the benefits of exclusive breastfeeding to ensure the success of optimum breastfeeding practices and to encourage mothers to take part in counseling about exclusive breastfeeding during antenatal care.

Implementation of exclusive breastfeeding counseling for prospective brides in Lueng Bata District, Banda Aceh City

The importance of increasing knowledge about exclusive breastfeeding for expectant mothers in Aceh Province is an effort to achieve exclusive breastfeeding success above the national achievement of 69,7%. Optimal breastfeeding practices are one of the keys to success in reducing stunting. Counseling is essential in increasing the knowledge of prospective mothers or brides, supported by the use of media such as flyers that make it easier to understand the importance of exclusive breastfeeding for babies. This community service activity aims to increase the knowledge of prospective brides through counseling on exclusive breastfeeding using flyer media. Community service was carried out using a pretest-posttest non-equivalent group approach, namely providing exclusive breastfeeding counseling to prospective brides in Lueng Bata District. The number of participants was 20 people (10 couples), and activities were carried out in 2020. The counseling media is an exclusive breastfeeding flyer from the Indonesian Ministry of Health. Data collection was conducted through interviews using a questionnaire. The evaluation was carried out descriptively, consisting of a pretest and a posttest. The results showed an increase in average knowledge between before (26,3), and after (33,1) exclusive breastfeeding counseling was given using flyer media to prospective brides, or there was an increase in knowledge of 60,0%. In conclusion, through flyer media, exclusive breastfeeding counseling can improve the knowledge or understanding of prospective brides about exclusive breastfeeding.

What Are the Individual, Household, and Community Factors Associated With Optimal Breastfeeding Practices in Three Selected West African Countries?

Optimal breastfeeding is rarely practiced among mothers across the three studied countries: Guinea, Nigeria, and Sierra Leone. The methodological approach used in this study is the first of its kind in the study area. It provides answers to the statistical association between individual, household, and community factors and optimal breastfeeding practices. The study adopted a cross-sectional research design. It employed secondary data. The study data were extracted from the Demographic Health Surveys in Guinea (2012 GDHS), Nigeria (2013 NDHS), and Sierra Leone (2013 SLDHS). Information was extracted from mothers (20–49 years) who had at least one child before the surveys. Optimal breastfeeding was coded into “1” if adhered to and “0” if otherwise. Multilevel mixed-effect logistic regression was used. It was found that optimal breastfeeding was infrequently practiced in Guinea (5.3%), Nigeria (8.6%), and Sierra Leone (14.0%). The fixed-effects results showed that optimal breastfeeding was significantly associated with individual, household, and community-level factors (p < .05). The random effect results showed that community factors accounted for 40.4%, 20.3%, and 20.7% variation in adherence to optimal breastfeeding for mothers in Guinea, Nigeria, and Sierra Leone, respectively. The study concluded that mothers in the study area rarely practice optimal breastfeeding.

Magnitude and determinants of breastfeeding initiation within one hour among reproductive women in Sub-Saharan Africa; evidence from demographic and health survey data: a multilevel study

BackgroundEarly initiation of breastfeeding is one of the most simple and essential intervention for child development and survival in the world. World Health Organization recommended to begin breast milk with one hour after delivery. The objective of this study was to determine the magnitude of early initiation of breastfeeding in Sub-Saharan Africa using DHS data set.MethodsThis study was carried out within 32 Sub-Saharan African countries from 2010–2020, a pooled study of early initiation of breastfeeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with early initiation of breastfeeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major breastfeeding factors.ResultThe pooled prevalence of early initiation of breastfeeding in Sub-Saharan Africa countries was 57% (95% CI; 56%—61%), the highest prevalence rate of early initiation of breastfeeding was found in Malawi while the lowest prevalence was found in Congo Brazzaville (24%). In multilevel multivariable logistic regression model; wealth index (AOR = 1.20; 95% CI 1.16 – 1.26), place of delivery (AOR = 1.97; 95% CI 1.89 – 2.05), skin-to-skin contact (AOR = 1.51; 95% CI 1.47 – 1.57), mode of delivery (AOR = 0.27; 95% CI 0.25 – 0.29), media exposure (AOR = 1.36; 95% CI 1.31 – 1.41) were significantly correlated with early initiation of breastfeeding in Sub-Saharan Africa.ConclusionThe magnitude of early initiation of breastfeeding rate was low in Sub-Saharan Africa. Covariates significantly associated with early initiation of breastfeeding was wealth index, place of delivery, mode of delivery, women educational status, and media exposure. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Sub-Saharan Africa.

Bristol Breastfeeding Assessment Tool-Thai Version: Translation, Validity, and Reliability.

In 2019, 14.0% of infants in Thailand were exclusively breastfed up to 6 months of age. To increase exclusive breastfeeding, an objective assessment measure would be useful to maternity care providers for appraising the problems encountered by new mothers' experiences with breastfeeding. To translate the Bristol Breastfeeding Assessment Tool from English into Thai; to assess the reliability and validity of the Thai Bristol Breastfeeding Assessment Tool; and to explore the relationship of a mother's self-efficacy to successful breastfeeding. Using a methodological design, we purposively sampled 302 new mothers from two tertiary hospitals in Thailand who had given birth to a single baby with an uncomplicated vaginal birth. The Thai Bristol Breastfeeding Assessment Tool's structure was examined using confirmatory factor analysis. Concurrent and convergent validity were assessed using the Thai LATCH instrument and Thai Breastfeeding Self-Efficacy Scale, respectively. The inter-item Thai Bristol Breastfeeding Assessment Tool correlation coefficients were positive and strong. The correlation between scores of the Thai Bristol Breastfeeding Assessment Tool and Thai LATCH instrument were positive and strong and had acceptable concurrent validity. The confirmatory factor analysis model fit the Thai Bristol Breastfeeding Assessment Tool data perfectly and the Cronbach's alpha coefficient had acceptable internal reliability. The Thai Bristol Breastfeeding Assessment Tool is a cross-culturally translated instrument equivalent to its English version and demonstrated acceptable validity and reliability. The instrument provides a mechanism for an objective assessment and monitoring system of optimal breastfeeding practices in Thai mothers with newborns.

Prevalence of stunting and its associated factors among children 6-59 months of age in pastoralist community, Northeast Ethiopia: A community-based cross-sectional study.

Globally, stunting is a significant public health concern and it is very critical in Ethiopia. This research aims to determine the prevalence of stunting and its correlates among children in the pastoral community. A community-based cross-sectional study was conducted in Dubti District, Afar Region, North East Ethiopia from 2-31 January 2018. A total of 554 children were recruited using a multi-stage sampling technique and participated in this study. A binary logistic regression analysis was performed to determine factors linked to stunting. The significance of the associations was determined at a p-value < 0.05 and the adjusted odds ratio at 95% CI was calculated to evaluate the strength of the associations. The prevalence of stunting was 39.5% (95% CI: 35.4-43.5%). The odds of stunting were increased, so does the age of the child increased as compared to 6-11 months of children. Initiating breastfeeding after 1 hour after birth (AOR = 1.99; 95% CI: 1.22, 3.23), not exclusively breastfeeding for at least 6 months (AOR = 2.57; 95% CI: 1.49, 4.42), poor dietary diversity (AOR = 1.93; 95% CI: 1.03, 3.62), and using unprotected water for drinking (AOR = 1.68; 95% CI: 1.21, 2.94) were significant factors. Among children aged 6-59 months, the level of stunting in the pastoral community was significantly high. The study found that stunting was associated with multiple nutritional and non-nutritional factors. To tackle stunting, inter-sectoral cooperation is needed by enhancing the clean water supply of the community, optimal breastfeeding practice, food diversity, and economic status.

Breastfeeding Knowledge, Attitude and Intention of Nursing Students in Nigeria

Background: Nurses are important frontline health workers that promote and support optimum breastfeeding. They are, therefore, expected to have basic breastfeeding knowledge and favaourable attitude for better clinical experience as students and intention to breastfeed as potential parents. This study aimed to assess the breastfeeding knowledge, attitude, and intention of nursing students in Nigeria. Methods: This cross-sectional study was conducted among 142 nursing students. A validated tool was used to obtain breastfeeding knowledge, attitude, and intention of the students. Descriptive and inferential statistics were used to analyze the data. Results: The majority (81%) of the nursing students had adequate breastfeeding knowledge, however, only four out of every 10 students had a positive attitude towards breastfeeding and 36.6% had good intention to breastfeed in the future. This study revealed no significant relationship (p = 0.102) between the breastfeeding knowledge and attitude of the students while a significant relationship (p = 0.002) existed between breastfeeding knowledge and future breastfeeding intention of the nursing students. Conclusion: Nursing students demonstrated adequate knowledge of breastfeeding; however, their attitudes towards breastfeeding and the intention to breastfeed were inadequate. There is a need to focus on the attitudinal changes of the nursing students which could influence their future professional practices and engagement in the optimal breastfeeding practices.

What does early initiation and duration of breastfeeding have to do with childhood mortality? Analysis of pooled population-based data in 35 sub-Saharan African countries

BackgroundBreastfeeding practices and their impact on infant health and survival are unquestionably of global interest. The aim of this study was to examine the link between breastfeeding initiation within one hour of birth, breastfeeding duration and childhood mortality in sub-Saharan Africa.MethodsThis study used data from the Demographic and Health Survey, which was conducted in 35 Sub-Saharan African countries between 2008 and 2017. Early initiation and duration of breastfeeding, food consumption indices, and infant mortality were all important variables. Analysis used percentage, median/interquartile range, and regression models (logistic, linear, Cox).ResultsEarly initiation of breastfeeding within one hour after birth was lowest in Chad (23.0%) and highest in Burundi (85.0%). The pooled median duration of breastfeeding was 12 months. Female children had 3% significant lower odds of consuming tinned, powdered or fresh milk, compared with male children (OR 0.97; 95% CI 0.94, 0.99). Conversely, female children were more likely to be put to breast within one hour after birth, compared with male children (OR 1.03; 95% CI 1.01, 1.05). Results from the pooled sample showed approximately 20% (HR 0.80; 95% CI 0.67, 0.96) and 21% (HR 0.79; 95% CI 0.77, 0.80) reduction in infant mortality for children breastfed within one hour after birth and for every unit increase in the months of breastfeeding respectively. In addition, countries with the leading infant mortality rate include; Sierra Leone (92 deaths per 1000 live births), Chad (72 deaths per 1000 live births), Nigeria (69 deaths per 1000 live births), Cote d’ Ivoire (68 deaths per 1000 live births), Guinea (67 deaths per 1000 live births), Burkina-Faso (65 deaths per 1000 live births) and Mozambique (64 deaths per 1000 live births) respectively.ConclusionsThe findings from this study underscores the need for early breastfeeding initiation and prolong breastfeeding to be considered in programmes on improving childhood survival. Efforts should be made to improve optimal breastfeeding practices as only about half of children in the pooled sample had best practices of breastfeeding.

Socioeconomic inequalities in early initiation and exclusive breastfeeding practices in Bangladesh: findings from the 2018 demographic and health survey

BackgroundOptimal breastfeeding practices including early initiation of breastfeeding and exclusive breastfeeding (EBF) are associated with positive health outcomes. Socioeconomic inequalities in key breastfeeding indicators may play a role in the prevalence of breastfeeding practices. The objective of this study was to examine the socioeconomic inequalities in early initiation of breastfeeding and EBF practices in Bangladesh based on the 2018 Bangladesh Demographic and Health Survey (BDHS).MethodsThis was a secondary data analysis of the nationally representative 2018 BDHS. Data on 4950 women of reproductive age who had ever given birth and 924 children aged 0–5 months were extracted, for early initiation of breastfeeding and EBF. Early initiation of breastfeeding was determined from children who were put to the breast within the first hour of birth. Exclusive breastfeeding was estimated from children aged 0–5 months who were exclusively breastfed.ResultsThe weighted prevalence of early initiation of breastfeeding and EBF were 60.8% (95% CI; 59.0, 62.6%) and 66.8% (95% CI; 63.1, 70.3%), respectively. The estimated prevalence of early initiation among the poorest, poorer, middle, richer and richest households were 67.8, 66.3, 58.4, 56.3 and 54.4%, respectively. Similarly, early initiation prevalence of 64.4, 65.0, 61.1 and 52.3% were estimated among women with no formal education, primary, secondary and higher education, respectively. The estimated prevalence of EBF among the poorest, poorer, middle, richer and richest households were 63.0, 65.2, 67.7, 66.7 and 69.9%, respectively. Similarly, the estimated EBF prevalence were 62.5, 66.0, 66.3 and 68.9% among women with no formal education, primary, secondary and higher education, respectively. Early initiation of breastfeeding was higher among lower household wealth (Conc. Index = − 0.049; SE = 0.006) and lower educational attainment groups (Conc. Index = − 0.035; SE = 0.006).ConclusionsImproving optimal breastfeeding practices in Bangladesh should be given utmost priority. A need to address the socioeconomic inequalities in breastfeeding practices was also identified.

The Undernutrition Prevalence of Under-Two-Years Infant in Indonesia: Do breastfeeding Practices Ecologically Matter?

Undernutrition due to inappropriate feeding practices for children increases morbidity. Breastfeeding isconsidered the most important in a baby's growth and development. Breastfeeding started within one hour ofbirth and was maintained exclusively for the first six months until one year of age or more to obtain optimalbenefits. The study aims to determine the ecological relationship between undernutrition in 2-year-old infantand breastfeeding practice in Indonesia. This study is based on environmental analysis using a report of the2018 Indonesia Basic Health Survey. The dependent variable was the prevalence of undernutrition in 2-yearoldinfant. Besides, the independent variables were four optimum breastfeeding practices. The analysisused bivariate analysis with scatter plot in statistic application. The study results show . The higher theproportion of early initiation of breastfeeding in a province, the lower the levels of undernutrition in childrenaged two years in that province. The higher the ratio of starting to breastfeed less than one hour in an area,the lower the undernutrition levels in children aged two years in that area. On the other side, the higher theproportion of the mother giving all colostrum in a province, the lower the undernutrition levels in childrenaged two years in Indonesia in that province. The higher the proportion of still being breastfed 0-23 monthsin a region, the lower the undernutrition levels in children aged two years in that region. The study concludedthat optimal breastfeeding practices negatively affect the levels of undernutrition in children aged two years.

Breast Feeding in Pandemic Situation. How Does Sri Lanka Face the Challenge?

ObjectivesSri Lanka has been awarded the first-ever ‘Green’ breastfeeding (BF) nation status by the World Breastfeeding Trends Initiative (WBTi) in January 2020 (1) with the support of public health system. But, deviating attention of health services towards emergency pandemic situation has resulted in strained health systems and interruptions in humanitarian response leading to eroding access to essential and often life-saving nutrition services. Therefore, optimal breast feeding practices are at risk due to infected mothers’ isolation practices, exhausted public health system and misbeliefs among the community (2). This finds out how Sri Lanka plans to maintain high standards of breast feeding in pandemic situation.MethodsWe searched for the publications on breast feeding, Sri Lanka in pandemic situation from January 2020 to date.ResultsAs a low and middle income country with an unbeatable public health system, Sri Lanka has already issued an interim guideline for public health staff in continuation maternal and child care services (3). It ensures domiciliary visits by public health midwives (PHMs), although the clinic based teaching sessions on breast feeding have been cancelled. Community awareness has been created that no evidence of transmission of SARS COV-2 via breast milk is available and how the benefits of breast feeding outweigh the risk of infection (4). It is recommended that breast feeding shouldn't be interrupted at all and hand hygienic practices before touching the baby are ideal. Infected mothers can wear a protective mask and rooming in, and kangaroo mother care should be practiced. Sri Lanka already had guidelines on ensuring adequate and appropriate infant feeding guidelines in emergency situations (5).ConclusionsDespite the challenges faced by community and public health staff, Sri Lanka make efforts to maintain the achieved breast feeding standards. Further studies are needed to assess the impact of the pandemic on breast feeding practices in near future.Funding SourcesNone

Skin-to-Skin Care Practice and Its Associated Factors Among Postpartum Mothers in Gurage Zone, Southern Ethiopia: A Cross-Sectional Study.

BackgroundSkin-to-skin care is placing an unclothed or diaper-only newborn baby on the mother’s bare chest, covered with a warm blanket. The World Health Organization recommends immediate, uninterrupted, and continuous mother–newborn skin-to-skin care practice almost immediately after birth. Despite this recommendation, separation of the newborn from the mother is common in many public health institutions. There was a limited study that examined the prevalence of skin-to-skin care practice and associated factors in Ethiopia. Therefore, the main aim of this study was to assess the prevalence of skin-to-skin care practice and its associated factors among postpartum mothers in Gurage Zone public health centers, Southern Ethiopia, 2020.MethodsAn institution-based cross-sectional study was conducted in twenty-two public health centers of Gurage Zone from January 1st up to 30th, 2020. A total of 382 postpartum mothers were selected using a systematic sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires. Data were entered into EpiData version 3.1.0 and exported to SPSS version 23 for analysis. Both bivariable and multivariable logistic regression analyses were used to identify significant factors associated with skin-to-skin care practice. Statistical significance was declared at a P-value of <0.05 with a 95% confidence level.ResultsAbout 35.3% (95% CI; 31.3%–40.4%) of new-borns were received skin-to-skin care practice. Being urban residence [AOR=2.23, (95% CI; 1.17–4.23)], normal newborn birth weight (≥2500gm) [AOR=3.1, (95% CI; 2.15–3.89)], early initiation of breastfeeding [AOR=2.93, (95% CI; 1.29–6.64)], colostrum feeding [AOR=4.19, (95% CI; 2.01–8.73)], and having mothers good knowledge on skin-to-skin care practice [AOR=8.51, (95% CI; 4.32–16.75)] were some of factors associated with mother to newborn skin-to-skin care practice.ConclusionThe proportion of mother newborn skin-to-skin care practice was low in the study area. Mothers resided in the urban areas, normal newborn birth weight, early initiation of breastfeeding, colostrum feeding, and having good knowledge of the mothers about skin-to-skin care were factors associated with skin-to-skin care practice. Therefore, health care workers should counsel mothers on optimal breastfeeding practice and enhance maternal awareness regarding the merits of skin-to-skin care practice before discharge from the health facilities are recommended.

The Impact of Formula Industry Marketing on Breastfeeding Rates in Native and Migrant Mothers.

Introduction: Lifelong benefits of breastfeeding are far-reaching. However, optimal breastfeeding practices may be negatively affected by the marketing of different forms of breast milk substitutes. In addition, whether market factors have a different impact on migrants' breastfeeding practices when compared to natives has been poorly investigated. Objectives: Our study's aims are (1) to assess the effect of market factors on breastfeeding discontinuation (any and exclusive), (2) comparing migrant and native women. Methods: A longitudinal study was conducted within baMBINO, a nationwide project on perinatal health among migrant women in Portugal. Our final sample included 1,251 migrants and 1,150 natives recruited between April 2017 and March 2019 in 32 public maternities. Cox regression analysis was performed, adjusting for important confounders, and interactions were tested. Results: Market factors were associated with any and exclusive breastfeeding discontinuation. Participants receiving free formula samples from a health professional were more likely to stop exclusive breastfeeding (adjusted hazard ratios [aHR] = 1.37, 95% confidence intervals [95% CI] = 1.13-1.66, p = 0.002). Reporting exposure to formula discounts was associated with discontinuation of exclusive (aHR = 1.22, 95% CI = 1.09-1.38, p = 0.001) and any breastfeeding (aHR = 1.21, 95% CI = 1.00-1.46, p = 0.046). No interactions were found between being migrant and exposure to market factors. Conclusions: Market factors influence discontinuation of any and exclusive breastfeeding. The impact of marketing does not differ between native and migrant women.

Knowledge, Attitude and Practices Regarding Breast Feeding Among Primiparous and Multiparous Mothers in an Urban Slum, West Tripura: A Comparative Cross Sectional Study

Background:Inadequate knowledge or inappropriate practices of breastfeeding may lead to undesirable consequences.Objectives: To assess the knowledge, attitude and practices (KAP) regarding breastfeeding among primiparous and multiparous mothers in an urban slum. Methods: A community based cross sectional study was conducted among 200 mothers (100 primiparous and 100 multipara) in an urban slum and eligible mothers were selected using simple random sample technique. Results: The mean knowledge score on breastfeeding for the primiparous mothers was 8.4 ±1.8 and multiparous was 9.5±2.2. The mean attitude score for the primiparous mothers was 47.27±3.09 and 48.38±2.7 for the multiparous mothers. Out of 200 mothers, 118 (59%) had adequate knowledge and 86 (43%) mothers were correctly done breast feeding practices. However, 52% multiparous were found more correctly practicing breastfeeding than primiparous (34%) and it was statistically significant (P=0.01). The level of knowledge among multiparaous (71%) were found more adequate than primiparous (47%) and significant difference was observed (P=0.001). Most of mothers (83%) had positive attitude towards breastfeeding (82% primiparous and 84% multiparous) and mothers did not have any negative attitude towards breastfeeding. Conclusions: The level of Knowledge is still needed to be improved in primipara mothers and however, the correct practice of breastfeeding was also found low in primipara mothers than multipara mothers. These findings suggest an urgent need for dissemination of information about optimal breastfeeding practices through mass media and education of mothers during antenatal visits and immunization sessions especially in primipara mothers in the study area.

Breastfeeding Practices among Adolescent Mothers and Associated Factors in Bangladesh (2004-2014).

Optimal breastfeeding practices among mothers have been proven to have health and economic benefits, but evidence on breastfeeding practices among adolescent mothers in Bangladesh is limited. Hence, this study aims to estimate breastfeeding indicators and factors associated with selected feeding practices. The sample included 2554 children aged 0–23 months of adolescent mothers aged 12–19 years from four Bangladesh Demographic and Health Surveys collected between 2004 and 2014. Breastfeeding indicators were estimated using World Health Organization (WHO) indicators. Selected feeding indicators were examined against potential confounding factors using univariate and multivariate analyses. Only 42.2% of adolescent mothers initiated breastfeeding within the first hour of birth, 53% exclusively breastfed their infants, predominant breastfeeding was 17.3%, and 15.7% bottle-fed their children. Parity (2–3 children), older infants, and adolescent mothers who made postnatal check-up after two days were associated with increased exclusive breastfeeding (EBF) rates. Adolescent mothers aged 12–18 years and who watched television were less likely to delay breastfeeding initiation within the first hour of birth. Adolescent mothers who delivered at home (adjusted OR = 2.63, 95% CI:1.86, 3.74) and made postnatal check-up after two days (adjusted OR = 1.67, 95% CI: 1.21, 2.30) were significantly more likely to delay initiation breastfeeding within the first hour of birth. Adolescent mothers living in the Barisal region and who listened to the radio reported increased odds of predominant breastfeeding, and increased odds for bottle-feeding included male infants, infants aged 0–5 months, adolescent mothers who had eight or more antenatal clinic visits, and the highest wealth quintiles. In order for Bangladesh to meet the Sustainable Development Goals (SDGs) 2 and 3 by 2030, breastfeeding promotion programmes should discourage bottle-feeding among adolescent mothers from the richest households and promote early initiation of breastfeeding especially among adolescent mothers who delivered at home and had a late postnatal check-up after delivery.

Determinants of low breastfeeding self-efficacy amongst mothers of children aged less than six months: results from the BADUTA study in East Java, Indonesia

BackgroundDespite the increasing rate of exclusive breastfeeding in Indonesia, there is still a need for supportive interventions. The breastfeeding self-efficacy of mothers is a key factor positively associated with optimum breastfeeding practices. Our analysis aims to assess the determinants of low breastfeeding self-efficacy amongst a sample of women with children aged under 6 months in Malang and Sidoarjo Districts, East Java, Indonesia.MethodsWe used information from 1210 mothers of children aged < 6 months recruited in the BADUTA study conducted in 2015–2016 in Malang and Sidoarjo Districts. The outcome variable in this analysis was mothers’ self-efficacy for breastfeeding using the 14 statements in the Breastfeeding Self-Efficacy-Short Form. We evaluated 17 potential predictors of breastfeeding self-efficacy, organized into six sub-groups of variables: (1) context/demographic; (2) household factors; (3) maternal characteristics; (4) child characteristics; (5) breastfeeding practices; and (6) antenatal and delivery care. Logistic regression analyses were employed to examine factors associated with mothers’ self-efficacy with breastfeeding.ResultsMore than half of the women in this study had a low level of self-efficacy. One of the factors associated with low breastfeeding self-efficacy found in this study was mothers’ problems related to breastfeeding. Mothers who had problems with breastfeeding not related to illness (adjusted odds ratio [aOR] 3.27; 95% CI 2.45, 4.36) or problems related to both illness and non-illness conditions (aOR 3.57; 95% CI 1.37, 9.33) had higher odds of low breastfeeding self-efficacy than those who did not have any problems. Compared to mothers who completed university education, there was a significantly higher odds of low breastfeeding self-efficacy in mothers who completed primary school or lower (aOR 1.88; 95% CI 1.16, 3.05); completed junior high school (aOR 2.27; 95% CI 1.42, 3.63); and completed senior high school (aOR 1.94; 95% CI 1.29, 2.91). Other significant predictors of low breastfeeding self-efficacy were mothers not exposed to any breastfeeding interventions (aOR 1.87; 95% CI 1.09, 3.22); working outside the house (aOR 1.69; 95% CI 1.23, 2.32); not obtaining any advice on breastfeeding (aOR 1.40; 95% CI 1.08, 1.82); with low knowledge of breastfeeding (aOR 1.38; 95% CI 1.03, 1.84); and delivered by Caesarean section (aOR 1.34; 95% CI 1.05, 1.70).ConclusionsMultipronged breastfeeding education programs and support are required to improve women’s self-efficacy with breastfeeding. Improved access to breastfeeding counselors, active support for mothers following cesarean delivery, and increased supporting facilities at workplaces are essential to improve self-efficacy with breastfeeding.