Optimal Breastfeeding Practices Research Articles

Assessment of initiation and establishment of lactation among primiparous mothers

Breastfeeding the infants within one hour of birth can reduce infant mortality. Knowledge of exclusive breastfeeding among women is essential when promoting optimal breastfeeding practices. Hence, this study was conducted to evaluate initiation and establishment of lactation, level of knowledge and attitude, and actual practices of breastfeeding among postnatal primigravida mothers. This cross-sectional study was carried out on 400 postnatal primigravida mothers for one year. Mothers were interviewed and their socio-demographic details and data on time of initiation of prelacteal feeds, number of times of feeding per day, and breastfeeding duration were collected using semi-structured questionnaires. Proper counseling on breastfeeding practices including initiation and establishment of lactation was provided on the basis of the responses to the questionnaire. Pre- and post-counseling scores were interpreted and compared for all the primiparous mothers. The association between variables was examined using t-test. P-value of <0.0001 was considered statistically significant. Remarkable improvement in the post-counseling test scores was observed in terms of education, age, residence, religion, mode of delivery, weight, occupation, type of family, and sex of the baby (p<0.0001). A significant improvement was noted in mothers with more than 12th grade level of education and those who were from nuclear families and resided in urban areas (p<0.0001). Knowledge of initiation and establishment of lactation improved in primiparous mothers. Counseling improved the attitude towards lactation in all the primiparous mothers. Hence, wherever possible, relevant health programs on the awareness of timely breastfeeding should be initiated in future for all primiparous mothers.

Time trends and determinants of breastfeeding practices among adolescents and young women in Nigeria, 2003–2018

IntroductionOptimal breastfeeding practices have far-reaching health and economic benefits. Evidence suggests disparities in breastfeeding practices by maternal age-groups, with younger mothers often having lower rates of breastfeeding initiation, continuation and...

Prevalence and factors associated with early initiation of breastfeeding among women in Moshi municipal, northern Tanzania

BackgroundEarly initiation of breastfeeding (EIBF) is a predetermining factor for exclusive breastfeeding, and thus a foundation for optimal breastfeeding practices. Rates of EIBF are low globally (42%) and in Tanzania (51%), yet few studies have been done on this issue in Tanzania. This study aimed to determine the prevalence and factors associated with early initiation of breastfeeding among women in northern Tanzania.MethodologyThis study extracted information from a cohort of 536 women who were followed from 3rd trimester period October 2013 to December 2015 in Moshi municipal, northern Tanzania. The data for this paper was collected by the use of questionnaires at enrolment, delivery and 7 days after delivery. The analysis is based on data from 413 women for whom complete information was obtained. Log binomial regression analysis was used to determine factors associated with early initiation of breastfeeding.ResultsThe prevalence of EIBF was 83%. Overall, women had high knowledge on colostrum (94%), knowledge on exclusive breastfeeding (81%) and time of breastfeeding initiation (71%), but only 54% were counseled on breastfeeding during antenatal care. Knowledge on timely initiation of breastfeeding during pregnancy and vaginal delivery were associated with EIBF.ConclusionEarly initiation of breastfeeding is high (83%) in Moshi Municipal but still below the universal coverage recommended by WHO and UNICEF. There is missed opportunity by health facilities to counsel and support early initiation of breastfeeding given high antenatal and facility delivery in this setting. There is a need to evaluate health facility bottle necks to optimal support of early initiation of breastfeeding in Tanzania.

Association between Bioactive Molecules in Breast Milk and Type 1 Diabetes Mellitus.

The association between breastfeeding and type 1 diabetes mellitus (T1DM) is controversial. However, several recent studies have established a link between these two factors, necessitating a need to review this subject to raise public awareness. Current research indicates that breast milk contains a variety of bioactive substances including immunoglobulins, oligosaccharides, insulin, lactoferrin, lysozyme, cytokines, epidermal growth factors, leukocytes, nucleotides, beneficial bacteria and vitamins. Such substances strengthen the breastfeeding infant’s immune system, both directly, by increasing gut microbiota diversity and attacking harmful bacteria and pro-inflammatory molecules, and indirectly, by increasing thymus performance. Accordingly, a lack of or inadequate breastfeeding may predispose infants to several autoimmune disorders, including T1DM. Nursing mothers and caregivers are therefore advised to follow optimal breastfeeding practices prior to introducing complementary foods.

Prevalence of Exclusive Breastfeeding Practice and Its Associated Factors Among Mothers with Children Aged 6 - 12 Months in Hargeisa City, Somaliland

Breastfeeding has many health benefits for both mother and infant. Breast milk contains all the nutrients an infant need in the first 6 months of life. Exclusive breastfeeding is the most widely known and effective intervention for preventing early-childhood deaths. Optimum breastfeeding practices can prevent 1.4 million deaths worldwide among children under five every year. The aim of this study was to assess the prevalence of exclusive breastfeeding and associated factors among mothers who have an infant six months up to one year old in Hargeisa, Somaliland. A community based cross-sectional study was conducted from November to December, 2019. A cluster along with simple random sampling technique was used to select sample population. A total of 357 mothers with children aged six months to one year old were included in this study. Data were collected using questionnaires administered at interview. Both bivariate and multivariate logistic regression analyses were carried out to identify factors associated with exclusive breastfeeding. The prevalence of exclusive breastfeeding was 68%. Those mothers who were heard information on EBF [AOR=14.243 CI (4.630, 43.816)], attend ANC service [AOR=25.412 (3.506, 184.179)], received breastfeeding counseling during antenatal care (ANC) [AOR=6.037 (2.878, 12.666)], aware that breastfeeding is enough the child up to six months [AOR=3.411 (1.536, 7.577)], and had fed colostrum [AOR=4.663 CI (2.107, 10.321)] were more likely to practice EBF than their counterparts. The proportion of exclusive breastfeeding in the city was below WHO Infant and Young Child Feeding recommendations. The practice of exclusive breastfeeding in mothers of under 6 months children was influenced by receiving information about EBF, colostrum discharging, awareness of breast feeding is enough the child up to six month and antenatal care visit were significantly associated with EBF practice (P < 0.05).

Workplace support for breastfeeding employees in educational and healthcare settings in Ghana

Background. Maternal employment outside the home is associated with shorter breastfeeding duration among full-time working mothers. However, few studies have explored breastfeeding practices among working mothers in the context of less-developed countries, where an increasing number of women are entering the labour force as full-time workers. Objectives. To assess the nature of existing support systems and the needs of breastfeeding working mothers in Ghana. Methods. A descriptive cross-sectional study design was used. Convenience sampling was used to recruit participants ( N =128) from 15 healthcare and 12 educational institutions ( n =27) to complete a self-administered questionnaire. The data analysis employed descriptive statistics to analyse both the demographic and the main study variables. Results. The mean breastfeeding support score for both workplaces was nearly identical: 1.44 for healthcare institutions and 1.30 for educational institutions. With the exceptions of peer support and breastfeeding breaks, which were found to be common forms of support for breastfeeding employees, there was an evident lack of support systems to promote workplace breastfeeding. An increase in maternity leave from 3 months to 6 months, a private designated space for breastfeeding and a workplace creche were found to be the greatest needs expressed by working mothers in Ghana. Conclusion. There is a lack of targeted interventions to promote optimal breastfeeding practices among working mothers. Policy interventions should address the identified support needs of working mothers through the provision of private breastfeeding rooms, workplace creches and an increase in maternity leave from 3 to 6 months.

Factors Associated with the Implementation of the WHO Breastfeeding Recommendations in Momo Division, North-West Region of Cameroon

Breastfeeding is essential to break the spiteful cycle of malnutrition in children. In spite of the WHO recommendations on optimum breastfeeding practices and their extensively acknowledged benefits, adherence to these recommendations in Cameroon remains incredibly low. The aim of this study was to identify the factors associated with the implementation of the WHO breastfeeding recommendations among mothers whose children are aged 0 to 24 months in Momo Division, Cameroon. To achieve this goal, 540 mothers attending 22 health units in the 5 sub divisions of Momo division completed structured interviewer administered questionnaire. Through this questionnaire, information on their socioeconomic and demographic characteristics, their knowledge and cultural beliefs about breastfeeding practices and the characteristics of their babies were collected. Results show that 51.5% of babies were girls and 46.1% of mothers had secondary education as their highest level of education. The monthly household income of most (80%) of the mothers was less than 100000frs CFA. Factors found to influence pre-lacteal feeding were mode of delivery, mother’s attitude on the type of first food to be given to the baby and birth order. Breastfeeding initiation within one hour following delivery was associated with place of delivery and mode of delivery. Exclusive breastfeeding was influenced by breast problems, mother’s employment status and misconceptions. The only factor associated with frequency of breastfeeding was the infant’s age. Duration of breastfeeding was associated with birth weight, and maternal knowledge on recommended duration of breastfeeding. The main impairments to breastfeeding practices were mistaken ideas based on misinformation, inadequate or no maternity leave, caesarian method of delivery, delayed breast milk secretion, breast problems and non-satiation of the baby after breastfeeding. The misconceptions noticed amongst mothers in this Division was the belief that breast milk alone is not enough to meet the nutritional needs of the baby for up to six months, expressed breast milk should not be fed to the baby and that infants below 6 months need water to quench their thirst. Maternal knowledge on breastfeeding was good as many knew the importance of breast milk.

Main Barriers to Optimal Breastfeeding Practices in Armenia: A Qualitative Study.

In 2015, the median duration of exclusive breastfeeding was 2.2 months in Armenia, and only 15% of 4-5-month-old children were exclusively breastfed, indicating an issue with breastfeeding knowledge and practices. To identify the main barriers to optimal breastfeeding practices in Armenia. We used qualitative research methods via focus group discussions and in-depth interviews with four groups of providers from different levels of care, and mothers of young children, from Yerevan city and two provinces, Lori and Shirak. Overall, eight in-depth interviews and 13 focus group discussions were conducted with a total of 99 participants. Qualitative content analysis was applied, with elements of both inductive and deductive approaches. We identified two main categories of barriers to optimal breastfeeding-systemic barriers and knowledge deficiencies. The main themes within systemic barriers were lack of skilled breastfeeding support services and low motivation of providers-mainly related to inadequate recognition of their role in breastfeeding counseling and low remuneration. The main knowledge-related barriers were insufficient counseling of mothers, lack of reliable information sources about infant feeding, and misconceptions among both mothers and providers. Optimal breastfeeding is crucial for the best start to an infant's life; however, there were a number of barriers to optimal breastfeeding practices in Armenia. Our findings and recommendations could help policymakers apply effective strategies for improving breastfeeding rates in Armenia. Considering the similar historical backgrounds of the post-Soviet countries, our findings could also be applicable to other Commonwealth of Independent States countries.

Influences of Exclusive Breastfeeding Among Low-wage, Working Mothers in Kenya: Perspectives from Managers, Healthcare Providers, Daycare Directors, Mothers, and Fathers (OR30-02-19)

ObjectivesKenya has legislation and policies on maternity leave and workplace support for breastfeeding (BF), and breastmilk expression. The extent to which this framework influences the BF practices of low-wage mothers is unknown. The purpose of this study was to understand the influences of EBF for 6 mo among mothers employed in the commercial agriculture and tourism industries. MethodsWe conducted in-depth interviews with employed mothers (n = 25), husbands of employed mothers (n = 10), managers of commercial flower farms and hotels (n = 8), daycare directors (n = 22), and health care providers (n = 20) in Naivasha, Kenya. ResultsDespite a widespread recognition of the recommended 6 months duration for EBF, employed mothers describe early cessation of EBF in preparation for their return to work, following a mandated 3-mo maternity leave. Husbands of employed women support EBF and would like to see the duration of EBF extended, but note similar challenges. Managers support lactating mothers through flexible work schedules and duties, yet few farms or hotels have designated lactation areas, and most recognize that mothers prefer to arrive later or leave early rather than visit children to feed during the workday. Daycare directors describe lack of refrigeration for expressed milk, and low interest from mothers in leaving expressed milk to feed their children during the workday. Employers with on-site housing and/or daycare report a more favorable environment to support EBF. Health care providers perceive low-wage, maternal employment as a challenge to 6 months of EBF, yet see childcare and a strengthened continuum of education from antenatal care to immunization services and community outreach as opportunities to improve EBF promotion. ConclusionsBeliefs about optimal BF practices do not align with practice. Mothers employed in low-wage work receive some benefits from their employers to support child care responsibilities, but distance from daycare, a low efficacy for expressing and storing milk, and lack of support for milk expression currently make EBF unattainable for most mothers in these industries. Interventions to improve the desirability and feasibility of milk expression are needed to strengthen the opportunity for EBF for employed mothers. Funding SourcesFogarty International Center, National Institutes of Health.

Socio-Economic Differences in Early Initiation of Breastfeeding Among Children in a Ugandan Cross-Sectional Study

Early initiation of breastfeeding reduces neonatal and maternal morbidity and mortality, enhances mother-infant dyad bonding and maternal optimal breastfeeding practices. Studies on socio-economic inequalities in early initiation of breastfeeding are sparse in Uganda. This study therefore aimed to examine the association between socio-economic status and early initiation of breastfeeding among 5504 children aged 0-23 months in a country-wide population based cross-sectional study. Early initiation of breastfeeding defined as initiation of breastfeeding within an hour of birth was the outcome of interest. Proxy measures of socio-economic status (maternal occupation and household wealth index) were the exposure variable of interest. Bivariate analysis was conducted to determine the distribution of the prevalence of early initiation of breastfeeding by infant-mother dyad characteristics. Multivariate binary logistic regression models adjusted for relevant confounders were fitted to examine the association between socio-economic status and early initiation of breastfeeding. The results showed an overall prevalence early initiation of breastfeeding of 67.8% among Ugandan children. Children whose mothers self-reported their occupation as farmers and skilled manual workers had lower odds of early initiation of breastfeeding compared to those whose mothers were doing professional/technical/managerial work; OR: 0.69 (0.51 - 0.95) and 0.70 (0.49 - 0.99) respectively. On the other hand, children that lived in the poorest and poorer households had lower odds of early initiation of breastfeeding OR: 0.46 (0.32-0.67) and 0.64 (0.43-0.94) respectively. In conclusion, we found individual and household socio-economic inequality in EIB among children less than two years of age. Targeting interventions for promotion of EIB to less affluent mother-child dyads and households might be important in increasing optimal breastfeeding practices.

Trends and predictors of optimal breastfeeding among children 0-23 months, South Asia: Analysis of national survey data.

Optimal breastfeeding practices, including early initiation of breastfeeding (EIBF) within 1 hr of birth, exclusive breastfeeding (EBF) for the first 6 months of age, and continued breastfeeding (CBF) for 2 years of age or beyond with appropriate complementary foods, are essential for child survival, growth, and development. Breastfeeding norms differ within and between countries in South Asia, and evidence is needed to inform actions to protect, promote, and support optimal practices. This study examines time trends and predictors of EIBF, avoidance of prelacteal feeding (APF), EBF, and CBF to 2 years using survey data from Afghanistan, Bangladesh, India, Nepal, and Pakistan since 1990. EIBF, APF, and EBF increased in Bangladesh, India, and Nepal from 1990 to 2016. EIBF and EBF increased in Pakistan from 1990 to 2013, but both EIBF and APF decreased in recent years. In Afghanistan, EIBF, APF, and EBF decreased from 2010 to 2015. CBF remained fairly constant across the region although prevalence varied by country. Significant (p < 0.05) predictors of suboptimal practices included caesarian delivery (4–25%), home delivery, small size at birth, and low women's empowerment. Wealth, ethnic group, and caste had varied associations with breastfeeding. Progress towards optimal breastfeeding practices is uneven across the region and is of particular concern in Afghanistan and Pakistan. There are some common predictors of breastfeeding practices across the region, however country‐specific predictors also exist. Policies, programs, and research should focus on improving breastfeeding in the context of women's low empowerment and strategies to support breastfeeding of infants born small or by caesarian section, in addition to country‐specific actions.

Pre-lacteal feeding practice and associated factors among mothers having children less than two years of age in Aksum town, Tigray, Ethiopia, 2017: a cross-sectional study

BackgroundPre-lacteal feeding has continued as a deep-rooted nutritional malpractice in developing countries. Pre-lacteal feeding is a barrier to the implementation of optimal breastfeeding practices and increases the risk of neonatal early-life diseases and mortality. Therefore, the aim of this study was to assess pre-lacteal feeding practice and associated factors among mothers having children less than 2 years of age in Aksum town, central Tigray, Ethiopia.MethodsA community-based cross-sectional study was conducted to interview 477 mother-child pairs by systematic random sampling technique. Data were collected through interviewer-administered semi-structured questionnaires. Data were coded, entered, cleaned and edited using EPIDATA version 3.1 and export to SPSS Version 22.0 for analysis. To identify the significant variables binary logistic regression were employed. Variables with p-value < 0.05 at 95% CI in multivariate logistic regression were considered statistically significant.ResultThe prevalence of pre-lacteal feeding in Aksum town was 10.1% (95% CI: 7.3%, 13%). Mothers with no previous birth (AOR: 2.93(95% CI:1.21,7.09)), birth spacing less than 24 (AOR: 2.88(95% CI: 1.15,7.25)), colostrum discarding (AOR: 6.72 (95% CI: 2.49,18.12)), less than four anti natal care follow up (AOR: 10.55 (95% CI: 4.78,23.40)), those who underwent cesarean section (AOR: 4.38 (95% CI:1.72,11.12)) and maternal believe on purported advantage of pre-lacteal feeding (AOR: 3.36 (95%CI: 1.62,6.96)) were more likely to practice pre-lacteal feeding to their infants.ConclusionsPre-lacteal feeding is still practiced in the study area. Childbirth spacing, colostrum discarding, antenatal Care follow up, maternal belief in pre-lacteal feeding was contributing factors for practicing of pre-lacteal feeding. Coordination and sustaining the existing strategies and approaches are recommended to give emphasis on the nutritional value of colostrum and anti-natal care follow up.

Implementation of the International Code of Marketing of Breastmilk Substitutes in the Eastern Mediterranean Region

Optimal breastfeeding practices and appropriate complementary feeding improve child health, survival and development. The countries of the Eastern Mediterranean Region have made significant strides in formulation and implementation of legislation to protect and promote breastfeeding based on The International Code of Marketing of Breast-milk Substitutes (the Code) and subsequent relevant World Health Assembly resolutions. To assess the implementation of the Code in the Region. Assessment was conducted by the World Health Organization (WHO) Regional Office for the Eastern Mediterranean using a WHO standard questionnaire. Seventeen countries in the Region have enacted legislation to protect breastfeeding. Only 6 countries have comprehensive legislation or other legal measures reflecting all or most provisions of the Code; 4 countries have legal measures incorporating many provisions of the Code; 7 countries have legal measures that contain a few provisions of the Code; 4 countries are currently studying the issue; and only 1 country has no measures in place. Further analysis of the legislation found that the text of articles in the laws fully reflected the Code articles in only 6 countries. Most countries need to revisit and amend existing national legislation to implement fully the Code and relevant World Health Assembly resolutions, supported by systematic monitoring and reporting.

Obesity and Optimal Breastfeeding Practices in Developing Countries: A Double Staged Study

Background: Developing countries suffer escalating rates of overweight and obesity; increasing the burden of diseases attributable to obesity. Optimal breastfeeding is linked with prevention of obesity. Aim: To identify the optimal breastfeeding practices that can reduce the burden of overweight and obesity with a focus on countries of the Eastern Mediterranean region (EMR). Methods: This was a combined assessment double staged study. In the first stage WHO and UNICEF data base from household surveys for the 22 countries of the EMR for breastfeeding rates of timely first suckle (TFS), EBF, continued breastfeeding at 12 and 24 months and correlated and with data for overweight and obesity in children under five (CU5), youth and adults. In the second stage we conducted a retrospective cross-sectional field survey in one country (Egypt) for 120 preschool children, 60 were breastfed and 60 were artificially fed. The groups were compared for weight, length and midarm circumference using the WHO growth standards. Results: Obesity in the EMR countries is high and is on the rise. Breastfeeding practices mainly TFS and continued breastfeeding for 24 months are suboptimal in the EMR countries irrespective of their socioeconomic status. There were significant negative correlations between TFS and obesity among CU5 (r- 0.51) and obesity in adults (r-0.37). Continued breastfeeding for 12 and 24 months were also significantly correlated with obesity in CU5 (r- 0.475 and r-0.33 respectively) and obesity in adults (r-0.49 and r-0.52 respectively). This was confirmed by the field study that was done for the children under five of age that showed a significant difference in weight centiles between the breastfed and non-breastfed children at P<0.05. Conclusions: Early feeding practices are suboptimal in EMR countries and influence the high rates of obesity and overweight in the countries of the region. Focus on improving timely initiation of breastfeeding in the first hour and prolonging the duration of breastfeeding to two years may contribute significantly in the reduction of the burden of overweight and obesity in the region.

Suboptimal Breastfeeding Practices among Women in Rural and Low-Resource Settings: a Study of Women in Rural Mysore, India

BackgroundBreastfeeding rates are progressively increasing worldwide while optimal breastfeeding practices are lagging behind, especially in rural and low resource settings like India. ObjectivesThis study estimated the prevalence of and factors associated with suboptimal breastfeeding practices among mother-infant dyads in rural southern India. MethodsThis is a cross-sectional analysis of data collected in Mysore District from 2008-2011 from 1294 mother-infant dyads. All women answered an interviewer-administered survey, which included maternal, infant, and sociodemographic information and breastfeeding-related characteristics. Logistic regressions were conducted to determine factors associated with suboptimal breastfeeding practice. FindingsAbout 20% (n = 281) of mothers reported delayed initiation of breastfeeding. Mothers who were unsatisfied with the infant's gender had higher odds of delayed breastfeeding (adjusted odds ratio [AOR]: 1.42, 95% confidence interval [CI]: 1.00, 2.00). Odds of delayed initiation were significantly lower among mothers who received 7-10 antenatal checkups (AOR: 0.59, 95% CI: 0.41, 0.87) and assistance during breastfeeding (AOR: 0.73, 95% CI: 0.57, 0.95). About half (51.4%) the sample did not breastfeed exclusively for the first 6 months. Older age was associated with lower odds of nonexclusive breastfeeding (AOR: 0.95, 95% CI: 0.92, 1.00). Compared with mothers with no education, mothers with primary education (AOR: 1.94, 95% CI: 1.35, 2.79) or more than primary education (AOR: 1.58, 95% CI: 1.10, 2.26) had higher odds of nonexclusive breastfeeding. ConclusionsOptimal breastfeeding practices were influenced by a multitude of factors, including maternal age, education, number of antenatal checkups, receiving assistance with breastfeeding, and satisfaction with the infant's gender. Health promotion efforts should focus on encouraging mothers to attend antenatal care visits. Early antenatal education and counseling should include breastfeeding education in early antenatal visits. Further research should examine how to mitigate the effect of gender preference on initiation of breastfeeding.

Determinants of exclusive breastfeeding in infants less than six months of age in Hawassa, an urban setting, Ethiopia

BackgroundThe World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for the first six months of life. However, the proportion of EBF in Ethiopia is 58%. The EBF practice and factors affecting it have not been studied in Hawassa, Southern Ethiopia. The aim of this study was to assess the prevalence and determinants of EBF practice among infants less than six months age in Hawassa city, Ethiopia.MethodsA total of 529 mothers with infants aged 0–6 months were involved in this study between November 2015 and January 2016. Trained interviewers collected data from the mothers of the infants. Exclusive breastfeeding was assessed based on infant feeding practice in the prior 24 h. Multivariable logistic regression analysis was conducted.ResultsInfants aged 0–5.9 months were studied with comparable gender composition (51.4% females). The exclusive breastfeeding prevalence was 60.9% (95% CI 56.6, 65.1). Mothers with infants aged 0–1.9 months and 2–3.9 months practiced EBF more likely than mothers with infants aged 4–6 months (Adjusted odds ratio [AOR] 3.59; 95% CI 2.07, 6.2) and (AOR 2.08; 95% CI 1.23, 3.5), respectively. Married mothers practiced EBF more likely than singles (AOR 2.04; 95% CI 1.03, 4.06). Housewives practiced EBF more likely than employed mothers (AOR 2.57; 95% CI 1.34, 4.9). Mothers who had a vaginal birth were more likely to practice EBF than mothers who gave birth via Cesarean section (AOR 2.8; 95% CI 1.7, 4.6). Mothers who gave birth at a healthcare facility were more likely to practice EBF than mothers who gave birth at home (AOR 8.8; 95% CI 5.04, 15.4). Mothers without a breast complication practiced exclusive breastfeeding more than mothers with breast complications (AOR 2.05; 95% CI 1.5, 4.1).ConclusionsThis study showed a low prevalence of exclusive breastfeeding. Younger infants, babies born to married women, who are housewives, having a vaginal birth in a health facility, and whose mother’s breasts were healthy, were predictors for EBF. The promotion of an institutional delivery, optimal breastfeeding practices, and designing strategies to better support employed mothers are recommended.

OPTIMAL BREASTFEEDING PRACTICES;

Background: Breastfeeding is a common practice in Pakistan but the reportedrates of optimal breastfeeding are quite low. A baseline data about maternal knowledgeand practices was required for the effective implementation of Infant and Young ChildrenFeeding (IYCF) strategy in the settings. Therefore, the study was aimed to assess the existingknowledge and practices of the mothers about optimal breastfeeding practices. Study Design:Cross sectional study. Setting: Pediatrics OPD of Sir Ganga Ram Hospital, Lahore. Period:November and December 2015. Methods: Mothers (n=100) having children less than 2 yearsof age. Optimal breastfeeding practices recommended by the WHO were used as a goldstandard to compare with the mothers’ knowledge and practices. Data was collected by usinginterviewer administered questionnaire; and analyzed by using Statistical Package for SocialSciences (SPSS) version 21. Results: Mean age of the mothers was 27.06±4.67 years. Othercharacteristics included urban background 94%; literate 81%; and housewives 96%. Meanmonthly income of the family was 20840±13850 PKR. Only 34% mothers were counseledabout optimal breastfeeding practices during antenatal care visits. Assessment of mothers’knowledge revealed that 57% were known to initiate breastfeeding within 1hr of birth; 93%replied that colostrum must be given to the child; and 75% said that exclusive breastfeedingperiod is upto 6 months of age. Mothers’ practices in comparison to their knowledge weredisappointing because only 29% mothers started breastfeeding within 1hr of birth; 71% mothersfed colostrum to their child; and 34% exclusively breastfed their child upto the age of 6 months.Inferential statistics showed statistically significant difference between mothers’ knowledge andtheir practices (p &lt;0.05). Conclusion: Two-third of mothers had not received any counselingabout breastfeeding practices during antenatal care visits. Though, mothers’ had betterknowledge about breastfeeding but the practices were suboptimal. Policy Message: Mothersneed continuous counseling and support to make their knowledge translated into practices.

English

Background: Breastfeeding is a common practice in Pakistan but the reportedrates of optimal breastfeeding are quite low. A baseline data about maternal knowledgeand practices was required for the effective implementation of Infant and Young ChildrenFeeding (IYCF) strategy in the settings. Therefore, the study was aimed to assess the existingknowledge and practices of the mothers about optimal breastfeeding practices. Study Design:Cross sectional study. Setting: Pediatrics OPD of Sir Ganga Ram Hospital, Lahore. Period:November and December 2015. Methods: Mothers (n=100) having children less than 2 yearsof age. Optimal breastfeeding practices recommended by the WHO were used as a goldstandard to compare with the mothers’ knowledge and practices. Data was collected by usinginterviewer administered questionnaire; and analyzed by using Statistical Package for SocialSciences (SPSS) version 21. Results: Mean age of the mothers was 27.06±4.67 years. Othercharacteristics included urban background 94%; literate 81%; and housewives 96%. Meanmonthly income of the family was 20840±13850 PKR. Only 34% mothers were counseledabout optimal breastfeeding practices during antenatal care visits. Assessment of mothers’knowledge revealed that 57% were known to initiate breastfeeding within 1hr of birth; 93%replied that colostrum must be given to the child; and 75% said that exclusive breastfeedingperiod is upto 6 months of age. Mothers’ practices in comparison to their knowledge weredisappointing because only 29% mothers started breastfeeding within 1hr of birth; 71% mothersfed colostrum to their child; and 34% exclusively breastfed their child upto the age of 6 months.Inferential statistics showed statistically significant difference between mothers’ knowledge andtheir practices (p &lt;0.05). Conclusion: Two-third of mothers had not received any counselingabout breastfeeding practices during antenatal care visits. Though, mothers’ had betterknowledge about breastfeeding but the practices were suboptimal. Policy Message: Mothersneed continuous counseling and support to make their knowledge translated into practices.

Overview of Optimal Breast-feeding Practices and a Study of Breast-feeding Practices among Suburban Mothers in South India

Background: The status of breast milk practices is dismal in India in spite of specialized nutrient to newborns by way of breast milk. Culture influences breastfeeding decisions of mothers which have an influence on overall growth, development, health and nourishment of infants and children. Objectives: Assessing the maternal information, approach, and practices towards breastfeeding among mothers. Breastfeeding correlation with a number of antenatal visits, hospital education, maternal education, parity, mode of delivery, holding the baby after delivery, socioeconomic status, employment, religion and sex of the child, and prelacteal feeds. Methods: In a study, 400 mothers with children up to 2 years attending hospitals over a one year period. Data was collected using a self-administered standardized questionnaire. Statistical Analysis: The data was analysed regarding mean, frequencies, percentages, Chi-Square test and Spearman’s correlation test. Results: Breast feeding was deferred in mothers who delivered by Caesarean section due to mothers being kept for observation. Forty-three point eight % of mothers initiated first breast feeds within an hour. Eighty-eight point six % had initiated breastfeeds within one to four hours, however, it was. Prelacteal feeds were given by twenty-seven % mothers. Most mothers fed colostrum to the infants. Mean duration of exclusive breastfeeding was four and a half months. There was no association between duration of exclusive breastfeeding with parity, hospital education, holding of baby socioeconomic status and sex of the child. 34% of mothers administered in addition to breast feeding bottle-feeding. The mean age of starting complementary foods was 6 and half months. Conclusion: Due to cultural factors and other social promotional activities, the majority of the mothers had adequate knowledge and a positive attitude towards infant breastfeeding practice. Delay in the initiation of breastfeeding will impact education programs and neonatal feeding practices.

Challenges and opportunities of optimal breastfeeding in the context of HIV option B+ guidelines

BackgroundIn 2013, the World Health Organization released a new set of guidelines widely known as Option B+. Prior to that there were guidelines released in 2010. Option B+ recommends lifelong antiretroviral treatment for all pregnant and breastfeeding women living with Human Immunodeficiency Virus. The study aimed at investigating challenges and opportunities in implementing Infant and Young Child Feeding in the context of Prevention of Mother To Child Transmission (PMTCT) guidelines among HIV positive mothers of children aged 0–24 months. The study also examined implications presented by implementing the 2013 PMTCT consolidated guidelines in the transition phase from the 2010 approach in Zambia.MethodsA mixed methods approach was employed in the descriptive cross sectional study utilizing semi structured questionnaires and Focused Group Discussions. Further, data was captured from the Health Information Management System.ResultsDuring the PMTCT transition, associated needs and challenges in institutionalizing the enhanced guidelines from option A and B to option B+ were observed. Nonetheless, there was a decline in Mother to Child Transmission (MTCT) of HIV rates with an average of 4%. Mothers faced challenges in complying with optimal breastfeeding practices owing to lack of community support systems and breast infections due to poor breast feeding occasioned by infants’ oral health challenges. Moreover, some mothers were hesitant of lifelong ARVs. Health workers faced programmatic and operational challenges such as compromised counseling services.ConclusionDespite the ambitious timelines for PMTCT transition, the need to inculcate new knowledge and vary known practice among mothers and the shift in counseling content for health workers, the consolidated guidelines for PMTCT proved effective. Some mothers were hesitant of lifelong ARVs, rationalizing the debated paradigm that prolonged chemotherapy/polypharmacy may be a future challenge in the success of ART in PMTCT. Conflicting breast feeding practices was a common observation across mothers thus underpinning the need to strongly invigorate Infant and Young Child Feeding information sharing across the continuum of heath care from facility level to community and up to the family; for cultural norms, practices and attitudes enshrined within communities play a vital role in child care.