Predictors Of Exclusive Breastfeeding Research Articles

Appetitive traits as predictors of exclusive breastfeeding in infants for the first six months

ABSTRACT This study aimed to identify whether appetitive traits predict exclusive breastfeeding (EBF) duration for the first 6 months of life and to assess other predictors of its duration. 186 six- month-old term infants were included. Appetitive traits were assessed at 3–4 months of age. EBF duration, feeding practices, sex, maternal age and education, socioeconomic level, mode of delivery and gestational age were also evaluated. Risk ratios (RR) and 95% confidence intervals (CI) were estimated through generalized linear regression models to identify predictors of EBF for the first 6 months of life. Only 32.9% of infants achieved 6-month EBF. Vaginal birth, not using formula the first 3 days, maternal education ≥ university and slowness in eating significantly increased the probability of EBF for 6 months. Slowness in eating was the only appetitive trait related to EBF for the first 6 months and was the most significant predictor in the multivariate model.

Predictors of Not Exclusively Breastfeeding Among Ghanaian Women: A CrossSectional Study

Background: Exclusive breastfeeding (EBF) is a practice highly recommended by WHO and UNICEF for all infants to be given solely breastmilk in the first six months. This practice is advised because breastmilk is the gold standard of infant feeding as it is untainted and comprises all of the essential nutrients for the first few months of a child’s life. The objective of this study is to focus on the factors that prevent mothers from not exclusively breastfeeding among Ghanaian women residents in rural and urban geographic locations. Methods: Data was acquired from the 2014 Ghana Demographic and Health Survey (GDHS) for this analysis. A total of 557 mothers who had infants in the last 2 years between the ages of 0 – 5 months were extracted from the individual child (KR) dataset. A Logistic regression model was utilized to ascertain the predictors of not exclusively breastfeeding among Ghanaian women. Results: Overall, mothers engaged in exclusive breastfeeding was 52%. Ethnicity, infant size, region, marital status, mother’s age, and husband’s occupation have a significant association with breastfeeding status [Table 1]. The binary logistic regression revealed that timing of first antennal visits, maternal education, region, ethnicity, and husband’s occupation were significantly associated with predictors of EBF. Mothers without formal education and mothers whose husbands/partners' occupation was skilled manual labor were more likely to not breastfeed exclusively. Mothers residing in the northern part of Ghana, mothers of a minority ethnic group, and the timing of first antennal visits had lower odds of not exclusively breastfeeding. Conclusion: The findings suggest that breastfeeding in Ghana is a universal practice since more than 98% of infants were birthed in the last 2 years before at some point. Despite the existence of breastfeeding campaigns and the high awareness created, EBF rates continue to decline in the nation. It is, therefore, crucial to develop and implement EBF intervention programs that aim at eliminating misconceptions and misinformation about the practice with more emphasis on the health and economic benefits of EBF.

FAKTOR - FAKTOR YANG BERHUBUNGAN DENGAN KEBERHASILAN PEMBERIAN ASI EKSKLUSIF OLEH IBU BEKERJA DI KOTA DENPASAR

A working mother is frequently facing barriers in breastfeeding their babies. Several barriers in breastfeeding faced by the working mothers are the long duration of work, the lack of opportunities and support provided by the workplace for mothers to do the breast milk due to the unavailability of breastfeeding facilities such as lactation rooms, and the lack of knowledge of working mothers regarding lactation management. This study aims to determine the factors associated with the success of exclusive breastfeeding by working mothers in Denpasar City. This study was quantitative correlative research by using a cross-sectional design and purposive sampling technique. Data collection was carried out on 97 respondents who visited Puskesmas 1 Denpasar Utara, Puskesmas 1 Denpasar Timur, Puskesmas 2 Denpasar Barat, and Puskesmas 2 Denpasar Selatan. Data collection used knowledge, availability of lactation facilities at work, and husband's support questionnaires. The eta test and contingency coefficient were used for the data analysis. The results showed that there was no correlation between age (p=0,08), parity (p=0,132), baby's gender (p=0,501), socioeconomic status (p=0,111), type of mother's occupation (p=0,70), knowledge (p=0,338), availability of lactation facilities (p=0,3), and husband's support (p=0,180) with exclusive breastfeeding. However, distance (0,019) and duration of work (p=0,044) were associated with exclusive breastfeeding (p<0,05). In conclusion, there is a relationship between distance and duration of work seem as predictors of exclusive breastfeeding by working mothers in Denpasar City. It is expected to increase knowledge of working mothers about the management of expressed breast milk, thus the exclusive breastfeeding can be achieved.

Knowledge, attitude, practice and determinants of exclusive breastfeeding among women in Ethiopia: Systematic review and meta-analysis

ObjectiveThis study aimed to assess the pooled estimate of Ethiopia's women's knowledge, attitudes, practices, and determinants of exclusive breastfeeding. MethodsPubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, study setting, and publication. The pooled odds ratio for associated factors was also computed. ResultsOut of 995 studies reviewed, 33 met our eligibility criteria and were included in this meta-analysis study. The total number of study participants was 13,397. The pooled prevalence of good knowledge, positive attitude, and poor practice of kangaroo mother care were 74.2% (95% CI: 62.9–85.4), 77.2% (95%CI: 68.3–86.0), and 58.3% (95% CI: 49.9–66.6), respectively. In sub-group analysis, the highest prevalence of knowledge was in institution-based studies (78.3%) and unpublished studies (76.3%). A positive attitude was also highest in institutional-based studies (81%). The highest practice prevalence was in Afar (68%) and the lowest was in Addis Ababa (34.6%).Women who had a secondary level of education (AOR = 3.3; 95%CI: 1.8–6.0) were a housewife (AOR = 3.1; 95%CI: 2.1–4.7), delivered vaginally (AOR = 2.0; 95%CI: 1.4–2.9), health facility delivery (AOR = 3.3; 95%CI: 2.1–5.1) and attending antenatal care were predictors of exclusive breastfeeding. ConclusionAlthough women have good knowledge and positive attitude toward exclusive breastfeeding, there is a significant gap in exclusive breastfeeding practice. Maternal education, occupation, vaginal delivery, institutional delivery, and antenatal care visit were predictors of exclusive breastfeeding. It is recommended to strengthen maternal and child health services.

Breastfeeding Self-Efficcacy pada Ibu Hamil Trimester III Hingga Menyusui

Self-efficacy is an important psychological and motivational factor in breastfeeding and is a valuable framework for predicting breastfeeding outcomes and demonstrating a mother's confidence in breastfeeding. Breastfeeding Self-efficacy is a predictor of exclusive breastfeeding. The purpose of this study was to determine the determinants and their relationship with breastfeeding self-efficacy in Pringsewu District. Study design correlational quantitative used in 100 pregnant women in the third trimester and breastfeeding mothers of 0-6 months incidentals sampling. Mothers filled out the online questionnaire themselves which was distributed by the research team during April - July 2021. The results of the study showed that 67% of respondents had high breastfeeding self-efficacy. There is a significant relationship between education level, parity, employment status, knowledge, breastfeeding experience, observation of others, and husband's verbal persuasion with breastfeeding self-efficacy mother (p-value<0.05). The conclusion in this study is that most respondents have good breastfeeding self-efficacy, various factors such as education level, occupation, parity, mother's knowledge, breastfeeding experience, observation of others, and husband's verbal persuasion proved to have a significant relationship with the mother's breastfeeding self-efficacy. Suggestions for health workers and further researchers, Breastfeeding self-efficacy should be detected early in pre-pregnancy and early pregnancy so that mothers who are at risk of failure to give exclusive breastfeeding can be immediately given the right intervention. Then it is maintained until the mother can exclusively breastfeed and continues to breastfeed her baby for up to 2 years or more.

Impact of excessive gestational weight gain on exclusive breastfeeding among women with Type 1 and Type 2 diabetes and obesity.

Pregestational diabetes, obesity and gestational weight gain (GWG) are associated with adverse perinatal outcomes, however, the influence of excessive GWG on lactation at discharge is less known. Our aim is to evaluate the impact of excessive GWG using the LifeCycle project guidelines on exclusive breastfeeding (EBF) and any BF rates at discharge among 171 women with Type 1 and 294 Type 2 diabetes and obesity who intended to BF. Retrospective cohort study. Obesity was defined by BMI (kg/m2) as grade 1 (30-34.9), grade 2 (35-39.9) or grade 3 (≥40). GWG was categorized as adequate, inadequate or excessive according to the 2019 LifeCycle Project guidelines. Women with Type 1 were younger (30 vs 33y), primiparous (51 vs 32%), delivered earlier (37 vs 38w) than women with Type 2 andwere different in grade 1 (40 vs 26%), grade 3 obesity (19 vs 49%) and median GWG (15 vs 11kg). Of all 465 women with Type 1 and Type 2 combined, 365 (78%) who had excessive GWG and 100 (22%) who had non-excessive GWG showed similar EBF (27 vs 25%) and any BF (72 vs 72%) rates. Regression analysis showed that after adjusting for potential confounders excessive GWG was not a predictor of EBF or any BF at discharge. Type 1 and Type 2 diabetes, obesity and excessive GWG are associated with low EBF, however, excessive GWG is not an independent predictor of low EBF or any BF at discharge.

Is Infant birth weight and mothers perceived birth size associated with the practice of exclusive breastfeeding in Ghana?

IntroductionDespite widespread advocacy for exclusive breastfeeding, and the associated benefits of exclusive breastfeeding for both infants and mothers, there is low prevalence in both developed and developing countries. Additionally, although several studies have been conducted on exclusive breastfeeding, very few of such studies have linked birth weight and birth size to exclusive breastfeeding. This study seeks to examine the influence of birth weight and birth size on exclusive breastfeeding.MethodologyThis study adopted a sequential explanatory mixed method approach using both quantitative and qualitative methods. The quantitative approach used cross-sectional data from the 2014 Ghana Demographic and Health Survey (GDHS) and the qualitative data from interviews with exclusive breastfeeding mothers from two health facilities in La Nkwantanang Municipal Assembly in Accra, Ghana. Logistic regression analysis was used to examine whether infants birth weight and mothers perceived birth size are associated with the practice of exclusive breastfeeding while the qualitative data provided further insights into the findings from the quantitative analysis.ResultsMajority (85%) of the infants in the study were of normal birth weight while 52% of the infants were perceived by their mothers to be of small birth size. The prevalence of exclusive breastfeeding was found to be 54.8%. The birth weight of infants and mothers’ perceived birth size were found to be significant predictors of exclusive breastfeeding. Infants of normal birth weight (OR = 7.532; 95% CI: 2.171–26.132) and high birth weight (OR = 6.654; 95% CI: 1.477–29.978) were more likely to be exclusively breastfed compared to low-birth-weight infants. Similarly, infants perceived to be of normal birth size were more likely (OR = 1.908; 95% CI: 1.058–3.441) to be exclusively breastfed compared to infants perceived to be of small birth size. The findings from the qualitative analysis show that birth weight rather than birth size influence mothers’ decision to practice exclusive breastfeeding.ConclusionThe findings of the study underscore the relevance of infant birth weight and perceived birth size in the practice of exclusive breastfeeding and highlights the need to incorporate both actual measurement of birth weight, and perception of infant’s birth size into policies targeted at exclusive breastfeeding. There is the need for deliberate targeted efforts at women who deliver infants of low birth weight and women who perceive their children to be of small birth size to practice exclusive breastfeeding.

Determinants of Optimal Breastfeeding Practices in Indonesia: Findings From the 2017 Indonesia Demographic Health Survey.

ObjectivesUnderstanding the factors influencing mothers’ decision to breastfeed their infants is essential to formulate effective breastfeeding interventions. This study explored the determinants of optimal breastfeeding indicators in Indonesia.MethodsWe used the 2017 Indonesia Demographic and Health Survey to analyze factors associated with early initiation of breastfeeding, exclusive breastfeeding (EBF), and continued breastfeeding at 1 year (CBF-1) and 2 years (CBF-2). Multivariate logistic regression models were used to examine bio-demographic, socio-cultural, and behavioral characteristics associated with breastfeeding after considering the survey design effect.ResultsThe risk of delayed breastfeeding initiation was higher among infants who were born smaller, first-born children, were delivered via cesarean delivery, and did not have immediate skin-to-skin contact (p<0.01). Infant’s age, birth pattern, household wealth index, and the mother’s occupation and smoking status were predictors of EBF (p<0.05). CBF-1 was less common among first-time mothers and those working in the non-agricultural sector, mothers from wealthier families, and mothers who had cesarean deliveries (p<0.01). Infant’s age was negatively associated with CBF-2 (adjusted odds ratio [aOR], 0.85; 95% confidence interval [CI], 0.74 to 0.99). Mothers attending college were less likely to practice CBF-2 than those with no education or primary education (aOR, 0.45; 95% CI, 0.26 to 0.77). The absence of postnatal visits was a risk factor for CBF-1 and CBF-2 (p<0.05).ConclusionsBreastfeeding interventions in Indonesia should pay particular attention to at-risk groups such as women from wealthier families, working outside the agricultural sector, and with a higher education level. Nutrition-sensitive programs (e.g., postnatal care and smoking cessation) should also be encouraged.

Extent, duration and predictors of exclusive breastfeeding in a longitudinal study: adjusting for missing data using an accelerated failure time model and multiple imputation

&#x0D; Background: The World Health Organization recommends at least 6 months of exclusive breastfeeding (EBF). Longitudinal studies facilitate estimation of EBF duration, but often suffer from loss to follow-up and missing information. The study estimates the prevalence of EBF, duration and predictors of EBF duration while adjusting for missing data using multiple imputation (MI).&#x0D; Methods: A longitudinal study was conducted on all women giving birth between September 2009-February 2010 in selected hospitals (N=2119). Data on EBF and socio-demographic and other characteristics were collected at birth, and at 2, 6, 12 and 24 months. Information on EBF status and duration was missing for 29%. To deal with missing data, we generated multiple datasets using logistic regression-based MI to impute missing EBF practice, and an accelerated failure time (AFT) model to impute missing duration of EBF. The latter model also identified factors associated with EBF duration.&#x0D; Results: The observed 64% of women practicing EBF (95%CI; 62%-66%) was adjusted, after imputation, to 62% (95%CI; 60%-65%). After imputation, the estimated median time of EBF among women practicing EBF was 4.9 months. Predictors of EBF duration were stated intention to breastfeed, religious observance, and giving formula milk while in hospital.&#x0D; Conclusion: Adjusting estimates of EBF practice and duration using MI is feasible and potentially important. Using an AFT model for EBF duration enables the execution of MI in such studies and allows direct interpretation of the impact of various factors on EBF duration. &#x0D;

Prevalence and Predictor of Exclusive Breastfeeding among Mothers of 0 to 6 months Infants from Pastoralists and Hunters' Community in Tanzania; A Community Based Cross-Sectional Study.

Background:Initiating breastfeeding during the first hour after birth and continuing breastfeeding exclusively for 6 months prevents childhood infections such as diarrhoea. Exclusive breastfeeding (EBF) for the first 6 months of life of the baby is recognised globally as the best and the most effective intervention to ensure the survival of babies. The aim of this study was to determine the prevalence of EBF and its predictors among mothers of 0 to 6 months infants from pastoralists and hunters’ community in Manyara region-Tanzania.Methods:This was a community-based analytical cross-sectional study that involved 342 mothers of 0 to 6 months infants who were randomly selected through 4 stage multistage sampling technique. Data was collected using an interviewer-administered questionnaire. Collected data was analysed using Statistical Package for Social Sciences (SPSS) version 20. Binary Logistic Regression analysis was used to establish factors associated with EBF practices.Results:The prevalence of EBF among postnatal women from hunters and pastoralists societies was 47.1% at 95% CI=41.7%-52.5%. After adjusted for confounders, the predictors of EBF practice were age of infants (0–1 months, AOR = 2.838 at 95% CI = 1.326–6.075, p=.007), age of mothers (26-35 years, AOR=1.851 at 95% CI= 1.059–3.234, p=.031), Level of education of infants’ mothers (primary education, AOR= 2.374 at 95% CI= 1.321–4.265, p=.004) and knowledge on exclusive breast feeding, AOR=2.51 at 95% CI= 1.435–4.393, p=.001.Conclusion:Majority of mothers from pastoralists’ and hunters’ societies were not practising EBF. Predictors of EBF practice were; the age of infants, maternal age, level of education of the mother and knowledge on exclusive breastfeeding. Poor EBF practice was mainly contributed to low level of knowledge about the EBF. The low level of knowledge could have been contributed by poor access to maternal services. Nature of living (lack of permanent settlement) of the study population could have contributed to low access to maternal services. An innovative interventional study is highly recommended to come up with strategies that will improve knowledge on EBF and practice of EBF

Predictors of exclusive breastfeeding in the first six months: four consecutive surveys in a tertiary hospital in Lithuania

BackgroundThere are little up-to-date data available on the duration of exclusive breastfeeding in Lithuania. The aim of our study was to examine the factors that could influence exclusive breastfeeding during the first 6 months of life.MethodsIn 2016, a survey was conducted at the Obstetrics and Gynecology Clinic of Vilnius University Hospital, Santaros Klinikos. Women in postnatal wards were opportunistically offered questionnaires and later followed up by telephone interviews at 6 weeks, 3 months, and 6 months postpartum. We used binary logistic regression to determine the factors that impacted exclusive breastfeeding during the first 6 months following childbirth.ResultsOf 475 eligible women that were approached, a total of 447 women were recruited, with response rates of 76.1, 71.4 and 67.0% at 6 weeks, 3 months, and 6 months postpartum, respectively. The prevalence of exclusive breastfeeding through the 6 month postpartum period was 39.8%. Exclusive breastfeeding during days 2 to 4 postpartum was positively influenced by factors such as a natural childbirth, the practice of breastfeeding on demand and maternal self-confidence in breastfeeding. Subsequently, exclusive breastfeeding on demand in the immediate postpartum period and exclusive breastfeeding for up to 3 months were associated with successful exclusive breastfeeding up to 6 months. However, the adverse factors that limited the success and duration of exclusive breastfeeding included free samples of human milk substitutes or advertising at primary healthcare centers 6 weeks after childbirth, pacifier use 6 months after childbirth, as well as amniotomy for labor induction.ConclusionsOur research demonstrated that exclusive breastfeeding is impacted in both directions by a range of factors during particular periods after delivery. One of the novel findings was the adverse influence of amniotomy for labor induction on exclusive breastfeeding rates. Taking into account diverse factors influencing exclusive breastfeeding and the absence of a single way to promote it, there is a crucial need to increase the incidence of exclusive breastfeeding until infants reach the age of 6 months.

Prevalence and predictors of exclusive breastfeeding in urban slums, Bihar.

Objective:Various socio-cultural factors influence infant feeding practices and thus early childhood nutrition and child survival in India. This study aimed to examine the prevalence of exclusive breastfeeding, its promoters and barriers in urban slums of Bihar, India.Methods:We conducted a community based cross-sectional survey involving 297 mothers living in slum settlements in Bihar. Data were collected using structured questionnaire on exclusive breastfeeding practices, and the factors that could influence this. Descriptive analysis was done to estimate the prevalence of exclusive breastfeeding and regression model was performed to identify the predictors of exclusive breastfeeding.Results:Only 23% of mothers initiate breastfeeding within 1 hour of delivery and 27.6% mothers practise exclusive breastfeeding up to six months. Mother's education was found to be associated with duration of exclusive breastfeeding (OR 11, 95% CI 2-59). Term babies were more likely to be breastfed exclusively for six months than pre-term babies (OR 8.6, 95% CI 1.6-47.6). Antenatal care visits and completing immunization were significantly associated with duration of exclusive breastfeeding (P < 0.001). The majority of mothers acquire exclusive breastfeeding knowledge through television/radio (OR 68, 95% CI 5.5-832.5) and newspaper advertisements (OR 14, 95% CI 2.6-76).Conclusion:Prevalence of exclusive breastfeeding up to six months of age and early initiation of breastfeeding remains low in slums of Bihar. Exclusive breastfeeding and early initiation of breastfeeding rates could be improved by educating and counselling mothers during health facility contacts by primary care providers.

Patterns and predictors of exclusive breastfeeding in Chinese Australian mothers: a cross sectional study

BackgroundWhile exclusive breastfeeding is recommended to 6 months of age, just 15% of mothers in Australia achieve this. The rate appears to be even lower among mothers born in China, where 90% have introduced infant formula by this time. This study aimed to examine infant feeding patterns in the first 12 months of life and the factors associated with exclusive breastfeeding at 4 months of age and infant formula introduction by 1 month of age among Chinese Australian mothers.MethodsChinese Australian women with a child aged 1 to 4 years born in Australia were recruited through social media and asked to complete an online survey. Chinese ethnicity was defined as the mother or her parents having been born in mainland China, Taiwan or Hong Kong. Infant feeding practices since birth and a range of psychosocial and cultural factors were assessed. A total of 289 Chinese Australian mothers completed the survey. The relationships between exposure variables and exclusive breastfeeding at 4 months or infant formula use by 1 month were examined using multivariable logistic regression.ResultsAlmost all (93%) mothers initiated breastfeeding, however by 1 month of age exclusive breastfeeding rates reduced to 44%, with a further decline to 33 and 18% at 4 and 6 months respectively. Concurrently, 7% of parents reported infant formula feeding at birth increasing to 55 and 63% at 1 and 6 months of age respectively. The rates of any breastfeeding were 81% at 6 months and 50% at 12 months of age. Breastfeeding intention, self-efficacy and awareness of the infant feeding guidelines were key factors associated with sustained exclusive breastfeeding to 4 months.ConclusionsWhile Chinese Australian mothers had comparable exclusive breastfeeding rates at 6 months to the general Australian population, twice as many had introduced infant formula by 1 month of age. There is an urgent need to support Chinese Australian mothers in the perinatal period to strengthen their knowledge, intention and confidence to delay early introduction of infant formula and promote exclusive breastfeeding in the early postpartum period.

Predictors of Exclusive Breastfeeding Among Health Care Workers in Urban Kano, Nigeria

ObjectiveTo investigate knowledge, attitudes, and predictors of exclusive breastfeeding (EBF) among female health care workers. DesignCross-sectional survey. SettingKano, northern Nigeria. ParticipantsThe study population (N = 261) included all consenting female health care workers (nurse/midwives, n = 157; physicians, n = 39; pharmacists, n = 16; and other health care workers, n = 49) at an urban teaching hospital who were of reproductive age (18–49 years) with children less than 5 years of age (0–59 months). MethodsThe respondents completed a structured, self-administered questionnaire. Knowledge and attitude scores for EBF were computed and adjusted odd ratios (aORs) generated from a logistic regression model. ResultsOf 261 respondents, including nurse/midwives, doctors, pharmacists, and other health care workers, 61 (23.4%), 184 (70.5%), and 16 (6.1%) had good, fair, and poor knowledge of EBF, respectively. Approximately 70% (n = 182) of the respondents exclusively breastfed their infants for 6 months. About one half (50.5%, n = 132) of the respondents supported breastfeeding in the workplace. Being a nonphysician (aOR = 4.68, 95% confidence interval [CI] [2.24, 9.79]), having an older index child (age ≥12 months; aOR = 2.12, 95% CI [1.13, 4.49]), spontaneous vaginal birth (aOR = 3.31, 95% CI [1.49, 7.37]), and good knowledge of the benefits of EBF (aOR = 1.34, 95% CI [1.12, 3.53]) increased the odds of EBF. ConclusionWe found knowledge, support, and practice of EBF among health care workers in Kano, Nigeria, to be suboptimal. Type of health care worker, age of the index child, type of birth, and breastfeeding knowledge independently predicted EBF. We recommend continuing education to address knowledge deficits and promote EBF among health care workers in Nigeria.

Exclusive breastfeeding and associated factors among HIV positive mothers in Northern Ethiopia.

BackgroundIt is estimated that sub-optimal feeding, especially non-exclusive breastfeeding in the first 6months of life, results in 1.4million deaths and 10% of disease burden in children younger than five years. Worldwide, it is estimated that only 34.8% of infants are exclusively breastfed for the first 6months of life, the majority receiving some other food or fluid in the early months. Besides, the Ethiopian demographic and health survey (2016) stated that the median duration of exclusive breastfeeding in Tigray region was 3.8 months which is shorter than the recommended duration. The main purpose of this study was to determine the magnitude of exclusive breastfeeding practice and associated factors among HIV positive mothers in public hospitals of Tigray region, Northern Ethiopia.MethodsA facility based cross-sectional study was conducted from July 9 to October 11, 2016, in public hospitals of Tigray region. Data was collected by using structured questionnaire using face-to-face interview among 304 eligible women through a systematic sampling technique. Data was analyzed using SPSS version 20.0. Binary and multiple variable logistic regressions (“odds ratio”) analyses were calculated with 95% CI and p value ≤ 0.05 as significance were used.ResultTwo hundred seventy (88.8%) of mothers practiced exclusive breastfeeding for the first six months of life. Infant feeding counseling during antenatal care of last pregnancy [AOR = 6.9, 95% CI; 2.63, 17.99], knowledge on exclusive breastfeeding (AOR = 5.5, 95% CI; (2.12, 14.02] and attitude towards exclusive breastfeeding [AOR = 7.9; 95% CI; 2.96, 21.21] had significant association with exclusive breastfeeding practice.ConclusionsA high proportion of mothers practiced exclusive breastfeeding for the first six months of life. Infant feeding counseling, knowledge and attitude towards exclusive breastfeeding practice were the predictors of exclusive breastfeeding among HIV positive mothers. Strengthening infant feeding counseling during antenatal care and improving mothers’ knowledge and attitude on exclusive breastfeeding is essential.

Exclusive Breastfeeding Rates and Factors Associated with Exclusive Breastfeeding Practices in Northern Tanzania: Measurement using Two Different Methodologies-24 Hours Recall and Recall Since Birth.

Background:Exclusive breastfeeding (EBF) has many benefits to the child from mental to physical growth and development; however, methods of measuring EBF have raised a number of policy and programmatic questions. This study assesses EBF rates and factors associated with EBF practices in Northern Tanzania using two different methodologies, namely, the 24-hours recall and recall-since-birth.Methods:A cohort study was conducted from October 2013 to December 2015 among mother-infants’ pairs. Mothers with child delivery information (N=430) were followed and included in the analyses. We enrolled pregnant women who were in their third trimesters and interviewed them with the help of questionnaires at enrollment, delivery, 7 days and thereafter monthly up to nine months after delivery. At each visit after delivery, information on breastfeeding using the two methods (24 hours recall and recall-since-birth) was collected.Results:The prevalence of EBF dropped from one month to six months when using both the 24 hours recall and the recall since birth methods, but at different rates. At six months, 24.2% of the mothers practiced EBF when measured with the recall since birth method, compared to 38.8% when measured with the 24 hour recall. Predictors of EBF were also different. When using the recall since birth method, women who had received counseling on infant feeding had increased odds of practicing EBF compared to those who did not receive counseling, [AOR=2.3; 95% CI (1.2, 3.7)]. When using 24 hours recall, women who were unemployed had increased odds of practicing EBF compared to those who were employed [AOR=1.5;95% CI(1.1,2.5)], and women aged 35 - 49 years had decreased odds of practicing EBF compared to younger women[AOR=0.28; 95 % CI(0.1,0.7)].Conclusions and Global Health Implications:The two methods for EBF give substantially different results, both in the prevalence of EBF and factors associated with EBF. The higher EBF obtained with 24 hours recall represents an overestimation and thereby an overly positive picture of the situation.

Prevalence and predictors of exclusive breastfeeding among immigrant and Canadian-born Chinese women.

Breastfeeding is the optimal method for infant feeding, yet migrant women may be at risk for suboptimal exclusivity rates. In a cohort of immigrant and Canadian-born Chinese women, our objectives were to (a) describe patterns and prevalence of exclusive breastfeeding at 1, 3, and 6months postpartum; (b) identify risk and protective factors associated with exclusivity; and (c) examine potentially differential importance of these factors across this 6-month period. This was a prospective study of 565 immigrants and Canadian-born Chinese women (Toronto, Canada). Exclusive breastfeeding was measured at 1, 3, and 6months postpartum. Predictors comprised fixed (demographics, history of depression, immigrant status, prenatal breastfeeding classes, in-hospital formula supplementation, baseline social support, and baseline acculturative stress) and time-dependent (depression, anxiety, fatigue, and breastfeeding problems) variables. Descriptive statistics, logistic regression, and generalized linear mixed models, respectively, were undertaken to address the objectives. Patterns of breastfeeding practices included exclusive breastfeeding in all time points (26.8%) or none (32.9%) and moving from exclusive to nonexclusive (20.3%) or nonexclusive to exclusive breastfeeding (15.2%). Women less likely to breastfeed exclusively at 1, 3, or 6months were those whose infants received in-hospital formula supplementation. Exclusivity attrition was higher between 3 and 6months than 1-3months. Immigrant status and in-hospital formula supplementation had a significant impact on exclusivity earlier in the postpartum period while breastfeeding problems were associated with decreased exclusivity across time. Proactive preventive efforts are need to maintain breastfeeding exclusivity especially between 3 and 6months if women are to meet international breastfeeding recommendations.

Breastfeeding Self-Efficacy as a Predictor of Exclusive Breastfeeding: A Clinical Trial

Background: breastfeeding (EBF) is globally promoted as the ideal method of infant feeding during the first six months of life due to its health benefits to both the mother and child (1). The aim of this study was to examine the effect of the interventions leading to increased awareness, knowledge, and self-efficacy regarding exclusive breastfeeding and duration of breastfeeding. Methods: This clinical trial was conducted on 129 pregnant women before the gestational age of 21 weeks and 6 days referring to Vali-e-Asr Hospital in Tehran, Iran. The study population was selected using the convenience sampling method. The participants were randomly assigned into two groups of intervention (n=64) and control (n=65). The mothers in the intervention group received one training session on breastfeeding self-efficacy, as well as training and audio packages regarding postpartum care and relationship with neonates. In addition, the women who suffered from anxiety, stress, or depression were provided with psychotherapies. The data collection instruments included the Self-Efficacy Scale, Edinburgh Postnatal Depression Scale, and Spielberger's State-Trait Anxiety Inventory. Results: Exclusive breastfeeding was higher in the intervention group than in the control group during the first six months postpartum (P=0.015). The follow-up study showed that there were higher rates of breastfeeding for the two-year-old children in the intervention group (P<0.001). In addition, self-efficacy was associated with anxiety and depression. Conclusion: As the findings indicated, psychological intervention aimed at increasing self-efficacy had a significant impact on maternal breastfeeding self-efficacy and duration of breastfeeding.

LATCH Score as a Predictor of Exclusive Breastfeeding at 6 Weeks Postpartum: A Prospective Cohort Study.

Assessment of breastfeeding efficiency by objective means is essential to increase the success of breastfeeding. To study the utility of LATCH score in predicting exclusive breastfeeding rates at 6 weeks postpartum along with an optimum cutoff between January 2016 and June 2016. One hundred mother-infant dyads born of vaginal delivery with gestational age ≥37 weeks and singleton births were included with LATCH scores assessed at birth and 48 hours/discharge and followed up at 6 weeks postpartum. Sixty-two of 100 (62%) infants were exclusively breastfeeding at 6 weeks. Mean LATCH scores at birth (7.17 ± 1.13 versus 4.26 ± 1.7, p = <0.0001) and 48 hours/discharge (9.22 ± 1.01 versus 5.78 ± 1.29, p = <0.0001) were higher in mothers who were breastfeeding at 6 weeks. LATCH score ≥6 at birth had a sensitivity 93.5% and specificity 65.78% and these mothers were 5.92 times more likely to be breastfeeding at 6 weeks. LATCH score ≥8 at 48 hours/discharge had a sensitivity 93.55% and specificity 92.1% with these mothers being 9.28 times more likely to be breastfeeding at 6 weeks postpartum. Receiver operating characteristic (ROC) for LATCH score at birth and exclusive breastfeeding (EBF) at 6 weeks had an area under curve (AUC) 0.915 (cutoff ≥5.5 sensitivity 93.5%, false positive rate-34.2%). ROC for LATCH score at 48 hours/discharge and EBF 6 weeks had an AUC 0.979 (cutoff ≥7.5 sensitivity 93.5%, false positive rate-7.9%). LATCH represents a simple, cost-effective tool capable of predicting breastfeeding as early as in the first 24 hours of life, especially in resource-limited settings.

Predictors of exclusive breastfeeding across three time points in Bangladesh: an examination of the 2007, 2011 and 2014 Demographic and Health Survey.

BackgroundThe objective of this study was to explore predictors of exclusive breastfeeding (EBF) in Bangladesh using data from 2007, 2011 and 2014, specifically focusing on potential reasons why rates of EBF changed over those time periods.MethodsData on mother/infant pairs with infants <6 months of age were examined at the three time points using the Bangladesh Demographic and Health Survey. The EBF prevalence, changes in EBF since the previous survey and determinants of EBF at each time period were examined using t-tests, χ2 and multilevel logistic regression.ResultsThe prevalence of EBF was 42.5, 65 and 59.4% in 2007, 2011 and 2014, respectively. The age of the child was significantly associated with EBF across all time points. The largest changes in EBF occurred in the 3- to 5-month age group. Predictors of EBF in this specific age group were similar to overall predictors (e.g. age of the child and region). Participation of the mother in household decisions was a significant predictor in 2014.ConclusionsEBF prevalence in Bangladesh increased between 2007 and 2011 and then decreased between 2011 and 2014. The increase in 2011 may have been the result of widespread initiatives to promote EBF in that time frame. Due to the unexplained decrease in EBF between 2011 and 2014, there is still a need for interventions such as peer counselling, antenatal education and community awareness to promote EBF.