Women intending to breastfeed: predictors of early infant feeding experiences

We conducted interviews prenatally and postpartum with 187 women, all of whom intended to breastfeed their newborns. However, 18% of these women either never initiated breastfeeding or stopped within one week. Among women who initiated breastfeeding, we identified four variables as significant predictors of failure to breastfeed for more than seven days: lower confidence in ability to breastfeed, less certainty in the decision to breastfeed, delayed first breastfeeding experience, and lack of rooming in with the baby. Results of this study suggest that women at high risk for not implementing their prenatal breastfeeding intention can be identified for additional support; interventions should focus on prenatal confidence building, early and continuing contact with the newborn, anticipatory guidance prior to discharge, and early pediatric follow-up.     

Factors Associated with Intention to Breastfeed Among Low-Income,Inner-City Pregnant Women

Objectives: To examine the relationship between sociodemographic factors, maternal characteristics, and intention to breastfeed among low-income, inner-city pregnant women. Methods: English and Spanish speaking low-income women recruited from local Philadelphia health centers were surveyed at the time of their first prenatal care visit. At the time of the visit, respondents were asked whether or not they planned to breastfeed their infant. The responses of 2,690 women were included in these analyses. Multivariate logistic regression was used to assess the independent associations of race/ethnicity, nativity status, education, and other factors on the odds of intending to breastfeed. Results: About half (53%) of the respondents reported that they intended to breastfeed their infant. In adjusted logistic regression models, immigrant black (adjusted OR [aOR] 5.82; 95% confidence interval [CI] 3.86, 8.77), other Hispanic (who were predominantly foreign-born) (aOR 6.05; 95% CI 3.92, 9.33), and island-born Puerto Rican (aOR 3.48; 95% CI 2.04, 5.95) women were significantly more likely to report that they intended to breastfeed than non-Hispanic whites. Somewhat surprisingly, non-Hispanic, US-born African Americans in this low-income sample were more likely to report that they intended to breastfeed than non-Hispanic white respondents (aOR 1.59; 95% CI 1.20, 2.11). Lower education, not living with the baby's father, multiparous pregnancy, and smoking were negatively and independently associated with intention to breastfeed. Maternal age, household income, public housing, and depressive symptoms were not significant predictors of breastfeeding intention in adjusted multivariate models. Conclusions: Significant differences were documented in breastfeeding intention in our sample of low-income, inner-city women. Most notable was the higher likelihood of anticipated breastfeeding among our immigrant sub-groups when compared with non-Hispanic white women. An unexpected finding was the higher likelihood of anticipated breastfeeding among native-born, non-Hispanic African American women than among non-Hispanic white respondents. Because intentions are important predictors of future behavior, more focus needs to be directed towards breastfeeding promotion during the prenatal period and towards a better understanding of why some mothers intend to breastfeed while others do not.     

Predictors of Breastfeeding Intention Among Low-Income Women

OBJECTIVE: Breastfeeding rates are below the Healthy People 2010 goals despite recognized benefits of breastfeeding. This study determined factors that predict breastfeeding initiation among low-income pregnant women. METHODS: A self-administered closed-ended questionnaire was introduced to 694 pregnant women who were certified for WIC in Mississippi. The questionnaire collected data about demographics, breastfeeding intention, breastfeeding knowledge, self-efficacy, and three recognized barriers to breastfeeding: embarrassment, time and social constraints, and lack of social support. RESULTS: In bivariate analysis, women who intended to breastfeed were more often white and had at least some college education, higher income, a smaller family size, fewer children, and previous breastfeeding experience than women who did not intend to breastfeed. Intenders had higher levels of breastfeeding knowledge and self-efficacy and reported fewer barriers to breastfeeding than nonintenders. In multivariate logistic regression, fewer children, past breastfeeding experience, breastfeeding knowledge, self-efficacy, and perceived social support were independent predictors of breastfeeding intention. CONCLUSIONS: Women at high risk for not wanting to breastfeed can be identified for additional support. Interventions should focus on improving breastfeeding knowledge, enhancing confidence in one's ability to breastfeed, and overcoming barriers to breastfeeding, especially lack of social support, among low-income women.     

Intention or experience? Predictors of continued breastfeeding.

Despite the known benefits of breastfeeding, many women do not breastfeed their infants or stop breastfeeding early. This study examines the effects of prenatal intention and initial breastfeeding experiences on breast-feeding initiation and duration among 1,665 U.S. women completing questionnaires on infant feeding practices. Outcomes included no initiation of breastfeeding at birth and termination at <10 weeks, 10 to <20 weeks, or 20 to <30 weeks. Predictor variables included intended breast feeding duration and early breast feeding experiences with analyses controlling for demographic characteristics, previous breastfeeding experience, and prenatal intentions to work after delivery. Prenatal intentions to never initiate or to stop breastfeeding early were significant risk factors for all breastfeeding outcomes. Initial breastfeeding experiences were significant risk factors for early termination. This study supports using the intention construct from the theory of reasoned action to predict initiation of behavior but suggests the need to include initial experience when predicting maintenance of behavior.     

A comparison of social support variables between women who intend to breast or bottle feed.

Social support has been identified as an important element for encouragement and success of lactation. The sources, types and amounts of perceived social support were determined for women during their third trimester of pregnancy and at four weeks of postpartum breastfeeding. Differences in social support were reported for women who stated an intention to breastfeed and those who planned to bottle feed. The tangible, emotional and informational functions of social support were measured as aggregate values across support sources. Tangible and emotional support were not significantly different between intended breast or bottle feeders. However, informational support was higher for women who intended to breastfeed compared to those who intended to bottle feed. Mean scores were then analyzed for specific individuals who might provide support. The baby's father was a more important source of tangible support for intended breastfeeders. Intended breastfeeders also indicated they received more emotional and informational support from the baby's father and prenatal classes. Tangible, emotional and information support did not change pre- and postnatally for women who breastfed. However, certain sources did provide more support postnatally. Finally, predictors such as level of education, a belief that breastfeeding was better for health and emotional closeness, fewer children, moderate tangible and emotional support and more informational support were identified for women who intended to breastfeed.     

Attitudes to breastfeeding among adolescents

Background: Breastfeeding is a major public health concern and a decision to breastfeed has important health benefits for both the infant and mother. Breastfeeding rates are low in many Western countries, and evidence is accumulating to suggest that breastfeeding should be promoted in schools. The present study aimed to employ the theory of planned behaviour (TPB) to predict and explain young people’s motivations to breastfeed with a view to designing an intervention to positively promote breastfeeding among adolescents. Methods: Senior schools in Northern Ireland were sorted by a number of key stratification variables, and then randomly sampled. In anticipation of a nonresponse, a first and second reserve list was drawn using matched replacements. Selected schools were contacted by letter, followed by a telephone call. Thirty‐six schools agreed to take part in the research, and a cross‐sectional survey was conducted with 2021 Year 10 pupils. Results: Having been breastfed as a child and having seen a mother breastfeeding significantly correlated with intention among both females and males. In descending order of importance, the TPB direct constructs were all significantly correlated with intention among males and females. A hierarchical multiple regression was performed with the intention to breastfeed/encourage partner to breastfeed as the dependent variable, and the TPB successfully predicted intention among males and females. Conclusions: The findings obtained in the present study suggest that the TPB is a useful framework on which to base the design of an intervention to promote attitude change, and highlight the importance of key theoretical constructs in predicting intentions to breastfeed.     

Breastfeeding duration and perinatal cigarette smoking in a population-based cohort

OBJECTIVES: We examined the association between breastfeeding duration and maternal smoking before, during, and after pregnancy. METHODS: Data from the 2000-2001 Oregon Pregnancy Risk Assessment Monitoring System were used. Early weaning was defined as not breastfeeding at 10 weeks postpartum. RESULTS: At 10 weeks after pregnancy, 25.7% of mothers who initiated breastfeeding no longer breastfed. After controlling for confounders, quitters (mothers who quit smoking during pregnancy and maintained quit status after pregnancy) and postpartum relapsers (mothers who quit smoking during pregnancy and resumed smoking after delivery) did not have significantly higher risk for early weaning than nonsmokers. However, persistent smokers (mothers who smoked before, during, and after pregnancy) were 2.18 times more likely not to breastfeed at 10 weeks (95% confidence interval=1.52, 2.97). Women who smoked 10 or more cigarettes per day postpartum (i.e., heavy postpartum relapsers and heavy persistent smokers) were 2.3-2.4 times more likely to wean their infants before 10 weeks than were nonsmokers. CONCLUSIONS: Maternal smoking is associated with early weaning. Stopping smoking during pregnancy and decreasing the number of cigarettes smoked postpartum may increase breastfeeding duration.     

The influence of psychosocial factors on the duration of breastfeeding

AIM: A study was undertaken to examine to what extent psychosocial factors are related to the length of breastfeeding. METHODS: A cohort of Danish mothers giving birth to a single child was followed up for four months. Information on mother and baby including psychosocial variables was obtained from a self-report questionnaire. Breastfeeding status was subsequently monitored by a health visitor. RESULTS: A total of 471 (88%) mothers participated, 98.7 % initiated breastfeeding and after four months 277 (59%) were still exclusive breastfeeding; 99 mothers, 51% of those who stopped, stopped within the first five weeks. In Cox regression analyses the duration of breastfeeding showed a positive association with mother's schooling (p=0.002), her intention to breastfeed (p=0.001), previous experience with breastfeeding (p<0.001), self-efficacy with respect to breastfeeding (p<0.001), her confidence in breastfeeding (p=0.012) and knowledge about breastfeeding (p=0.001). The effect of the mother's knowledge depended on the parity of the child. Among primiparous mothers high knowledge was associated with long duration of breastfeeding, but this association was not found among the multiparous. CONCLUSIONS: To help the mothers who would like to breastfeed their baby, we must improve our ability to identify mothers at risk of early cessation. Mother's schooling, her intention, self-efficacy and earlier breastfeeding experience can be used as early predictors. An intervention should aim at improving the self-efficacy and resources of these mothers, with a focus on practical knowledge. The first five weeks, when the largest proportion of the cessations occurred, require special attention.     

Breastfeeding outcomes of women following uncomplicated birth in Hamilton-Wentworth

OBJECTIVE: To examine infant feeding practices up to 8 weeks postpartum in Hamilton-Wentworth. METHODS: A cross-sectional survey of 227 women using a pre-discharge, self-administered questionnaire, medical record review and follow-up telephone interview. RESULTS: Breastfeeding initiation rate was 85%. By 6-8 weeks postpartum, 30% of women had stopped breastfeeding; 55% had switched to formula within the first 14 days. Infants who did not receive supplementation in hospital were 2.49 times more likely than infants who received supplementation to breastfeed for at least 6 weeks. Although 54% of mothers who initiated breastfeeding reported receiving formula gift packs, no association was found. CONCLUSIONS: The breastfeeding initiation rate appears to have increased in Hamilton-Wentworth since 1995. However, this study reinforces the need to address early cessation and infant supplementation, and raises concern about violation of the WHO/UNICEF International Code of Marketing of Breastmilk Substitutes through mailing of formula coupons.     

Measuring young people's attitudes to breastfeeding using the Theory of Planned Behaviour

BACKGROUND: The focus of this study was to design and pilot a questionnaire to measure young people's attitudes to breastfeeding using the Theory of Planned Behaviour (TPB). This is intended for subsequent use in a large-scale attitude survey, which in turn will inform the design of a breastfeeding intervention programme with adolescents. METHODS: The first three phases of a research programme employing the theory are described: belief elicitation, questionnaire development and a pilot study. Firstly, an elicitation study to identify the modal salient beliefs underlying young peoples' motivations to breastfeed, using six semi-structured focus groups with 48 young people, was performed. Secondly, the measurement instrument was constructed, incorporating all the key theoretical constructs and both direct and belief-based measures. The questionnaire was then piloted on a sample of 121 female and male schoolchildren to identify and assess the relative importance of the determinants of breastfeeding intention. RESULTS: The questionnaire proved to be reliable, and preliminary analysis provided strong support for the predictive power of the TPB. CONCLUSIONS: Some key issues involved in the operationalization of the theory are highlighted, which may be of interest to researchers involved in the design of TPB questionnaires for use in other intervention programmes.     

The extended Theory of Planned Behavior in explaining exclusive breastfeeding intention and behavior among women in Kelantan,Malaysia

BACKGROUND/OBJECTIVESThe purpose of this study is to utilize an extended Theory of Planned Behavior in identifying predictors of exclusive breastfeeding intention and behavior among women in Kelantan, Malaysia.SUBJECTS/METHODSA prospective cohort study was conducted, recruiting pregnant womenthrough two-stage cluster sampling. Their exclusive breastfeeding intention, attitude, perceived norm, perceived behavioral control and past behavior were obtained at baseline through interviewer-guided questionnaire. At one month after delivery, another interview was conducted to determine the two additional variables in the extended theory, which were their postpartum support and breastfeeding difficulty. The behavior, which was the actual duration of exclusive breastfeeding, was obtained from the second follow-up at six months. Pearson correlation and two hierarchical regression analyses were conducted.RESULTSA total of 200 women completed the study follow-up. Their median intended exclusive breastfeeding duration was 4.0 (IQR 5) months, and the median actual duration was 1.0 (IQR 4) month. The Theory of Planned Behavior explained 51.0% of the variance in intention, with perceived behavioral control and attitude were the significant predictors. It also explained 10.0% of the variance in behavior, but the addition of postpartum support and breastfeeding difficulty increased the amount of explained variance in behavior by 6.0%. The significant predictors of exclusive breastfeeding behavior were intention, postpartum support and breastfeeding difficulty.CONCLUSIONThe extended Theory of Planned Behaviorhad a good predictive ability in explaining exclusive breastfeedingintention and behavior. The women''s intention to practice exclusive breastfeeding may be improved by improving their perceived behavioral control and attitude. Providing correct postpartum support and skills to handle breastfeeding difficulties after delivery will improve their exclusive breastfeeding behavior.     

Timing of return to work and women's breastfeeding practices in urban Malaysia: A qualitative study

Nearly half of the working population in Malaysia are women, and with only a short period of maternity leave, they may struggle to achieve the recommended 6 months of exclusive breastfeeding. The aim of this paper was to explore the relationship between the timing of return to work and beliefs and breastfeeding practices among women in urban Malaysia. A qualitative inquiry based on a phenomenological framework and multiple methods was used: face‐to‐face interview, participant diary and researcher field notes. Data collection took place in Penang and the Klang Valley, Malaysia, from March to September 2011. Eligible participants were purposely identified at randomly selected recruitment sites. A thematic analysis method was used to develop the typologies and categories of the findings. A total of 40 working women with a mean age of 32 years (SD 3.4) were interviewed and 15 participated in the diary writing. Most women (75%) returned to work between 2 and 3 months. Only 10% returned to work 4 months or later postpartum, and 15% had an early return to work (defined here as less than 2 months). The women fell into three groups: Passionate women with a strong determination to breastfeed, who exclusively breastfed for 6 months; Ambivalent women, who commenced breastfeeding but were unable to sustain this after returning to work; and Equivalent women, who perceived formula feeding as equally nutritious as breast milk. Although longer maternity leave was very important for Ambivalent women to maintain breastfeeding, it was not as important for the Equivalent or Passionate women. In conclusion, returning earlier was not an absolute barrier to continuing breastfeeding. Instead, a woman's beliefs and perceptions of breastfeeding were more important than the timing of her return to work in determining her ability to maintain breastfeeding or breast milk feeding.     

Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice

OBJECTIVE: To examine infant feeding intentions of HIV-infected and uninfected women and the appropriateness of their choices according to their home resources; and to determine their adherence to their intentions in the first postnatal week. METHODS: Feeding intentions of pregnant women were compared against four resources that facilitate replacement feeding: clean water, adequate fuel, access to a refrigerator and regular maternal income. First-week feeding practices were documented. FINDINGS: The antenatal feeding intentions of 1253 HIV-infected women were: exclusive breastfeeding 73%; replacement feeding 9%; undecided 18%. Three percent had access to all four resources, of whom 23% chose replacement feeding. Of those choosing replacement feeding, 8% had access to all four resources. A clean water supply and regular maternal income were independently associated with intention to replacement feed (adjusted odds ratio (AOR) 1.94, 95% confidence interval (CI) 1.2-3.2; AOR 2.1, 95% CI: 1.2-3.5, respectively). Significantly more HIV-infected women intending to exclusively breastfeed, rather than replacement feed, adhered to their intention in week one (exclusive breastfeeding 78%; replacement feeding 42%; P<0.001). Of 1238 HIV-uninfected women, 82% intended to exclusively breastfeed; 2% to replacement feed; and 16% were undecided. Seventy-five percent who intended to exclusively breastfeed adhered to this intention postnatally, and only 11 infants (<1%) received no breast milk. The number of antenatal home visits significantly influenced adherence to feeding intention. CONCLUSION: Most HIV-infected women did not have the resources for safe replacement feeding, instead choosing appropriately to exclusively breastfeed. Adherence to feeding intention among HIV-infected women was higher in those who chose to exclusively breastfeed than to replacement feed. With appropriate counselling and support, spillover of suboptimal feeding practices to HIV-negative women is minimal.     

Are women with an unintended pregnancy less likely to breastfeed?

OBJECTIVE: To examine the association between unintended pregnancy and the initiation and duration of breastfeeding. STUDY DESIGN: This was a secondary data analysis of the 1995 Cycle 5 of the National Survey of Family Growth. POPULATION: We studied 6733 first singleton live births to US women aged 15 years to 44 years. OUTCOMES: Using the 1995 Institute of Medicine definitions, pregnancies were classified as intended or unintended; unintended pregnancies were further categorized as either mistimed or unwanted. We measured initiation of breastfeeding and duration of nonexclusive breastfeeding for at least 16 weeks. RESULTS: In this study, 51.5% of women never breastfed, 48.5% initiated breastfeeding, and 26.4% of all women continued breastfeeding for at least 16 weeks. US women with unwanted unintended pregnancies were more likely not to initiate breastfeeding (odds ratio [OR] = 1.76; 95% CI, 1.26-2.44) and more likely not to continue breastfeeding (OR = 1.69; 95% CI, 1.12-2.55) than women with intended pregnancies. White women with unwanted unintended pregnancies were more likely not to breastfeed than those with intended ones (initiation: OR = 2.50; 95% CI, 1.54-4.05; continuation: OR = 2.56; 95% CI, 1.34-4.87). This finding was not seen for black or Hispanic women. CONCLUSIONS: In the United States, women with unwanted pregnancies were less likely either to initiate or to continue breastfeeding than women with intended pregnancies. A strong inverse association between unwanted pregnancies and breastfeeding was observed only for white women. Education for women with unintended pregnancies may improve breastfeeding rates and subsequently, the health of women and infants.     

Breastfeeding and breast cancer: a case-control study in Southern Brazil

To investigate the relationship between breastfeeding and breast cancer in Southern Brazil, a case-control design was employed, with two age-matched control groups. A total of 250 cases of breast cancer were identified in women from 20 to 60 years of age, with 1,020 hospital and community controls. The main study variables were occurrence of breastfeeding and duration of breastfeeding. A multivariate conditional logistic regression analysis was employed. According to the results, breastfeeding did not have a protective effect against breast cancer. The odds ratio (OR) for women who breastfed was 0.9 (95% CI: 0.8-1.2) compared to women who did not breastfeed. For women who breastfed for six months or less, the OR was 1.0 (95% CI: 0.6-1.8). In pre-menopausal women who breastfed for more than 25 months, the OR was 0.95 (95% CI: 0.5-3.5), and in post-menopausal women OR was 1.27 (95% CI: 0.5-3.1), compared to women who had not breastfeed.     

Factors associated with weaning in the first 3 months postpartum

OBJECTIVE: To determine the demographic, behavioral, and clinical factors associated with breastfeeding termination in the first 12 weeks postpartum. STUDY DESIGN: This was a prospective cohort study. POPULATION: Breastfeeding women in Michigan and Nebraska were interviewed by telephone at 3, 6, 9, and 12 weeks postpartum or until breastfeeding termination. OUTCOMES MEASURED: We measured associations of demographic, clinical, and breastfeeding variables with weaning during the first 12 weeks postpartum. RESULTS: A total of 946 women participated; 75% breastfed until 12 weeks. Women older than 30 years and women with at least a bachelor's degree were more likely to continue breastfeeding in any given week. Mastitis, breast or nipple pain, bottle use, and milk expression in the first 3 weeks were all associated with termination. Beyond 3 weeks, women who expressed breast milk were 75% less likely to discontinue breastfeeding than women who did not. Women who used a bottle for some feedings during weeks 4 to 12 were 98% less likely to discontinue breastfeeding than women who did not use a bottle. "Not enough milk" was the most common reason given for termination in weeks 1 through 3 (37%) and weeks 4 through 6 (35%); "return to work" was the most common reason given in weeks 7 through 9 (53%) and weeks 10 through 12 (58%). CONCLUSIONS: Younger women and less educated women need additional support in their breastfeeding efforts. Counseling and assistance should be provided to women with pain and mastitis. Exclusive breastfeeding for the first 3 weeks should be recommended. After the first 3 weeks, bottles and manual expression are not associated with weaning and may improve the likelihood of continuing breastfeeding, at least until 12 weeks.     

Breastfeeding Practices: Does Method of Delivery Matter?

Objective of this study was to assess the relationship between method of delivery and breastfeeding. Using data (2005–2006) from the longitudinal Infant Feeding Practices Study II (n = 3,026) we assessed the relationship between delivery method (spontaneous vaginal, induced vaginal, emergency cesarean, and planned cesarean) and breastfeeding: initiation, any breastfeeding at 4 weeks, any breastfeeding at 6 months, and overall duration. We used SAS software to analyze data using multivariable analyses adjusting for several confounders, including selected demographic characteristics, participants’ pre-delivery breastfeeding intentions and attitude, and used event-history analysis to estimate breastfeeding duration by delivery method. We found no significant association between delivery method and breastfeeding initiation. In the fully adjusted models examining breastfeeding duration to 4 weeks with spontaneous vaginal delivery group as the reference, those with induced vaginal deliveries were significantly less likely to breastfeed [adjusted odds ratio (AOR) = 0.53; 95 % CI = 0.38–0.71]; and no significant relationship was observed for those who had planned or emergency cesarean deliveries. Again, compared with spontaneous vaginal delivery group, those with induced vaginal [AOR = 0.60; 96 % CI = 0.47–0.78] and emergency cesarean [AOR = 0.68; 96 % CI = 0.48–0.95] deliveries were significantly less likely to breastfeed at 6 months. Median breastfeeding duration was 45.2 weeks among women with spontaneous vaginal, 38.7 weeks among planned cesarean, 25.8 weeks among induced vaginal and 21.5 weeks among emergency cesarean deliveries. While no significant association was observed between delivery method and breastfeeding initiation; breastfeeding duration varied substantially with method of delivery, perhaps indicating a need for additional support for women with assisted deliveries.     

The struggle of weaning: Factors determining breastfeeding duration in East Bhutan

This paper presents the qualitative part of a project in a traditional community in East Bhutan, which, among other items, investigates the effects on child health of breastfeeding, weaning and subsequent pregnancy of the mother. Quantitative data from the project have shown that children who are weaned during a subsequent pregnancy of the mother have a reduced weight gain and an increased incidence of infectious diseases during weaning, while this is not so for children weaned from non-pregnant mothers. In-depth interviews with 35 women with experience from breastfeeding were carried out in the local language in order to obtain qualitative data regarding the processes underlying the mother decisions during weaning. Breastfeeding was found to fulfil a valuable social function in addition to its biological and emotional properties. The breastfed child had an undebatable “right of access” to the mother's care, not only her breast, whenever it wanted. This child also assumed a status in the family in which both its vulnerability, its special needs and its value were clearly recognized. The mothers expressed a basic motivation to breastfeed “as long as possible”. There were, however, important limitations as to how this was manifested in the practical weaning process. If the mother was pregnant at the time of weaning, these limitations tended to be mother-centred. Most of the women had experienced tenderness of the breasts and a reduced milk production from the start of the next pregnancy. It was believed that the breast milk of a pregnant woman could “rot” and cause disease in the child. In spite of this belief, concurrent breastfeeding and pregnancy were common, but a pregnant mother whose breastfed child got ill, e.g. with diarrhoea, would immediately stop breastfeeding. The child would thereby abruptly loose the most important protection against the negative effects of the disease, when this protection was most needed. Concurrent pregnancy and lactation are common in many areas of the poor world. This has important consequences for the health of mothers and children, and has only recently been given the attention it derserves.     

Breastfeeding Practices in the United Arab Emirates: Prenatal Intentions and Postnatal Outcomes

Breastfeeding provides the ideal nutrition in infancy, and its benefits extend to the health of mothers. Psychosocial factors such as the intention to breastfeed, self-efficacy, or maternal confidence to breastfeed have been shown to impact breastfeeding outcomes in other communities. The aim of this study was to assess the potential associations between mothers’ prenatal intention to breastfeed and post-delivery breastfeeding practices. A cross-sectional study was conducted from March to September 2017. Emirati and non-Emirati mothers with children below the age of 2 were recruited from maternal and child health centers in various geographical areas in Abu Dhabi Capital district, United Arab Emirates. The variables (mothers’ intention to breastfeed, breastfeeding knowledge, support from family and health care professionals, and initiation and duration of breastfeeding) were collected by research assistants during an in-person interview, using a structured questionnaire. A total of 1799 mothers participated in this study. Mothers’ prenatal intention to breastfeed was significantly associated with breastfeeding initiation (p < 0.001) and length of exclusive breastfeeding (p = 0.006). Furthermore, intention to breastfeed during early pregnancy showed a strong association (p < 0.001) with mothers who had exclusively breast fed for more than three months. In addition, knowledge on the benefits of breastfeeding and getting support from relatives and non-relatives demonstrated significant relationship with a longer period of exclusive breastfeeding (p < 0.01) In total, mothers in the study reported receiving almost four thousand advice about breastfeeding, of which 3869 (97%) were encouraging to our others in the study. Our findings on prenatal intentions, knowledge and network support on exclusive breastfeeding indicates the importance of including breastfeeding knowledge and support as critical topics during prenatal education, not only to the mothers but also to close network members who seek a healthy pregnancy outcome.     

Investigation of a model for the initiation of breastfeeding in primigravida women

Primigravida women are faced with the decision about how they will feed their infants. Many will decide to breastfeed but the motivation for this choice is unclear. While certain beliefs and worries about breastfeeding appear to predict women who will choose to breastfeed, such concepts are influenced by a combination of other values, support resources and socioeconomic background. The main goal of this research was to demonstrate how multivariate analysis can be applied to the infant-feeding decision and how it can lend a theoretical interpretation to social issues such as the initiation of breastfeeding. One hundred completely breastfeeding and 57 bottle feeding primigravida women were enrolled in the study and completed a pretested Likert-type questionnaire. Three primary predictors for the initiation of breastfeeding were identified: positive maternal beliefs about breastfeeding; the absence of maternal worries about breastfeeding; and higher levels of maternal education. Secondary psychosocial predictors significantly associated with maternal breastfeeding beliefs included maternal beliefs in increased personal satisfaction from breastfeeding and maternal beliefs in preventive health measures. Secondary psychosocial predictors significantly related to maternal worries about breastfeeding before breastfeeding began. Over half of the strength of the direct psychosocial predictors for breastfeeding initiation could be attributed to their respective groups of indirect predictors. Thus, the main contribution of this research has been to shift the emphasis of past research away from differences between groups of bottle feeders and breastfeeders to focus more precisely on the decision-making process involved in the infant feeding choice.(ABSTRACT TRUNCATED AT 250 WORDS)