Knowledge, Attitudes, Exposure, and Future Intentions of Hong Kong University Students Toward Infant Feeding

Examining Sociocultural Influences on Breastfeeding Attitudes Among Syrian and Hungarian Female Students

BACKGROUND

Breastfeeding in Syria is a common practice supported by social norms, family traditions, and cultural values. In Hungary, recent statistics show that exclusive breastfeeding is significantly lower than the recommendation of the World Health Organization. Understanding the perspectives of educated young ladies is crucial for discovering the difficulties of breastfeeding practices within Syrian-Hungarian societies. This study explores the sociocultural factors and their impact on breastfeeding behaviours among female students in Syria and Hungary.

METHODS

A comprehensive, multi-section questionnaire was administered to 317 students from Damascus University and 303 students from Hungarian universities, designed to assess breastfeeding behaviours evaluated through The Breastfeeding Behaviour Questionnaire (BBQ).

RESULTS

The results in both societies showed remarkable awareness and understanding among participants regarding breastfeeding. Traditions and culture affect Syrian society more than Hungarian society; the two societies have restricted responses toward breastfeeding in public and different reactions to breastfeeding in front of males or females. Most students disagree with preferring formula feeding to breastfeeding when it is related to the family or the husband's desire only. At the same time, agreement with choosing the bottle when the mother returns to work instead of exclusively breastfeeding is valued differently in the two societies.

CONCLUSIONS

This study elucidates the essential the sociocultural factors influencing breastfeeding attitudes among Syrian and Hungarian female students, highlighting the need for culturally suitable strategies to improve breastfeeding practices in both countries.

Exploring the Impact of Offering an Undergraduate Lactation Elective Course as a Strategy for Normalizing Breastfeeding

Background

More breastfeeding interventions targeting female and male undergraduates before they become parents are needed to foster accurate breastfeeding knowledge, positive attitudes toward breastfeeding, and a greater intent to breastfeed. This study aimed to assess the impact of completing a lactation elective course on undergraduates' breastfeeding knowledge, attitudes, and intention.

Methods

Pre- and postcourse surveys were administered to 96 undergraduates from various majors enrolled in a lactation elective.

Results

From pre- to postcourse, this study found significant increases in undergraduates' breastfeeding knowledge, attitudes, and intent.

Conclusions

Because most undergraduates in the United States become parents only after graduation, universities have an opportunity to foster the knowledge and attitudes needed to breastfeed successfully. As breastfeeding knowledge and attitudes in men and women are strong predictors of breastfeeding intent, initiation, and duration, offering undergraduate lactation elective courses is a promising strategy to improve future parents' breastfeeding knowledge, attitudes, and intention, helping to normalize breastfeeding and improve breastfeeding rates.

Validation of the Spanish-Mexican Version of the Australian Breastfeeding Attitude Questionnaire in Higher Education Health Students

Positive attitudes towards breastfeeding in health professionals/students have been associated with increasing their confidence to provide support and accompaniment to mothers. In Mexico, there is no valid/reliable tool to assess attitudes towards breastfeeding in this population. The Australian Breastfeeding Attitudes (and Knowledge) Questionnaire (ABAQ) measures attitudes in the Australian population. We aimed to adapt and validate the ABAQ in Mexican health students. We included 264 health students (nursing, nutrition, and medicine) from the University of Guadalajara. Bilingual translators carried out the Spanish adaptation with a reverse translation into English. Experts evaluated the content validity. Reliability was evaluated through an internal consistency analysis (Cronbach’s alpha) and construct validity through convergent–divergent validation, item–total correlation, exploratory factor analysis (by principal components), and confirmatory factor analysis. According to the exploratory factor analysis, only one component was identified. Seven items were removed (low correlation between items ≤0.2 and low factor load ≤0.3). The Cronbach’s alpha was 0.78. According to the confirmatory factor analysis, the one-factor solution of the ABAQ-13Mx showed a good model fit (X² = 98.41, G = 62, p = 0.02, CFI = 0.940, and RMSEA = 0.048). The ABAQ-13Mx is a reliable and valid instrument for evaluating attitudes towards breastfeeding in Mexican health degree students.

Development, psychometric assessment, and predictive validity of the comprehensive breastfeeding knowledge scale

AIM

To develop a breastfeeding knowledge scale that aligns with the Baby Friendly Hospital Initiative and psychometrically test it among expectant parents.

BACKGROUND

Although breastfeeding is recommended by all leading health authorities, rates remain suboptimal with women often not achieving their breastfeeding goals. One factor found to positively influence infant feeding behaviours is increased maternal breastfeeding knowledge. However, little research has been conducted validating the dimensions of breastfeeding knowledge to guide interventions to promote positive breastfeeding outcomes.

DESIGN

Following an extensive literature review, the 28-item Comprehensive Breastfeeding Knowledge Scale (CBKS) was developed and psychometrically tested.

METHOD

A sample of 217 Canadian expectant parents (113 women and 104 coparents) was recruited and administered the CBKS with follow-up questionnaires at 4 and 12 weeks postpartum. Psychometric analyses included exploratory factor analysis, internal consistency, concurrent validity, and predictive validity.

RESULTS

Exploratory factor analysis resulted in three dimensions: (1) managing milk supply; (2) persisting through challenges; and (3) correcting misconceptions. Coefficient alpha for the total scale was 0.83 and support for concurrent validity was demonstrated through significant positive correlations with the Iowa Infant Feeding Attitude scale. Further, higher total and subscale scores in pregnancy were associated with exclusive breastfeeding at 4 and 12 weeks postpartum, providing good evidence for predictive validity.

CONCLUSION

Preliminary data suggest the CBKS is a valid and reliable measure of breastfeeding knowledge. Upon further testing, this self-report measure may be used to (1) identify women with low breastfeeding knowledge requiring targeted support, (2) individualize health professional care with breastfeeding women, and (3) evaluate the effectiveness of breastfeeding interventions and programs.

Breastfeeding exposure is associated with better knowledge of and attitudes toward BF in Kuwaiti women

Objectives

Breastfeeding (BF) has many benefits for both infants and mothers. However, despite evidence in support of BF, its prevalence has remained low in Kuwait. The purpose of this study was to (1) assess and describe BF attitudes and knowledge among women at a college campus; (2) evaluate BF exposures and sociodemographic factors associated with attitudes toward BF; (3) determine the association between BF knowledge and attitudes.

Materials and methods

This survey was a cross-sectional descriptive study conducted from February to April 2016. A convenience sample of 330 women (students, faculty and staff) from the College of Life Sciences (CLS) at Kuwait University participated in the survey.

Results

Most of the participants respected women who breast fed (81.8%). Some participants believed that BF a baby is painful (43.3%), makes the breasts sag (35.8%), and restricts the mothers’ freedom (51.5%). Additionally, 47.6% of the participants reported that they would feel embarrassed if they saw a woman BF her baby. Acceptability of BF in public was low and most participants preferred BF only around friends and family (52.4%). A statistically significant positive association was observed between BF knowledge and attitudes (R²=6.5%, p<0.001); however, the relationship was not independent and was also associated with nationality and having been breast fed as a baby (R²=10.3%, p=0.021).

Conclusion

BF knowledge is important to encourage positive BF attitudes, and both are enforced with family values and practice across generations.

Exploring Breastfeeding Knowledge and Attitudes among Noncaregivers: A Narrative Review

Exclusive breastfeeding to 6 months with continued breastfeeding up to 2 years and beyond are well-established infant feeding recommendations based on evidence that breastfeeding has unparalleled maternal and infant health benefits as well as environmental and economic benefits. As with many high-income countries, breastfeeding rates remain suboptimal with only a quarter of Canadian and European infants receiving breast milk exclusively for the first 6 months. Breastfeeding promotion efforts have largely targeted caregivers in the prenatal and postnatal period; however, breastfeeding outcomes have been shown to be associated with broader sociocultural factors. Noncaregivers play an influential role in infant feeding at both an individual level (e.g., cues and input from health care practitioners and caregivers' social networks; as future parents) as well as a broader population level (sociocultural norms and policy decisions). This paper outlines recent research on breastfeeding knowledge and attitudes of noncaregivers by population subgroup. Positive correlations have been identified between breastfeeding attitudes, infant feeding knowledge, breastfeeding exposure, and breastfeeding intention among different subgroups; however, key knowledge gaps, lack of exposure to breastfeeding, and negative public perceptions of breastfeeding persist. Dietitians can advocate for breastfeeding promotion strategies that consider the role of noncaregivers to address sociocultural norms around breastfeeding.

Knowledge, Attitude, Exposure, and Future Intentions toward Exclusive Breastfeeding among Universiti Sains Malaysia Final Year Medical and Dental Students

BACKGROUND

Breastmilk is the best nourishment for an infant for the first 6 months of life. Health professionals like medical doctors and dentists can help promote and support exclusive breastfeeding. We aimed to assess knowledge, attitudes, exposure, and future intentions toward exclusive breastfeeding among final year medical and dental students at Universiti Sains Malaysia, Kelantan, Malaysia.

METHODS

A total of 162 students participated in this cross-sectional study that was conducted between May and September of 2015. Self-administered questionnaires were used to collect the variables of interest.

RESULTS

Most students knew exclusive breastfeeding is recommended for the first 6 months of life (98.1%). However, some students incorrectly thought formula milk can be given if the infant appears hungry after having been breastfed (61.7%). Additionally, some incorrectly thought expressed breastmilk can be warmed on direct heat (47.5%) and left-over expressed milk can be re-stored (60.5%). Most students agreed that exclusive breastfeeding is easier to practice than formula feeding and that it is the best choice for working mothers. Most students (93.2%) intend to breastfeed their children, and this intention was significantly associated with their experience being breastfed as infants and attitudes toward exclusive breastfeeding.

CONCLUSION

Generally, final year medical and dental students have favorable attitudes and future intentions toward exclusive breastfeeding, although some of them lacked knowledge about certain important aspects of the practice. Past experience of being exclusively breastfed and a more positive attitude toward the practice were associated with their future intentions to practice exclusive breastfeeding.

Women’s experiences of formula feeding their infants: an interpretative phenomenological study

Objective

This study aimed to explore the experiences of women in the process of formula feeding their infants. The World Health Organization has emphasized the importance of breastfeeding for infant health. After decades of breastfeeding promotions, breastfeeding rates in Hong Kong have been rising consistently; however, the low continuation rate is alarming. This study explores women’s experiences with formula feeding their infants, including factors affecting their decision to do so.

Methods

A qualitative approach using an interpretative phenomenological analysis (IPA) was adopted as the study design. Data were collected from 2014 to 2015 through individual in-depth unstructured interviews with 16 women, conducted between 3 and 12 months after the birth of their infant. Data were analyzed using IPA.

Results

Three main themes emerged as follows: (1) self-struggle, with the subthemes of feeling like a milk cow and feeling trapped; (2) family conflict, with the subtheme of sharing the spotlight; and (3) interpersonal tensions, with the subthemes of embarrassment, staring, and innocence. Many mothers suffered various stressors and frustrations during breastfeeding. These findings suggest a number of pertinent areas that need to be considered in preparing an infant feeding campaign.

Conclusions

The findings of this study reinforce our knowledge of women’s struggles with multiple sources of pressure, such as career demands, childcare demands, and family life after giving birth. All mothers should be given assistance in making informed decisions about the optimal approach to feeding their babies given their individual situation and be provided with support to pursue their chosen feeding method.

Female College Students Knowledge, Attitude and Future Intention towards Breastfeeding: Implications for Advocacy

INTRODUCTION

Breastfeeding is important for promoting child's health. Since, breastfeeding decisions are made before pregnancy and are strongly influenced by women's knowledge and attitude, it is important to identify knowledge gaps in youth girls.

AIM

To assess the knowledge, attitude and future intention regarding infant feeding among female college students in Puducherry, India.

MATERIALS AND METHODS

This descriptive study was done among 307 college going female students. Their knowledge, attitude and future intention was assessed using structured questions and Likert's scale. Data were summarized as percentages with 95% confidence interval. Responses to Likert's scale were analyzed using consensus index.

RESULTS

Around 98% (95% CI: 96.5%, 99.6%) and 86.3% (95% CI: 82.5%, 90.2%) knew that breast milk and colostrum respectively is good for the child. However, students had poor knowledge about exclusive breastfeeding, the age of starting supplementation, recommended duration of breastfeeding. Noteworthy, 15% and 38% of them thought that breastfeeding spoils the mother's beauty and interferes with mother's employment respectively. Around 98% (95% CI: 97.0%, 100.0%) wanted to breastfeed their child in future. A high proportion of students, 20.5% (95% CI: 16.0%, 25.0%) wanted to give formula feed before 6 months. Knowledge and future intention to breastfeed was better among 'arts and science' students than engineering students.

CONCLUSION

The knowledge and attitude of female college students on breastfeeding is good. Almost all students wanted to breastfeed their children in future. However, the study has identified knowledge gaps and misconceptions which need to be stressed during the health education activity to promote optimal breastfeeding practices.

Knowledge, Attitude, and Practice of Breastfeeding Among Working Mothers in South Jordan

Breast milk is the ideal food for human infants, with benefits to mothers and babies. However, working mothers are more likely to choose not to breastfeed or to interrupt breastfeeding prematurely. This study assessed breastfeeding knowledge and attitudes among working mothers in South Jordan. Four hundred cross-sectional, self-administered Arabic surveys were distributed to working mothers at their workplaces. In addition to measuring mothers' knowledge of and attitudes toward breastfeeding, barriers that prevented continuing breastfeeding beyond 6 months were also explored. Three hundred forty-four (80%) completed questionnaires were returned. The breastfeeding initiation rate was 72.4%, but only 20.9% were exclusively breastfeeding by 6 months. The participants showed satisfactory knowledge about breastfeeding and had positive attitudes toward breastfeeding. Most of the women who initiated breastfeeding reported ending breastfeeding prematurely. Approximately 30% of the mothers attributed premature cessation of breastfeeding to work. The results of this study could be useful for health care providers and policy makers when planning effective breastfeeding promotion programs and creating breastfeeding-friendly workplaces.

Using breastfeeding images to promote breastfeeding among young adults

Young adults’ reactions to breastfeeding images were assessed using varied approaches. In Study 1, participants viewed posters from a breastfeeding campaign; many anticipated negative reaction to the campaign. In Study 2, participants viewed novel infant-feeding posters; breastfeeding posters were viewed for less time than bottle-feeding posters, regardless of the task assigned. In Study 3, participants were asked to rate their comfort level viewing infant-feeding images; greater discomfort was reported for breastfeeding images. Taken together, we argue that many young adults expect, and experience, discomfort viewing breastfeeding, but it is important to continue using breastfeeding images in promotion efforts.

Effectiveness of a Breastfeeding Intervention on Knowledge and Attitudes Among High School Students in Taiwan

OBJECTIVE

To evaluate the effectiveness of an educational intervention on the breastfeeding knowledge and attitudes of female high school students living in Taiwan.

DESIGN

A prospective, two-group, quasi-experimental, repeated measure design.

SETTING

A high school in Taichung, Taiwan.

PARTICIPANTS

Two hundred four female high school students.

METHODS

Data were collected through a self-administered questionnaire at baseline, after the intervention, and 1 month later. After administration of the questionnaire at baseline, the experimental group (n = 103) received a 30-minute breastfeeding education; the control group (n = 101) did not.

RESULTS

Findings showed that students in the experimental group had significantly greater breastfeeding knowledge immediately after the intervention and at 1 month postintervention. Also, compared with the control group, the experimental group had significantly greater positive breastfeeding attitudes after the intervention period, and the effect lasted at least 1 month.

CONCLUSIONS

Breastfeeding interventions in schools improve adolescents' knowledge and attitudes. School nurses are well positioned to promote breastfeeding as a healthy lifestyle behavior within the school setting.

Predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers

BACKGROUND

In recent years there has been a steady influx of immigrants into Hong Kong from Mainland China, where breastfeeding patterns differ. Studies in other regions have found substantial differences in breastfeeding rates between native-born and immigrant mothers. The purpose of this study was to examine factors associated with breastfeeding initiation in Hong Kong born and Mainland China born mothers living in Hong Kong.

METHODS

We used a multi-center cross-sectional study design and recruited 2761 new mothers from the postnatal wards of all eight public hospitals in Hong Kong that offer obstetric services. We assessed breastfeeding status as well as various socio-demographic, maternal and birth characteristics. Chi-square tests and multivariable logistic regression were used to identify the predictors of breastfeeding initiation in Hong Kong born and Mainland China born participants.

RESULTS

80.3 % of Hong Kong and 81.1 % of Mainland Chinese born women initiated breastfeeding. In the fully adjusted models, multiparity (Odds Ratio [OR] 0.53, 95 % CI 0.43-0.66) and maternal smoking (OR 0.29, 95 % CI 0.18-0.45) were strongly associated with failure to initiate breastfeeding in both Hong Kong and Mainland China born participants. In Hong Kong born mothers, participants with lower maternal education and those who had a cesarean section were significantly less likely to breastfeed. For Mainland China born mothers, paternal smoking (OR 0.70, 95 % CI 0.49-0.99) and having a pregnancy-related health problem (OR 0.60, 95 % CI 0.38-0.94) were both additional risk factors for not breastfeeding.

CONCLUSION

This study has identified predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers. Given the current high breastfeeding initiation rates among both groups, antenatal breastfeeding education and promotion programmes need to specifically intervene with sub-groups of pregnant women at risk for not breastfeeding so that their efforts are more strategic and cost-effective.

The intergenerational continuity of breastfeeding intention, initiation, and duration: a systematic review

BACKGROUND

In studies investigating predictors of breastfeeding behaviors, it is not uncommon for researchers to adjust for participants' having been breastfed as an infant. This assumes an intergenerational effect of breastfeeding continuity. Our aim was to investigate the veracity of that assumption. Specifically, we sought to summarize and evaluate evidence of associations between breastfeeding in one generation and breastfeeding intentions and behaviors in the second generation.

METHODS

A systematic search of psychological, nursing, and medical databases was conducted for studies examining "having been breastfed" as a factor in breastfeeding intention, initiation, or duration. Quality indicators were assessed and limitations reported. Effects were explored according to outcomes of intention, initiation, and duration.

RESULTS

Fifteen papers were found to be eligible for the review. Having been breastfed as an infant was consistently correlated with breastfeeding intention, initiation, and duration. Effect sizes differed depending on methodology. Men's infant-feeding status was also related to later intentions to support or encourage a partner to breastfeed.

CONCLUSIONS

Robust evidence for intergenerational breastfeeding continuity is present; however, mechanisms that explain this association were not considered in the studies reviewed and would best be explored within longitudinal cohort studies.

Breastfeeding knowledge, attitude, perceived behavior, and intention among female undergraduate university students in the Middle East: the case of Lebanon and Syria

BACKGROUND

The Middle East has one of the lowest rates of exclusive breastfeeding in the world, highlighting the need to promote breastfeeding in this region. Young adults represent a key population of interest, since decisions about infant-feeding appear to be made before children are even conceived.

OBJECTIVE

To examine breastfeeding knowledge, attitude, and perceived behavior among female undergraduate students in Lebanon and Syria and determine factors associated with intention to breastfeed in this population.

METHODS

This cross-sectional study was conducted in 2010/11 in Damascus and Beirut. Four universities were selected in each city. A multicomponent questionnaire was administered to a convenience sample of participants (n = 194 from Beirut and n = 199 from Damascus). The questionnaire included breastfeeding knowledge (measured by the Infant Feeding Knowledge Test Form), attitude (Iowa Infant Feeding Attitude Scale), perceived behavior (Breastfeeding Behavior Questionnaire), and intention (Infant Feeding Intention Scale). Factors associated with intention to breastfeed were examined by multivariate linear regression analysis.

RESULTS

The participants had an average breastfeeding knowledge level (mean score, 10.39 +/- 2.09) and neutral perceived behavior (mean score, 22.00 +/- 3.68), while having relatively positive attitudes (mean score, 58.12 +/- 6.49). Knowledge gaps and negative perceptions were identified, particularly linked to breastfeeding in public and among working mothers. Breastfeeding intention was found to be significantly associated with knowledge and attitude in Lebanon (beta = 0.103 and beta = 0.230, respectively), and with perceived behavior in Syria (beta = -0.135).

CONCLUSIONS

By revealing specific knowledge gaps and misconceptions and identifying country-specific disparities in the predictors of the intention to breastfeed, the findings of this study may provide a basis for devising culture-specific interventions aimed at promoting breastfeeding.

Breastfeeding Knowledge, Attitudes, and Intention in a Sample of Undergraduate Students in Mainland China

BACKGROUND

Despite the high breastfeeding initiation rate in China (> 90%), the low exclusivity rate is of concern. Some traditional behaviors, combined with increasing popularity of infant formula, may negatively affect future breastfeeding rates. As suggested by the theory of planned behavior, understanding breastfeeding beliefs of young adults may help identify and address misperceptions of future parents, supporting maintenance of the current initiation rate while increasing rates of exclusivity and duration. No research has evaluated these factors among young adults in Mainland China.

OBJECTIVE

The objective was to explore any relationships between breastfeeding knowledge, attitudes, previous experiences, and future intention among undergraduate students in Mainland China.

METHODS

This was a cross-sectional, quantitative study conducted from May to June 2012. A convenience sample of 395 students from a major public university in southwest China participated in the survey.

RESULTS

Breastfeeding knowledge was moderate (76.7% of total score), and breastfeeding was considered to be painful (34.2%), to make breasts sag (43.1%), and to restrict the freedom of mothers (52.5%). In addition, 58.2% of students reported that they would feel embarrassed if they or their partners were to breastfeed in public, and acceptability of breastfeeding in public was low (34.7%). Three-fourths of the students (75.1%) expressed future breastfeeding intent, though males were more likely to report this intention (ie, to support a partner in breastfeeding) than were females (81.3% vs 71.7%, P = .04).

CONCLUSION

To create a more breastfeeding-friendly culture, future research is warranted to explore these negative beliefs about breastfeeding and to counter misunderstandings among future parents in Mainland China.

Attitudes of high school and vocational school students toward breastfeeding in taiwan

Infant feeding decisions depend on breastfeeding attitudes. This study examined the high school and the vocational school students' attitudes toward breastfeeding. The descriptive cross-section survey was applied. A stratified random sample of 1,319 male and female students was carried out. The results revealed that female students were more positive than male students in breastfeeding attitudes. Of the female students, 34.7% (n = 458) reported that they will plan to breastfeed, and 29% (n = 382) male students indicated that they will encourage breastfeeding. Moreover, two-thirds (60.7%, n = 801) of the participants favored the inclusion of breastfeeding information in the school curriculum. Findings from this study suggest that breastfeeding information needs to be addressed earlier among adolescent students to increase positive breastfeeding attitudes.

Are health science students' beliefs about infant nutrition evidence-based?

BACKGROUND

Globally, breastfeeding is a fundamental health promotion strategy, improving the health of mothers and infants, well beyond childhood. Healthcare professionals have the responsibility of providing breastfeeding education to families. Worldwide, most healthcare professionals do not receive sufficient evidence-based education to adequately support breastfeeding families.

OBJECTIVES

(1) What experiences have university health science students had with breastfeeding? (2) What are university health science students' beliefs and attitudes toward breast and formula feeding of infants? (3) What are the perceptions of university health science students about how other important people in their lives regard breastfeeding? (4) What are the relationships between students' personal experiences with breastfeeding and their beliefs and attitudes about infant feeding choices?

DESIGN

A descriptive cross-sectional survey conceptualized using the Theory of Planned Behavior.

SETTING

The health science college within a major metropolitan research university in the United States.

PARTICIPANTS

Health science undergraduate and graduate students (N=514), who were over the age of 18 and who were enrolled during the spring of 2011.

METHODS

Validated survey instruments were used to collect the data on the Theory of Planned Behavior variables. The request for participants was done by emailing all health science students. If students chose to participate, they filled out an anonymous on-line survey.

RESULTS

Most participants were not parents; however, the majority of the 95 (21.05%) students who were parents reported their child was breastfed. Significantly more positive attitudes and beliefs were found in graduate students (n=101; 20.10%) when compared to undergraduates (n=403; 89.9%).

CONCLUSIONS

Health science students' beliefs and attitudes toward infant nutrition often were not evidence-based. However, all students were remarkably consistent in their responses concerning formula feeding. Incorporating adequate education about human lactation is an unmet responsibility of university health science programs.

Infant Feeding Attitudes and Breastfeeding Intentions of Black College Students

Breastfeeding rates are lowest among Black women than women of other races. An understanding of infant feeding attitudes may help improve breastfeeding rates among Black women. The theory of planned behavior guided this study to explore infant feeding attitudes of Black college students and the contribution of attitudes to breastfeeding intentions after controlling for age, gender, income, and education level. A sample of 348 Black college students below 45 years old with no children and no history of pregnancies were recruited for this study. The Iowa Infant Feeding Attitude Scale and a Demographic Questionnaire were used to collect data. Participants agreed that breast milk is the ideal food for infants and 48% indicated high probability of breastfeeding intentions. Infant feeding attitudes also explained approximately 30% (Nagelkerke R2) of the variance in breastfeeding intentions. Therefore, breastfeeding interventions targeting Black women should focus on improving breastfeeding attitudes.

Evaluation of a theory of planned behaviour-based breastfeeding intervention in Northern Irish schools using a randomized cluster design

OBJECTIVE

The aim of this research was to evaluate the effectiveness of a school-based intervention designed to enhance young people's motivations to breastfeed.

DESIGN

A cluster randomized controlled trial was conducted involving 50 post-primary schools from across Northern Ireland. However, dropout and exclusion criteria utilized for the current study resulted in an effective sample size of 42 schools.

METHODS

The intervention was delivered in two 35-min classroom sessions targeting those beliefs identified by the theory of planned behaviour (TPB) as significant in predicting motivation to breastfeed. Questionnaires incorporating the key components of the TPB were administered to all intervention and control schools at baseline, 1 and 6 months post-intervention. Multi-level modelling was used to analyse the data.

RESULTS

Findings suggest that the intervention was effective in that it increased females' intentions to breastfeed, expanded their knowledge and led to more favourable attitudes and perceptions of subjective norms. Notably, females' knowledge increased more in secondary schools than in grammar schools irrespective of whether they were control or intervention schools.

CONCLUSION

The research has provided evidence to support the use of the TPB in the design and evaluation of an intervention to increase females' intentions to breastfeed.

Breastfeeding knowledge, attitudes, prior exposure, and intent among undergraduate students

BACKGROUND

Understanding breastfeeding knowledge, attitudes, and exposures among nonpregnant youth who are likely to be future parents may provide significant pathways to successfully increasing breastfeeding as the normal, accepted way of feeding infants. However, based on a recent review of the literature, only 3 studies have assessed these factors in nonpregnant, young adults in the United States in the past 10 years.

OBJECTIVE

The objective of this study was to gather more recent data regarding breastfeeding knowledge, attitudes, and prior exposure among undergraduate university students.

METHODS

This was a cross-sectional survey, conducted in November 2010. A convenience sample, consisting of undergraduates in attendance in 2 sections of an introductory nutrition class at a large research university, was used for this project (N = 248).

RESULTS

Breastfeeding knowledge was relatively good. However, overall breastfeeding attitudes were more neutral, which appeared to be explained by the belief that breastfeeding is painful, restrictive, and inconvenient, both in general and specifically for the working mother. Though support for breastfeeding in public was low, men were significantly less likely than women to believe it to be embarrassing or unacceptable. In addition, breastfeeding attitudes were more positive among older students and those who were breastfed as infants. Those who were breastfed as infants were also significantly more likely to intend to breastfeed future children.

CONCLUSIONS

Though this sample indicates good breastfeeding knowledge, attitudes were more neutral, and support for breastfeeding in public appears low. This finding is contradictory and warrants further exploration.

Breastfeeding attitudes among couples planning exclusive breastfeeding or mixed feeding

OBJECTIVES

The goals of the study were to describe maternal and paternal attitudes toward breastfeeding among couples planning exclusive breastfeeding and those planning mixed feeding and to compare maternal predictions of paternal attitudes with actual paternal attitudes.

METHODS

Expectant parents with the intention to breastfeed were recruited from outpatient clinics. During the third trimester of pregnancy, mothers and fathers independently completed a demographic questionnaire and a breastfeeding attitude survey. In addition, mothers were asked to predict fathers' attitudes.

RESULTS

Seventy-one subjects completed all study requirements: 56 planned to exclusively breastfeed, and 15 planned to mix feed. The majority of subjects were white, educated beyond high school, and married. Expectant parents planning to exclusively breastfeed were significantly more likely to report higher paternal age (p=0.019), higher maternal age (p=0.006), and higher maternal education (p=0.023) than those planning to mix feed. Among fathers, those planning exclusive breastfeeding expressed more favorable attitudes related to naturalness (p=0.009) and closeness (p=0.036) than their mixed-feeding peers. Compared with mothers planning mixed feeding, those planning exclusive breastfeeding indicated more favorable attitudes related to naturalness (p=0.006) and respect for breastfeeding women (p=0.005). Overall, mothers reported more favorable attitudes toward breastfeeding than fathers in several areas, including disease protection (p=0.004), respect for breastfeeding women (p=0.043), and naturalness (p=0.011). The mother's predictions were less favorable than the father's actual attitudes in the areas of purpose of breasts (p=0.007), respect (p=0.049), and closeness (p=0.024).

CONCLUSIONS

Results suggest expectant parents who plan to mix feed may be fundamentally different from those planning to exclusively breastfeed. There is a continued need to identify factors that influence the prenatal decision to mix feed and to develop strategies that promote exclusive breastfeeding in this population.

Knowledge, misconceptions, and future intentions towards breastfeeding among female university students in Kuwait

A cross-sectional study using a self-administered questionnaire was conducted on female university students (N = 1106) to explore their knowledge and misconceptions on breastfeeding. Most participants recognized the benefits of breastfeeding, but only a few were aware of the recommendation for exclusive breastfeeding in the first 6 months of life. Misconceptions were common; 66%, 60%, and 55% of participants thought mothers should temporarily stop breastfeeding if they had a fever, skin rash, or sore throat, respectively. Approximately 20% thought mothers should stop breastfeeding if the child had diarrhea, vomiting, or skin rash. Support of breastfeeding in public places was low, but 38% supported breastfeeding in female prayer rooms in public places. Efforts should be made to correct common misconceptions on breastfeeding and increase the support of breastfeeding in public places among university students. Female prayer rooms that exist in all public places in Kuwait can be used to promote breastfeeding in public places in Kuwait.

Breastfeeding attitudes of Finnish parents during pregnancy

BACKGROUND

Breastfeeding attitudes are known to influence infant feeding but little information exists on the prenatal breastfeeding attitudes of parents. The purpose of this study was to describe Finnish parents' prenatal breastfeeding attitudes and their relationships with demographic characteristics.

METHODS

The electronic Breastfeeding Knowledge, Attitude and Confidence scale was developed and 172 people (123 mothers, 49 fathers) completed the study. The data were analysed using factor analysis and nonparametric methods.

RESULTS

Breastfeeding was regarded as important, but 54% of the respondents wanted both parents to feed the newborn. The mean rank values of breastfeeding attitudes differed significantly when parity, gender, education, age, breastfeeding history and level of breastfeeding knowledge were considered. The respondents who were expecting their first child, were 18-26 years old or had vocational qualifications or moderate breastfeeding knowledge had more negative feelings and were more worried about breastfeeding than respondents who had at least one child, had a higher vocational diploma or academic degree or had high levels of breastfeeding knowledge. Respondents with high levels of breastfeeding knowledge did not appear concerned about equality in feeding.

CONCLUSIONS

Both mothers and fathers found breastfeeding important. A father's eagerness to participate in their newborn's life should be included in prenatal breastfeeding counselling and ways in which to support breastfeeding discussed. Relevant information about breastfeeding should focus on the parents who are expecting their first child, those who are young, those with low levels of education or those who have gaps in breastfeeding knowledge, so that fears and negative views can be resolved.

Reproductive-aged women's knowledge and attitudes regarding infant-feeding practices: an experimental evaluation

Using an experimental design, this study assessed knowledge, attitudes, and intentions regarding infant feeding practices among Canadian female university undergraduates (N = 285). Participants completed a survey of knowledge, attitudes, and intentions with respect to infant-feeding practices. Two versions of the survey were randomly distributed to participants: one containing a photograph of a woman breastfeeding her infant (n = 131) and the other containing a photograph of the same women bottle-feeding her infant (n = 154). Findings indicated that the majority of the sample had been breastfed (84%) and intend to breastfeed their own offspring (97%). The intention to breastfeed future offspring was predicted by knowledge, attitudes, and perceptions of social norms. Participants reported more positive attitudes toward visual depictions of breastfeeding compared with bottle-feeding but less positive views of breastfeeding in public compared with bottle-feeding in public. Participants also significantly underestimated the health benefits and optimal duration of breastfeeding. The findings highlight gaps in knowledge that may contribute to premature cessation of breastfeeding among Canadian women and suggest the need for breastfeeding education.

Development and evaluation of a Chinese-language newborn feeding hotline: a prospective cohort study

BACKGROUND

Preference for formula versus breast feeding among women of Chinese descent remains a concern in North America. The goal of this study was to develop an intervention targeting Chinese immigrant mothers to increase their rates of exclusive breastfeeding.

METHODS

We convened a focus group of immigrant women of Chinese descent in Vancouver, British Columbia to explore preferences for method of infant feeding. We subsequently surveyed 250 women of Chinese descent to validate focus group findings. Using a participatory approach, our focus group participants reviewed survey findings and developed a priority list for attributes of a community-based intervention to support exclusive breastfeeding in the Chinese community. The authors and focus group participants worked as a team to plan, implement and evaluate a Chinese language newborn feeding information telephone service staffed by registered nurses fluent in Chinese languages.

RESULTS

Participants in the focus group reported a strong preference for formula feeding. Telephone survey results revealed that while pregnant Chinese women understood the benefits of breastfeeding, only 20.8% planned to breastfeed exclusively. Only 15.6% were breastfeeding exclusively at two months postpartum. After implementation of the feeding hotline, 20% of new Chinese mothers in Vancouver indicated that they had used the hotline. Among these women, the rate of exclusive breastfeeding was 44.1%; OR 3.02, (95% CI 1.78-5.09) compared to women in our survey.

CONCLUSION

Initiation of a language-specific newborn feeding telephone hotline reached a previously underserved population and may have contributed to improved rates of exclusive breastfeeding.