Maternal prenatal attitudes and postnatal breast-feeding behaviours in rural Bangladesh

• Type of Material: Article
• Authors: Elaine A Yu, Emory University; Joan S Thomas, Emory University; Aatekah Owais, Emory University; Noor Tirmizi, CARE USA; ASG Faruque, iccdr, b (International Centre for Diarrhoeal Disease Research, Bangladesh); Sumon K Das, iccdr, b (International Centre for Diarrhoeal Disease Research, Bangladesh); Shahed Rahman, CARE Bangladesh; Benjamin Schwartz, CARE USA; Aryeh Stein, Emory University
• Language: English
• Date: 2015-03-01
• Publisher: CAMBRIDGE UNIV PRESS
• Publication Version: Final Published Version
• Copyright Statement: © The Authors 2014
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1017/S1368980014000937
• Title of Journal or Parent Work: PUBLIC HEALTH NUTRITION
• Volume: 18
• Issue: 4
• Start Page: 679
• End Page: 685
• Grant/Funding Information: This study was supported by a grant from CARE USA (000013123). The authors have no financial relationships relevant to this article to disclose.
• Keywords: DHAKA; DURATION; SELF-EFFICACY; Breast-feeding; LOW-INCOME WOMEN; ATTRITION PREDICTION TOOL; INITIATION; Life Sciences & Biomedicine; Science & Technology; Nutrition & Dietetics; PLANNED BEHAVIOR; Attitude; Knowledge; Public, Environmental & Occupational Health; ADOLESCENT MOTHERS; RANDOMIZED CONTROLLED-TRIAL; Self-efficacy; CONFIDENCE
• Research Categories: Health Sciences, Public Health

Abstract

Objective To assess the relationships between maternal breast-feeding intention, attitudes, self-efficacy and knowledge at 7 months' gestation with exclusive or full breast-feeding at 3months postpartum. Design Prospective cohort study with structured home interviews during pregnancy and 3 months after delivery. Setting Two rural sub-districts of Kishoreganj district, Bangladesh. Subjects Mother-infant dyads. Results Over 80 % of 2178 pregnant women intended to exclusively breast-feed (EBF). Maternal positive attitudes, self-efficacy and knowledge about breast-feeding were positively associated with EBF intention (all P<0·05). All mothers except one reported initiating breast-feeding and 99·6 % of children were still breast-fed at 3 months. According to 24 h dietary recalls, we categorized 985 (45·2 %) infants as EBF at 3 months (47·8 % among mothers with EBF intention; 31·7 % among mothers with no EBF intention; P<0·05) and 551 (25·3 %) infants as predominantly breast-fed at 3 months (24·2 % among mothers with EBF intention; 30·8 % among mothers with no EBF intention; P<0·05). Prenatal EBF intention was associated with EBF (OR=1·48, 95 % CI 1·14, 1·91) and with full breast-feeding (OR=1·34, 95 % CI 1·04, 1·72) at age 3 months. EBF at age 3months was not associated with maternal breast-feeding knowledge, attitudes or self-efficacy. Conclusions Despite widespread expressed maternal EBF intention and universal breast-feeding initiation, prevalence of both exclusive and full breast-feeding at 3months remains lower than WHO recommendations. EBF intention predicts breast-feeding behaviours, suggesting the importance of prenatal counselling to improve infant feeding behaviours.