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Nie J, Ye J, Wu S, Wang N, Li Y, Liu Y, Reheman Z, Wu J, Yang J, Shi Y. Beyond mothers: the crucial role of family caregivers' knowledge on exclusive breastfeeding in rural western China. Int Breastfeed J 2023; 18:58. [PMID: 37932785 PMCID: PMC10626667 DOI: 10.1186/s13006-023-00596-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/02/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND The exclusive breastfeeding rate in China remains significantly low. Numerous studies have identified the impact of maternal characteristics on exclusive breastfeeding; however, the correlation between primary family caregivers' characteristics, such as health and nutrition knowledge, and exclusive breastfeeding still lacks clarity. The aim of this study is to investigate the association between the health and nutrition knowledge of primary family caregivers and exclusive breastfeeding in rural China. METHODS In 2019, a cross-sectional study was conducted in two prefectures within the Qinba Mountains area, located in the southern region of Shaanxi province. Data on knowledge of health and nutrition, breastfeeding practices, breastfeeding family support, breastfeeding self-efficacy, and conflict frequency were collected via structured questionnaires from 372 caregiver-infant pairs. Infant feeding practices were assessed based on the caregivers' recall of the previous day (within the 24 h before the interview). The mother was interviewed first, followed by a brief questionnaire for the primary family caregiver, both conducted individually to minimize disruptions from other family members. Univariate and multivariate regression analyses were conducted to explore the correlation between knowledge of mothers and primary family caregivers and exclusive breastfeeding. RESULTS The exclusive breastfeeding rate for six-month-old infants in the sample was 15.7%. On average, mothers scored 4.6 (SD 1.4) for health and nutrition knowledge, while primary family caregivers scored 3.6 (SD 1.4). Both maternal (OR 1.48; 95% CI 1.16, 1.88) and primary family caregiver's (OR 1.34; 95% CI 1.05, 1.70) health and nutrition knowledge were significantly associated with exclusive breastfeeding. A positive correlation (OR 1.98; 95% CI 1.40, 2.80) existed between the average health and nutrition knowledge of the mother and primary family caregiver and exclusive breastfeeding. The primary family caregiver's health and nutrition knowledge was positively correlated with the practical family support perceived by the mother (OR 1.23; 95% CI 1.02, 1.49) and breastfeeding self-efficacy of the mother (β = 1.40; 95% CI 0.29, 2.50). CONCLUSIONS The characteristics of the primary family caregiver play a large role in exclusive breastfeeding. To promote exclusive breastfeeding, interventions should address the needs of the whole family instead of just mothers.
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Affiliation(s)
- Jingchun Nie
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China
| | - Jinbiao Ye
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China
| | - Shichong Wu
- School of Economics, Xiamen University, No. 422 Siming South Road, Siming District, Xiamen, Fujian Province, China
| | - Nan Wang
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China.
| | - Yangyuan Li
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China
| | - Yunjie Liu
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China
| | - Zulihumaer Reheman
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China
| | - Junhao Wu
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China
| | - Jie Yang
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China
| | - Yaojiang Shi
- Center for Experimental Economics in Education, Shaanxi Normal University, No. 620 West Chang'an Street, Chang'an District, Xi'an, Shaanxi Province, China
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Krikitrat P, Sansiriphun N, Deeluea J, Sonted S, Chaiwipassatorn W, Bressington D. Factors Affecting Thai Fathers' Self-Efficacy to Support Exclusive Breastfeeding. NURSING REPORTS 2023; 13:1511-1523. [PMID: 37987406 PMCID: PMC10660752 DOI: 10.3390/nursrep13040127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Breastfeeding is the ideal approach for feeding infants and is an important public health consideration. Successful exclusive breastfeeding initiation and duration is influenced by fathers' support. Paternal self-efficacy to support breastfeeding has also been shown to mediate infant feeding practices. The aim of this study was to investigate factors associated with Thai fathers' self-efficacy to support maternal exclusive breastfeeding. METHODS We adopted a cross-sectional survey design for this study. In total, 215 Thai fathers who had a partner with a term (37-42 weeks) pregnancy participated in the study. Data were collected from antenatal care clinics at two hospitals in Northern Thailand between June and August 2022. Participants completed a sociodemographic questionnaire, the Fathers' Attitude toward Exclusive Breastfeeding questionnaire, the Fathers' Knowledge about Exclusive Breastfeeding questionnaire, and the Breastfeeding Self-Efficacy Scale (Short-Form). Multiple linear regression and hierarchical regression were used to analyze factors influencing Thai fathers' self-efficacy to support maternal exclusive breastfeeding. RESULTS The mean breastfeeding self-efficacy score was 52.94 (SD = 8.58), indicating that fathers were confident they were able to support their partners' breastfeeding. Regression analysis revealed family type, fathers' attitude toward, and fathers' knowledge about exclusive breastfeeding significantly explaining 14.90% of the variance in paternal breastfeeding support self-efficacy. However, fathers' age, education, employment, income, and number of living children were not associated with their self-efficacy. CONCLUSIONS The results demonstrated that family type and fathers' attitudes/knowledge about breastfeeding influenced their self-efficacy to support exclusive breastfeeding. Nurses should consider implementing breastfeeding interventions specific to fathers to enhance their attitudes and knowledge about breastfeeding, including increasing fathers' self-efficacy to support maternal exclusive breastfeeding efforts.
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Affiliation(s)
- Preeyakamon Krikitrat
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Chiang Mai University, 239 Huay Kaew Rd, Tambon Su Thep, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50200, Thailand; (P.K.); (N.S.); (J.D.); (S.S.)
| | - Nantaporn Sansiriphun
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Chiang Mai University, 239 Huay Kaew Rd, Tambon Su Thep, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50200, Thailand; (P.K.); (N.S.); (J.D.); (S.S.)
| | - Jirawan Deeluea
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Chiang Mai University, 239 Huay Kaew Rd, Tambon Su Thep, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50200, Thailand; (P.K.); (N.S.); (J.D.); (S.S.)
| | - Sirirat Sonted
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Chiang Mai University, 239 Huay Kaew Rd, Tambon Su Thep, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50200, Thailand; (P.K.); (N.S.); (J.D.); (S.S.)
| | - Wongduean Chaiwipassatorn
- Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50200, Thailand;
| | - Daniel Bressington
- Visiting Professor, Faculty of Nursing, Chiang Mai University, Amphoe Mueang Chiang Mai, Chang Wat Chiang Mai 50200, Thailand
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Casuarina, NT 0810, Australia
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Modjadji P, Seabela ES, Ntuli B, Madiba S. Beliefs and Norms Influencing Initiation and Sustenance of Exclusive Breastfeeding: Experiences of Mothers in Primary Health Care Facilities in Ermelo, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1513. [PMID: 36674268 PMCID: PMC9864642 DOI: 10.3390/ijerph20021513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
Exclusive breastfeeding (EBF) is not a norm in many communities in South Africa despite the World Health Organizations' recommendations for EBF in the first six months of infant's life. Thus, South Africa continues to observe suboptimal and poor practices of EBF. The purpose of the study was to explore the experiences of mothers who are HIV-positive and negative on EBF and examine the extent to which initiation and sustenance of EBF is influenced by cultural beliefs, societal norms, and family norms and practices in Mpumalanga Province. Three focus group discussions and twelve in-depth interviews were conducted among thirty mothers who were purposively selected during their visits to the facilities for childcare services. Interviews were audiotaped, transcribed verbatim, and transcripts were analysed through thematic analysis using NVivo version 10. Mothers were aged between 18 and 42 years, most were unemployed and were living in poor sociodemographic backgrounds in extended family households. We found evidence of factors that influence the decision to EBF and mix feed infants among mothers. Traditional and cultural beliefs and norms that exist within their communities informed decisions mothers took to EBF. These beliefs existed alongside mothers' opinions on breastfeeding (BF) and HIV infection, as well as the fears of harming the baby through HIV infection, leading to early cessation of BF. Mothers were also advised by family members, friends, and even some healthcare workers to use traditional medicines while BF. The association of EBF with sagging breasts and weight loss as well as discomfort with public BF are personal beliefs that influenced initiation and early cessation of EBF. Breastfeeding messages ought to be context specific to improve the knowledge, understanding, acceptance and practice of EBF among HIV-positive and negative mothers. Culturally appropriate counselling messages that address the known cultural practices of the populations affected are essential to changing the beliefs and norms of the communities including extended families of EBF mothers.
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Affiliation(s)
- Perpetua Modjadji
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
| | - Ethel Sekori Seabela
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
| | - Busisiwe Ntuli
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
| | - Sphiwe Madiba
- Faculty of Health Sciences, University of Limpopo, Polokwane 0700, South Africa
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