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Vázquez‐Vázquez ADP, Fewtrell MS, Chan‐García H, Batún‐Marrufo C, Dickinson F, Wells JCK. Do maternal grandmothers influence breastfeeding duration and infant nutrition? Evidence from Merida, Mexico. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2022; 179:444-459. [PMID: 36790606 PMCID: PMC9826188 DOI: 10.1002/ajpa.24623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/25/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Breast-feeding is sensitive to somatic, hormonal, behavioral and psychological components of maternal capital. However, through grandmothering, older women may also influence breast-feeding by transferring informational resources to their daughters. We hypothesized that mothers with prolonged instrumental support from their own mother are more likely to have received advice and to have favorable attitudes/practices regarding breastfeeding, compared to those lacking such support, with implications for the grandchild's somatic capital. METHODS We recruited 90 mother-infant dyads (52 with grandmaternal support, 38 without) in Merida, Yucatan, Mexico. All children were first-borns, aged ~2 years. Anthropometry and body composition were assessed. Data on grandmother's breastfeeding advice and maternal breastfeeding duration were obtained by questionnaire. Maternal attitudes to breast-feeding were assessed using the Iowa Infant Feeding Attitude Scale. RESULTS Women with instrumental support were more likely to have received grandmaternal advice during pregnancy/infancy on exclusive breast-feeding duration (60% vs. 37%, p = 0.033) and the type of first complementary food (81% vs. 47%, p = 0.001). However, women with support had a less favorable attitude to breastfeeding than those without and breastfed their children for less time (median 5 vs. 10.5 months, p = 0.01). No group differences were found in children's length, weight, skinfolds or lean mass z-score. DISCUSSION Although grandmothers providing instrumental support provided advice regarding breastfeeding, their attitudes may reflect issues beyond nutritional health. Advice of maternal grandmothers did not promote extended breastfeeding, however the differences in breastfeeding attitudes were not associated with the children's nutritional status. Grandmothers should be included in public health interventions promoting breastfeeding.
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Affiliation(s)
| | - Mary S. Fewtrell
- Childhood Nutrition Research Centre, UCLGreat Ormond Street Institute of Child HealthLondonUK
| | - Hidekel Chan‐García
- Human Ecology DepartmentCentre for Research and Advanced Studies (Cinvestav)MeridaYucatanMexico
| | - Carolina Batún‐Marrufo
- Human Ecology DepartmentCentre for Research and Advanced Studies (Cinvestav)MeridaYucatanMexico
| | - Federico Dickinson
- Human Ecology DepartmentCentre for Research and Advanced Studies (Cinvestav)MeridaYucatanMexico
| | - Jonathan C. K. Wells
- Childhood Nutrition Research Centre, UCLGreat Ormond Street Institute of Child HealthLondonUK
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Erdim L, Zengin N. Validity and reliability of the Infant Feeding Attitude Scale in young people in Turkey. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01253-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Efrat M. Exploring the Impact of Offering an Undergraduate Lactation Elective Course as a Strategy for Normalizing Breastfeeding. CLINICAL LACTATION 2021. [DOI: 10.1891/clinlact-d-20-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundMore 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.MethodsPre- and postcourse surveys were administered to 96 undergraduates from various majors enrolled in a lactation elective.ResultsFrom pre- to postcourse, this study found significant increases in undergraduates' breastfeeding knowledge, attitudes, and intent.ConclusionsBecause 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.
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Efrat M, Boyns D, Rubino L. Exploring the Feasibility of Utilizing Undergraduate Lactation Education Courses as a Vehicle to Prepare the Future Healthcare Workforce to Educate and Support Breastfeeding Families in the Community. CLINICAL LACTATION 2020. [DOI: 10.1891/clinlact-d-19-00027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundMinimal lactation knowledge among healthcare professionals has been linked to low breastfeeding rates. To address this problem, one university integrated into its curriculum a lactation education course which aims to provide students from a variety of healthcare related bachelor programs, with the knowledge and skills needed to educate and support breastfeeding families in the community. The aim of this study was to evaluate the feasibility of utilizing undergraduate lactation education courses as a vehicle to better prepare the future healthcare work force to educate and support breastfeeding families in the community.MethodsA 62-question survey was administered pre and post course completion to students enrolled in four sections of a lactation course over the 2018/2019 academic year (n = 96).ResultsFindings suggest that pre to post course completion students had significant increases in their: lactation knowledge, confidence delivering lactation education, confidence in working with clients in a professional setting and positive attitude towards breastfeeding.ConclusionsGiven the lack of knowledge among healthcare professionals is a significant barrier to optimal breastfeeding rates, this evaluation study provides evidence that integrating lactation education courses into university curriculum may be an effective strategy for improving breastfeeding rates.
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Abdulahi M, Fretheim A, Argaw A, Magnus JH. Adaptation and validation of the Iowa infant feeding attitude scale and the breastfeeding knowledge questionnaire for use in an Ethiopian setting. Int Breastfeed J 2020; 15:24. [PMID: 32272963 PMCID: PMC7144343 DOI: 10.1186/s13006-020-00269-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 03/31/2020] [Indexed: 11/30/2022] Open
Abstract
Background Validated instruments to assess breastfeeding knowledge and attitude are non-existent in Africa including Ethiopia. We aimed to adapt and validate the Breastfeeding Knowledge Questionnaire (BFKQ) and the Iowa Infant Feeding Attitude Scale (IIFAS) for use in Afan Oromo (AO), the most widely spoken language in Ethiopia. Methods After forward-backward translation into Afan Oromo, the instruments were reviewed for content validity by a panel of a nutritionist and pediatricians, and pretested on a sample of 30 mothers. Then, a cross-sectional study involving 468 pregnant women in their second and third trimester was conducted between May and August 2017 in the Manna district, Southwest Ethiopia, using the final versions of the adapted questionnaires. We used exploratory and confirmatory factor analysis to assess the construct validity, receiver operating characteristic (ROC) curves to determine the predictive validity and Cronbach’s alpha coefficients to assess internal consistency. Results Using exploratory factor analysis (EFA), nine domains containing 34 items were extracted from the BFKQ-AO. A confirmatory factor analysis of the constructs from EFA confirmed construct validity of the instrument (χ2/df = 2.11, RMSEA = 0.049, CFI = 0.845, TLI = 0.823). In factor analysis of the IIFAS, the first factor explained 19.7% of the total variance and the factor loadings and scree plot test suggested unidimensionality of the tool. Cronbach’s alpha was 0.79 for the BFKQ-AO and 0.72 for IIFAS-AO suggesting an acceptable internal consistency of both instruments. For the sensitivity and specificity in predicting intention of breastfeeding for ≥24 months, the area under the curve (AUC) was 82% for IIFAS score and 79% for BFKQ score. Conclusions Here we present the first study that reported the use of the BFKQ and the IIFAS in Ethiopia. Our results showed that both BFKQ-AO and IIFAS-AO can be reliable and valid tools for measuring maternal breastfeeding knowledge and attitude in the study population, showing the potential for adapting these tools for application in a wider Ethiopian context.
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Affiliation(s)
- Misra Abdulahi
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia. .,Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway.
| | - Atle Fretheim
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - Alemayehu Argaw
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia.,Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Jeanette H Magnus
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, USA
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Khresheh R. Knowledge and attitudes toward breastfeeding among female university students in Tabuk, Saudi Arabia. Nurs Midwifery Stud 2020. [DOI: 10.4103/nms.nms_35_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Robinson A, Lauckner C, Davis M, Hall J, Anderson AK. Facebook support for breastfeeding mothers: A comparison to offline support and associations with breastfeeding outcomes. Digit Health 2019; 5:2055207619853397. [PMID: 31218076 PMCID: PMC6560800 DOI: 10.1177/2055207619853397] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 05/06/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES For breastfeeding mothers, online support groups through Facebook may be a more convenient and preferred source for accessing breastfeeding information and support, but few studies exist that examine the use of Facebook groups specifically for breastfeeding support. This study explores the sources of support among users of Facebook breastfeeding support groups and a possible mechanism by which support received on Facebook may translate to behavioral outcomes among breastfeeding mothers. METHODS From July-September 2017 a survey was distributed online to African American mothers (N = 277) who participate in breastfeeding support groups on Facebook. The survey assessed network support from Facebook and other sources of breastfeeding support, perceived breastfeeding norms, breastfeeding self-efficacy and breastfeeding attitudes. Correlations and linear regression analysis were used to examine the relationship between covariates and outcome variables. RESULTS The average intended breastfeeding duration among participants in this study was 19 months. Participants reported the highest amount of breastfeeding support received from their Facebook support group, in comparison to other sources of support, and Facebook support was significantly correlated with intended breastfeeding duration (p < 0.05). Self-efficacy and breastfeeding attitudes remained significant predictors of intended breastfeeding duration within the final regression model. CONCLUSIONS Breastfeeding support received within Facebook groups may compensate for inadequate support received within mothers' networks. More research is needed to understand the mechanism through which Facebook support may contribute to prolonged breastfeeding durations.
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Jefferson UT. Breastfeeding Exposure, Attitudes, and Intentions of African American and Caucasian College Students. J Hum Lact 2017; 33:149-156. [PMID: 28135485 DOI: 10.1177/0890334416679384] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND African American mothers lag behind in breastfeeding initiation. Research is needed to gain an understanding of potential reasons for breastfeeding disparities. Research aim: This study explored breastfeeding exposure, attitudes, and intentions of African American and Caucasian college students by race and gender. METHODS Women and men (696) attending college, who were younger than 45 years and without children, were included in this study. Survey data were collected using a demographic questionnaire and the Iowa Infant Feeding Attitude Scale. RESULTS Overall, students demonstrated favorable attitudes regarding breastfeeding but viewed formula feeding as more practical. Students who were Caucasian and female and experienced breastfeeding exposure demonstrated higher breastfeeding attitudes and intent. Breastfeeding exposure and attitudes contributed 32% of the variance in breastfeeding intentions. The odds of experiencing breastfeeding exposure and positive breastfeeding attitudes were approximately 3 times higher for Caucasian students than for African American students. CONCLUSION External factors demonstrated a stronger association with breastfeeding intentions. The link with race and gender appears to operate through their effect on attitudes and exposure. More research is needed to identify strategies to improve breastfeeding exposure and attitudes among African Americans.
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Bai YK, Dinour LM, Pope GA. Determinants of the Intention to Pump Breast Milk on a University Campus. J Midwifery Womens Health 2016; 61:563-570. [DOI: 10.1111/jmwh.12488] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/29/2016] [Accepted: 04/03/2016] [Indexed: 11/29/2022]
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Lau Y, Htun TP, Lim PI, Ho-Lim SST, Klainin-Yobas P. Psychometric Properties of the Iowa Infant Feeding Attitude Scale among a Multiethnic Population during Pregnancy. J Hum Lact 2016; 32:315-23. [PMID: 26151966 DOI: 10.1177/0890334415591813] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 05/22/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Iowa Infant Feeding Attitude Scale (IIFAS) was developed to measure maternal attitudes toward infant feeding, but a number of validated studies on the IIFAS found that it was subject to methodological limitations. OBJECTIVE The purpose of this study was to evaluate the psychometric properties of the IIFAS among a multiethnic population in Singapore. METHODS A cross-sectional research design was used on a sample of 417 antenatal women. The internal consistency and stability of the IIFAS were evaluated using Cronbach's α and test-retest reliability. Known-group comparisons discriminated certain group differences in a predictable way. A series of exploratory factor analyses (EFAs) was conducted to test the factor structure of the IIFAS using the maximum likelihood and principal axis factoring. The number of factors was selected according to theoretical and statistical considerations. A confirmatory factor analysis (CFA) was further performed to validate the factor structure constructed in the prior EFA. RESULTS The IIFAS had a Cronbach's α and Pearson correlation of 0.79 and 0.85, respectively. The known-group comparisons among certain groups were supported. The EFA results showed that the 3-factor structure produced the most interpretable and theoretical sense. A second-order CFA was conducted to confirm the construct dimensionality of the 15-item IIFAS, with satisfactory fit indices found. CONCLUSION The 15-item IIFAS is a psychometrically sound measurement tool that health care professionals can use to understand the diverse infant feeding attitudes and knowledge among different ethnic groups in order to provide breastfeeding interventions that are culturally sensitive.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tha Pyai Htun
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peng Im Lim
- Nursing Department, National University Hospital, Singapore
| | - Sarah Su Tin Ho-Lim
- Nursing/Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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McComb S, Jones C, Smith A, Collins W, Pope B. Designing Incentives to Change Behaviors: Examining College Student Intent Toward Healthy Diets. West J Nurs Res 2016; 38:1094-113. [PMID: 27094555 DOI: 10.1177/0193945916644705] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
College is a time when young adults establish lifestyle habits. This research examines how personalization and limited resources might be balanced most effectively when designing incentives to shift college students' intentions toward positive dietary changes. A randomized 2 × 2 experiment (Coaching/Coupons × Fruits and Vegetables/Low Fat) was conducted, where respondents were exposed to virtual interventions and asked pre- and post-intervention about their intent to eat healthy. Results suggest that interventions may incentivize students, but are dependent on student characteristics. On-campus students and students with more knowledge about healthy diets were more likely to increase their intent when offered coaching; students living off campus and those with less knowledge resonated with coupons. On- and off-campus students differed in their positive responses to eating fruits and vegetables versus low fat foods, respectively. Younger students may be more susceptible to interventions. Findings may be useful in designing meaningful incentives for college students.
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Predictors of Breastfeeding Attitudes Among College-Educated African Americans. Res Theory Nurs Pract 2015; 29:189-99. [DOI: 10.1891/1541-6577.29.3.189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Breastfeeding initiation among African American women has reached 60%; however, it is the lowest rate among all races. This racial disparity is a public health concern considering the impact of breastfeeding on infant morbidity and mortality. The purpose of this study was to explore breastfeeding exposure and determinants of breastfeeding attitudes among African Americans. The theory of planned behavior guided this study focusing on the impact of background factors on determinants of breastfeeding attitudes. This secondary analysis included 348 African American college students with a mean age of 22 years with no children. The Iowa Infant Feeding Attitude Scale and a demographic questionnaire were used to collect data. A significant association between knowing someone who breastfed her infant and being breastfed as an infant (p < .001) was observed. Although gender, education, and breastfeeding exposure explained 15% of the variance in breastfeeding attitudes, being breastfed as an infant had no significant (p = .611) contribution. Breastfeeding exposure to someone who has breastfed her infant is a modifiable factor that influenced positive breastfeeding attitudes. Therefore, it is essential to identify strategies in practice to increase breastfeeding exposure for vulnerable populations in efforts to improve breastfeeding attitudes, intentions, and initiation.
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