Gestational, perinatal, and postnatal factors that interfere with practice of exclusive breastfeeding by six months after birth

Pengaruh Aspek Sosio Budaya Gizi Terhadap Pemberian Asi Eksklusif Pada Etnik Madura Di Wilayah Kerja Puskesmas Bangkalan, Madura

ABSTRACT Background: Breast milk is the best nutrition for children's health and intelligence. Exclusive breastfeeding can prevent death and infectious diseases in infants. The socio-cultural factor is one of the strong driving factors towards mother's behavior in giving exclusive breastfeeding, especially to people who have strong adherence to the traditions of their ancestors such as the Maduranese.Objectives: The purpose of this study was to analyze the influence of socio-cultural nutrition on exclusive breastfeeding in the Bangkalan Health Center, Madura Methods: This study was using a cross sectional research design with a sample of mothers who have babies aged 6-12 months. The sample size of this study was 87 respondents. Sampling is done by stratified random sampling. Data collection through interviews using questionnaires and research results were analyzed using logistic regression tests.Results: There was an influence between socio- culture of nutrition in infants (P=0,000) on exclusive breastfeedingi the Bangkalan public health center. Mothers who have socio-culture of nutrition in infants more do not provide exclusive breastfeeding for 6 months.Conclusions: In conclusion, socio-culture of nutrition in infants in the form of prelacteal feeding and early MP-ASI can influence exclusive breastfeeding for infants for 6 months. It is hoped that health workers will educate mothers and husbands about the dangers of giving honey and MP-ASI early to babies and motivate husbands to provide support to mothers for exclusive breastfeeding. Increasing the role of cadres in moving the community to want to come in counseling about exclusive breastfeeding with her husband.ABSTRAKLatar Belakang: ASI merupakan nutrisi terbaik bagi kesehatan dan kecerdasan anak. Pemberian ASI eksklusif dapat mencegah kematian dan penyakit infeksi pada bayi. Faktor sosio budaya merupakan salah satu faktor pendorong yang cukup kuat terhadap perilaku ibu dalam  memberikan ASI eksklusif, terutama pada masyarakat yang memiliki kepatuhan yang kuat pada tradisi nenek moyang seperti pada etnik Madura.Tujuan: Penelitian ini bertujuan untuk menganalisis pengaruh sosio budaya gizi terhadap pemberian ASI eksklusif di wilayah kerja Puskesmas Bangkalan, Madura.Metode: Penelitian ini menggunakan rancangan cross sectional dengan sampel ibu yang memiliki bayi usia 6-12 bulan.  Besar sampel dari penelitian ini yaitu 87 responden. Pengambilan sampel dilakukan dengan stratified random sampling. Pengumpulan data melalui wawancara menggunakan kuesioner dan hasil penelitian dianalisis menggunakan uji regresi logistik.Hasil: Hasil penelitian menunjukkan bahwa terdapat pengaruh antara sosio budaya gizi pada bayi (P=0,000) terhadap pemberian ASI eksklusif di wilayah kerja Puskesmas Bangkalan. Ibu yang terdapat sosio budaya gizi pada bayi lebih banyak tidak memberikan ASI eksklusif selama 6 bulanKesimpulan: Dari hasil penelitian dapat disimpulkan bahwa sosio budaya gizi pada bayi berupa pemberian makanan prelakteal dan MP-ASI dini dapat mempengaruhi pemberian ASI eksklusif pada bayi selama 6 bulan. Diharapkan agar tenaga kesehatan mengedukasi ibu dan suami tentang bahaya memberian madu dan MP-ASI dini kepada bayi serta memotivasi suami agar memberikan dukungan kepada ibu untuk menyusui eksklusif. Meningkatkan peran kader dalam menggerakkan masyarakat agar mau datang dalam penyuluhan tentang ASI eksklusif bersama suami.

Feeding during the first 3 days after birth other than breast milk is associated with early cessation of exclusive breastfeeding

Exclusive breastfeeding (EBF) has significant effect on morbidity and mortality. EBF is established when breastmilk alone is exclusively fed from birth until 6 months of age. However, feeding during the first 3 days after birth is often ignored for various reasons. We aimed to assess the role of feeding during the first 3 days in respect of early cessation of EBF. Data of 1,040 children aged under 6 months was derived from the baseline survey of Suchana, a large‐scale nutrition program, conducted in Sylhet, Bangladesh, and subsequently analysed. Guidelines established by World Health Organization were used to define EBF and feeding during the first 3 days. The strength of the association between feeding during the first 3 days and early cessation of EBF was established using multiple logistic regression after adjusting for other covariates. Among all children, around 62% and 13% were exclusively breastfed and were fed something other than breastmilk within the first 3 days of birth, respectively. Feeding during the first 3 days was independently and significantly associated with early cessation of breastfeeding (adjusted odds ratio: 1.94, 95% confidence interval [1.31, 2.88], p = .001). Less than four antenatal care (ANC) visits, increased child's age and increased household size were also independently associated with early cessation of EBF. Feeding during the first 3 days of birth is a significant predictor of early cessation of EBF. Simple counselling activities to discourage feeding anything within the first few days of birth may increase the prevalence of EBF in rural Bangladesh without investing additional resources.

Determinants of exclusive breastfeeding among mothers of infants aged 6 to 12 months in Gwanda District, Zimbabwe

Background

In 2016, 98% of children in Zimbabwe received breastmilk, however only 40% of babies under six months were exclusively breastfed 24 h prior to data collection. A 2014 survey revealed that Matabeleland South Province had the country’s highest starvation rates and food insecurities were rife. This study aimed at investigating maternal, infant, household, environmental and cultural factors influencing exclusive breastfeeding (EBF) practice in Gwanda District.

Methods

A cross-sectional study was conducted from January to March 2018. Interviews used pretested structured questionnaires for 225 mothers of infants aged between six and twelve months at immunization outreach points and health facilities. Descriptive statistics, bivariate and multivariate analysis estimated the association between the dependent and independent variables. Exclusive breastfeeding was defined as feeding an infant on breast milk only from birth up to the age of six months.

Results

The majority of mothers (n = 193; 89%) had knowledge about EBF and 189 (84%) expressed a positive attitude towards the practice, however, only 81 (36%) practiced exclusive breastfeeding. The most common complementary food/fluid given to the infants was plain water (n = 85; 59%). Predictors for EBF were: maternal Human Immuno-deficiency Virus positive status (Odds Ratio [OR] 0.30; 95% Confidence Interval [CI] 0.17, 0.56) and being economically independent (OR 0.41; 95% CI 0.21, 0.79). Barriers to practicing EBF were: being a young mother under 25 years of age (OR 3.05; 95% CI 1.67, 5.57), having one or two children (OR 2.49; 95% CI 1.29, 4.79), living in less than two rooms (OR 3.86; 95% CI 1.88, 7.93) and having a baby of low birthweight (OR 1.05; 95% CI 0.40, 2.71). After multivariate analysis, only the mother’s economic independence was associated with practicing EBF (Adjusted OR [AOR] 0.83; 95% CI 0.30, 0.92). Key informants identified traditional family practices as the major barrier to EBF.

Conclusion

The exclusive breastfeeding rates were low despite the mothers’ high knowledge levels and positive attitudes towards the practice. In addressing the multiple factors influencing the cost effective practice, there is need to channel supportive measures through a system-wide approach. This can be achieved by realigning breastfeeding policy directives as well as community attitudes and values towards the exclusive breastfeeding.