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Kyei-Arthur F, Aballo J, Mahama AB, Adu-Afarwuah S. Infant and young child feeding practices among mothers in the pilot Micronutrient Powder Initiative in four geographically and ethnically diverse districts in Ghana. PLoS One 2024; 19:e0307961. [PMID: 39088512 PMCID: PMC11293642 DOI: 10.1371/journal.pone.0307961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 07/15/2024] [Indexed: 08/03/2024] Open
Abstract
In Ghana, breastfeeding and complementary feeding counselling have been used as a nutritional intervention to promote optimal Infant and Young Child Feeding (IYCF) and nutrition. This study examined IYCF practices in four geographically and ethnically diverse districts (Ho West, Tain, Talensi and Tolon). A qualitative study involving key informant interviews (KIIs) and focus group discussions (FGDs) was conducted between November and December 2019 among women who participated in a pilot micronutrient powder intervention for children 6-23 months of age. The KIIs and FGDs were audio-taped, transcribed verbatim, and analyzed thematically using NVivo 10. Three themes emerging from the KIIs and FGDs were: level of adherence to IYCF recommendations among mothers and caregivers; IYCF recommendations perceived as the hardest to follow; and perceived motivators, facilitators, and barriers to IYCF practices. Mothers in the four districts generally followed the eight IYCF recommendations. Mothers in the Tolon district demonstrated adherence to IYCF practices, often citing the need for early initiation of breastfeeding, timely introduction of complementary feeding, and feeding children aged 9-23 months 3 times daily in addition to breastfeeding. In contrast, mothers in other districts faced challenges that hindered adherence. Giving children 4 or more food groups and timely introduction of complementary feeding were perceived as the hardest practices to follow. The main facilitators of IYCF practices include midwives and frontline nurses teaching mothers how to breastfeed, and midwives ensuring mothers initiate breastfeeding immediately after delivery. The main barriers to IYCF practices identified were insufficient breastmilk; mothers-in-law giving water to children before six months; resumption of work; and lack of financial means. Mothers in the Ho West district reported more barriers to IYCF practices, followed by mothers in the Tain, Talensi, and Tolon districts. Health practitioners, stakeholders, and policymakers should design targeted interventions that address the contextual barriers to improve IYCF practices in the various districts.
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Affiliation(s)
- Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | | | | | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
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Zhang L, Liu HJ, Li P, Liu Y, Zhang T, Zhu JY, Zhu HM, Zhou YP, Wang HJ, Li Y. Association of early-term birth and breastfeeding practices with nutritional outcomes in singleton term infants: a multicenter cross-sectional study. Int Breastfeed J 2024; 19:46. [PMID: 38956574 PMCID: PMC11218344 DOI: 10.1186/s13006-024-00653-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/23/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Limited research has explored the associations of gestational age (GA) and breastfeeding practices with growth and nutrition in term infants. METHODS This multicenter cross-sectional study recruited 7299 singleton term infants from well-child visits in Shandong, China, between March 2021 and November 2022. Data on GA, gender, ethnicity, birth weight, parental heights, gestational diabetes and hypertension, age at visit, breastfeeding practices (point-in-time data at visit for infants < 6 months and retrospective data at 6 months for infants ≥ 6 months), complementary foods introduction, infant length and weight, were collected. 7270 infants were included in the analysis after excluding outliers with Z-scores of length (LAZ), weight or weight for length (WLZ) <-4 or > 4. Linear regression models adjused for covariates explored the impact of GA and breastfeeding practices on LAZ and WLZ, while logistic regression models evaluated their effect on the likelihood of moderate and severe stunting (MSS, LAZ<-2), moderate and severe acute malnutrition (MSAM, WLZ<-2) and overweight/obesity (WLZ > 2). Sensitivity analysis was conducted on normal birth weight infants (2.5-4.0 kg). RESULTS Infants born early-term and exclusively breastfed accounted for 31.1% and 66.4% of the sample, respectively. Early-term birth related to higher WLZ (< 6 months: β = 0.23, 95% confidence interval (CI): 0.16, 0.29; ≥6 months: β = 0.12, 95% CI: 0.04, 0.20) and an increased risk of overweight/obesity throughout infancy (< 6 months: OR: 1.41, 95% CI 1.08, 1.84; ≥6 months: OR: 1.35, 95% CI 1.03, 1.79). Before 6 months, early-term birth correlated with lower LAZ (β=-0.16, 95% CI: -0.21, -0.11) and an increased risk of MSS (OR: 1.01, 95%CI 1.00, 1.02); Compared to exclusive breastfeeding, exclusive formula-feeding and mixed feeding linked to lower WLZ (β=-0.15, 95%CI -0.30, 0.00 and β=-0.12, 95%CI -0.19, -0.05, respectively) and increased risks of MSAM (OR: 5.57, 95%CI 1.95, 15.88 and OR: 3.19, 95%CI 1.64, 6.19, respectively). Sensitivity analyses confirmed these findings. CONCLUSIONS The findings emphasize the health risks of early-term birth and the protective effect of exclusive breastfeeding in singleton term infants, underscoring the avoidance of nonmedically indicated delivery before 39 weeks and promoting exclusive breastfeeding before 6 months.
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Affiliation(s)
- Li Zhang
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 12675, Jingshi Road, Jinan, Shandong, 250014, China
| | - Hui-Juan Liu
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 12675, Jingshi Road, Jinan, Shandong, 250014, China
| | - Ping Li
- Department of Maternal and Child Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yi Liu
- Department of Maternal and Child Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Ting Zhang
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 12675, Jingshi Road, Jinan, Shandong, 250014, China
| | - Jin-Yi Zhu
- School of Clinical Medicine, Affiliated Hospital of Weifang Medical University, Weifang Medical University, Weifang, China
| | - Hong-Mei Zhu
- Department of Child Health Care, Tengzhou Maternal and Child Health Care Hospital, Tengzhou, China
| | - Ya-Ping Zhou
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 12675, Jingshi Road, Jinan, Shandong, 250014, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yan Li
- Research Center for Child Health, Department of Child Health Care, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 12675, Jingshi Road, Jinan, Shandong, 250014, China.
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Ikemi A, Horiuchi S. Mother's perception of early introduction of complementary feeding affecting stunting in Ghana: A qualitative research. Jpn J Nurs Sci 2024:e12611. [PMID: 38923823 DOI: 10.1111/jjns.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/12/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES The study aimed to explore mothers' perceptions for timely introduction of complementary feeding through interviews with 2-12-month-old infants' mothers in Ghana. METHODS Qualitative descriptive research with 16 semi-structured interviews with mothers attending the Child Welfare Clinic at Ejisu Hospital was conducted from June 2022 to May 2023. The study was guided by the Declaration of Helsinki, and all participants were instructed about informed consent for the study. Interviews and analysis were guided by Theory of Planned Behavior. NVivo 1.5 was used throughout the coding procedure. This study was conducted after the approval from St. Luke's International University. RESULTS Four themes were revealed: (1) attitude toward the behavior based on the mothers' experience raising children, (2) attitude toward the behavior influenced by subjective norm (grandmothers' recommendation), (3) attitude toward the behavior influenced by perceived behavioral control (difficulty in continuing breastfeeding), and (4) mothers who are worried about underweight despite timely introduction of complementary feeding. Attitudes toward the behavior were influenced by mothers' experiences raising children and grandmothers' recommendations. Surroundings disruptive of breastfeeding also influenced attitudes toward intentions and behavior. Moreover, some mothers suffered from underweight even if they introduce complementary feeding at an optimal time. CONCLUSION Supporting to continue breastfeeding and conducting re-education for grandmothers is a key recommendation for midwives and pediatric nurses. Moreover, pediatric nurses are required to further enhance not only health education regarding the timing of initiating complementary feeding but also support after the introduction.
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Affiliation(s)
- Ayame Ikemi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
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Sukmawati E, Wijaya M, Hilmanto D. Participatory Health Cadre Model to Improve Exclusive Breastfeeding Coverage with King's Conceptual System. J Multidiscip Healthc 2024; 17:1857-1875. [PMID: 38699558 PMCID: PMC11063463 DOI: 10.2147/jmdh.s450634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/19/2024] [Indexed: 05/05/2024] Open
Abstract
Objective The purpose of this research is to develop a participatory health cadre model to enhance exclusive breastfeeding coverage through initial stages using the Imogene King model. Methods This study employs a mixed-methods approach with sequential exploratory designs. Qualitative research utilized in-depth interviews with informants including the head of the community health center, nutrition officers from the health center, the coordinator of Maternal and Child Health (MCH) midwives, village midwives, breastfeeding mothers, families of breastfeeding mothers, and health cadres. Quantitative research respondents consist of health cadres. The quantitative study utilizes a quasi-experimental method with a design paradigm known as the one-group pre and post-test design to measure health cadre perception on exclusive breastfeeding. Results This study yields elements from Imogene King that form a participatory health cadre model to enhance exclusive breastfeeding coverage, consisting of interaction, perception, communication, transaction, role, growth and development, time, and space. Transactions represent the objective integration of the health cadre participation model, as demonstrated by the behavioral shifts observed in mothers regarding breastfeeding their infants. The t-test results indicate that exclusive breastfeeding monitoring training is effective and successful in enhancing exclusive breastfeeding coverage (Sig. value = 0.000 < 0.05). In addition, the effectiveness of exclusive breastfeeding monitoring training falls within the category of good or high. Conclusion The research findings indicate the success of the participatory health cadre model in improving exclusive breastfeeding coverage.
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Affiliation(s)
- Ellyzabeth Sukmawati
- Doctoral Program in Medical Sciences, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Merry Wijaya
- Medical Sciences, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Dany Hilmanto
- Department of Child Health Sciences, Medical Sciences, Universitas Padjadjaran, Bandung, 40161, Indonesia
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Mgongo M, Ickes SB, Leyaro BJ, Mboya IB, Grounds S, Seiger ER, Hashim TH, Conklin JL, Kimani-Murage EW, Martin SL. Early Infant Feeding Practices among Women Engaged in Paid Work in Africa: A Systematic Scoping Review. Adv Nutr 2024; 15:100179. [PMID: 38246350 PMCID: PMC10877690 DOI: 10.1016/j.advnut.2024.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
Around the world, paid work without appropriate structural support is a key barrier to optimal breastfeeding practices. To better protect, promote, and support optimal breastfeeding practices among working women in Africa, this scoping review sought to understand how paid work influences infant feeding practices in the first 6 mo of life and what support women need to manage work and optimal infant feeding practices. We systematically searched PubMed, Scopus, Global Health, and CINAHL Plus, screened 2436 abstracts, and reviewed 322 full-text articles using Covidence for review and charting. We identified 203 articles that met the inclusion criteria. We identified 32 quantitative, 10 qualitative, 3 mixed-methods, and 2 review articles that focused on examining the relationship between work and breastfeeding, and 109 quantitative, 22 qualitative, 21 mixed-methods, and 4 review articles that included work as part of broader breastfeeding research but did not focus on work. Most studies reported a significant negative association between work and exclusive breastfeeding. Three major domains were reported in the qualitative studies: challenges to managing work and infant feeding, receiving support from employers and family members/caregivers, and strategies for feeding infants when the mother is working. Reviewed studies proposed recommendations to increase support for breastfeeding through changes to policies and support within worksites, the health system, and childcare; however, evidence of previously implemented policies or programs is limited. We recommend more consistent definitions and measurement of women's work. Future research is needed on the impact of implementing various strategies and benefits for breastfeeding at workplaces, as well as efforts to support breastfeeding among informal workers.
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Affiliation(s)
- Melina Mgongo
- Institute of Public Health, Department of Community and Global Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania; Better Health for the African Mother and Child, Moshi, Tanzania.
| | - Scott B Ickes
- Department of Biological and Health Sciences, Wheaton College, Wheaton, IL, United States; Kenya Medical Research Institute, Nairobi, Kenya; Program in Nutritional Sciences, and Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States; Department of Kinesiology and Health Sciences, William and Mary, WIlliamsburg, VA, United States
| | - Beatrice J Leyaro
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Innocent B Mboya
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania; Department of Translational Medicine, Lund University, Malmo, Sweden
| | - Samantha Grounds
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Emily R Seiger
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Tamara H Hashim
- Institute of Public Health, Department of Community and Global Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Jamie L Conklin
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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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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Seabela ES, Modjadji P, Mokwena KE. Facilitators and barriers associated with breastfeeding among mothers attending primary healthcare facilities in Mpumalanga, South Africa. Front Nutr 2023; 10:1062817. [PMID: 36998907 PMCID: PMC10043338 DOI: 10.3389/fnut.2023.1062817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/10/2023] [Indexed: 03/15/2023] Open
Abstract
IntroductionDespite the health benefits of breastfeeding for both the mother and the child, early cessation of breastfeeding remains a public health problem in South Africa, attributed to contextual barriers and facilitators. Within the context of Mpumalanga province, which is characterized by low breastfeeding rates and high infant mortality rates in children under 5 years, we explored the facilitators and barriers to breastfeeding among mothers attending the three primary health facilities in Ermelo.MethodsUsing a semi-structured interview guide suggested by the socio-ecological model, three focus group discussions and 12 in-depth interviews were conducted among mothers selected using a purposive sampling. Transcripts from audiotaped and transcribed verbatim interviews were assessed through thematic analysis using NVivo version 10.ResultsMothers were aged between 18 and 42 years and from poor sociodemographic backgrounds. At the individual level, mothers valued breastfeeding facilitated by their commitment, maintaining it, eating healthy foods, and having sufficient breast milk. However, returning to work, insufficient breast milk, misconceptions about breastfeeding, and interference with social life were the barriers for mothers to breastfeed continuously. At the interpersonal level, the family was identified as the main form of support to breastfeeding mothers; however, family interference was also identified as a barrier. At the community level, mothers shared some family beliefs and practices but were still split between societal and cultural norms and traditional beliefs as facilitators or barriers to breastfeeding. At the organizational level, most mothers valued the support provided by healthcare workers on childcare and techniques for breastfeeding at the health facilities. They did however articulate concerns on the miscommunication some healthcare workers offered regarding breastfeeding, which negatively influenced their infant feeding practices.DiscussionIntervention efforts should focus on behaviour change to educate and equip mothers to overcome the barriers that are within their control. Such interventions should further focus on family-centered education and strengthening the proficiency of healthcare workers on advising breastfeeding mothers.
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Affiliation(s)
- Ethel Sekori Seabela
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- *Correspondence: Perpetua Modjadji
| | - Kebogile Elizabeth Mokwena
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
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Dadzie B, Bayor F, Doat AR, Kappiah JB, Akayuure CA, Lamptey AA, Yakong VN, Kampo S. Investigating factors that influence the practice of exclusive breastfeeding among mothers in an urban general hospital in Ghana: a cross-sectional study. BMC Womens Health 2023; 23:24. [PMID: 36650492 PMCID: PMC9847114 DOI: 10.1186/s12905-023-02164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND In Ghana, only 52% of mothers exclusively breastfeed their babies and the rate of increase has been steadily slow across all geographical areas of Ghana. The purpose of this study was to determine the various factors that influence exclusive breastfeeding (EBF) among mothers who visited the child welfare clinic at the Tema General Hospital, Accra, Ghana. METHODOLOGY This descriptive cross-sectional study was carried out at the Child Welfare Clinic of the Tema General Hospital, Accra, Ghana. A random sampling technique was used to recruit mothers with children between the ages of 6 months and 24 months attending the Child Welfare Clinic. Mothers were interviewed with the aid of a structured questionnaire. RESULTS Out of the 222 of mothers interviewed, 68.8% of them exclusively breastfed their infants up to 6 months. Mothers who have good knowledge were more than 3 times (AOR = 3.484, 95% CI 1.200, 10.122, P = 0.022) likely to breastfeed their children exclusively. Those who had positive attitudes towards EBF were about 4 times (COR: 4.018, 95% = 1.444, 11.181, P = 0.008) more likely to exclusively breastfeed than those who had poor attitudes towards EBF. Also, mothers whose spouses complained about EBF were about 3 times (AOR: 2.655, 95% CI 0.620, 11.365, P = 0.018) at increased odds of not exclusively breastfeeding their babies. CONCLUSIONS High rate of EBF among mothers who visited the child welfare clinic was found. The mothers' level of knowledge and attitude towards EBF significantly influenced the 6 months of EBF. Spouses also showed a high influence on whether or not mothers should exclusively breastfeed their babies.
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Affiliation(s)
- Baaba Dadzie
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Fidelis Bayor
- Department of Physiology, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | - Abdul-Razak Doat
- Department of Nursing, School of Nursing and Midwifery, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Jamilatu B Kappiah
- Department of Nursing, School of Nursing and Midwifery, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Collins Adombire Akayuure
- Department of Nursing, School of Nursing and Midwifery, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Aubrey A Lamptey
- Department of Pediatric Critical Care, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis TN, Accra, Ghana
| | - Vida Nyagre Yakong
- Department of Preventive Health Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | - Sylvanus Kampo
- Department of Nursing, School of Nursing and Midwifery, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
- Department of Anaesthesia and Intensive Care, School of Medicine and Dentistry, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
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Obeng C, Jackson F, Nsiah-Asamoah C, Amissah-Essel S, Obeng-Gyasi B, Perry CA, Gonzalez Casanova I. Human Milk for Vulnerable Infants: Breastfeeding and Milk Sharing Practice among Ghanaian Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416560. [PMID: 36554441 PMCID: PMC9779609 DOI: 10.3390/ijerph192416560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/13/2023]
Abstract
Human milk has the best impact on childhood survival. In Ghana, it is estimated that 43% of women exclusively breastfeed for 0-5 months and only 42% of breastfeeding mothers continue through 20-23 months. Although the Ghanaian government has implemented policies to facilitate exclusive breastfeeding, substantial gaps to achieve optimal newborn health and wellbeing remain. The purpose of this study was to evaluate breastfeeding prevalence and human milk sharing practices among Ghanaian women. Qualitative responses were received from Ghanaian females (n = 1050). In our sample, 81% indicated they breastfed their children and 8% reported ever sharing breastmilk with another mother. Reasons for sharing milk included (i) insufficient breastmilk production of the recipient mother, and (ii) mother's unavailability prompting women to offer their milk to a crying baby. About 60% of our sample reported that they were not concerned about sharing their milk. Findings present a strong indicator for milk donation towards the establishment of a human milk bank in Ghana. Health promotion efforts should aim at increasing education about the risks involved in milk sharing as well as the benefits of human milk donation through formal and safer channels such as a Human Milk Bank.
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Affiliation(s)
- Cecilia Obeng
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| | - Frederica Jackson
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| | - Christiana Nsiah-Asamoah
- Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast TF0494, Ghana
| | - Salome Amissah-Essel
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast TF0494, Ghana
| | - Barnabas Obeng-Gyasi
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| | - Cydne A. Perry
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
| | - Ines Gonzalez Casanova
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN 47405, USA
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Spyrakou E, Magriplis E, Benetou V, Zampelas A. Factors Associated with Breastfeeding Initiation and Duration in Greece: Data from the Hellenic National Nutrition and Health Survey. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111773. [PMID: 36421222 PMCID: PMC9688813 DOI: 10.3390/children9111773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022]
Abstract
Despite its well-documented benefits, breastfeeding rates and duration worldwide do not meet the recommended goals set by the World Health Organization. Data on infant feeding, socio-demographic, lifestyle and perinatal factors were used from 490 mothers (and 958 children), participants at the Hellenic National Nutrition and Health Survey between 2013−2015. Clustered multiple logistic regression and multilevel mixed-model regression analyses were performed to identify factors associated with breastfeeding initiation and duration, respectively. Maternal lower education [Odds Ratio (OR): 2.29, 95% Confidence intervals (95% CI): 1.30−4.04; p = 0.004], smoking during pregnancy (OR: 3.08, 95% CI: 1.64−5.77; p < 0.001), caesarean section (OR = 3.26, 95% CI: 1.83−5.83; p < 0.001), prematurity (OR = 2.74, 95% CI: 1.40−5.37; p = 0.003) and higher birth order (OR = 1.30, 95% CI: 1.04−1.62; p = 0.020) were associated with increased odds of not initiating breastfeeding. Living in rural areas [beta coefficient b = −27.93, p = 0.043], smoking during pregnancy (b = −64.47, p < 0.001), caesarean section (b = −28.76, p = 0.046) and prematurity (b = −46.67, p = 0.048) were significantly associated with shorter breastfeeding duration. Children born chronologically closer to the survey were more likely to breastfeed and for longer periods. Educational promotion and enhancement of breastfeeding awareness that account for maternal exposures are required. Prevention of prematurity and avoidance of unnecessary caesarean section is crucial, while additional breastfeeding support is needed when preterm birth occurs, or caesarean section cannot be avoided.
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Affiliation(s)
- Efthimia Spyrakou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece
- Correspondence:
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
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