Adolescents' Knowledge of Breastfeeding and Their Intention to Breastfeed in the Future

Well-Informed and Willing, but Breastfeeding Does Not Work: A Qualitative Study on Perceived Support from Health Professionals among German Mothers with Breastfeeding Problems

Although exclusive breastfeeding is recommended for the first six months of life, a large number of women worldwide do not practice it successfully. Our study aimed to investigate the perceived support from health professionals for women who experienced difficulties in breastfeeding. Furthermore, we examined women’s knowledge about breastfeeding and motivation to breastfeed. We conducted a qualitative exploratory study (June to October 2019) among 15 women who had experienced breastfeeding problems in Germany. Semi-structured interviews were audiotaped, transcribed verbatim, and analyzed using qualitative content analysis following Mayring’s approach. Prior to giving birth, the women’s motivation to breastfeed and theoretical knowledge were high, and breastfeeding problems were not anticipated. Difficulties in breastfeeding after giving birth created a highly demanding situation for the mothers. Health professionals were either perceived as very supportive, for example, by providing helpful technical advice or being emotional assistance, or they could be perceived as nonhelpful, thereby worsening the situation, for example, by pressuring the women to breastfeed or making improper remarks. Adequate support for young mothers in childbed consists of the provision of useful and realistic information concerning breastfeeding and a sensitive treatment when breastfeeding problems occur. Paying attention to this specific group of women who are experiencing difficulties in breastfeeding may improve maternal and child well-being and potentially enable breastfeeding.

Exclusive Breastfeeding Intentions Among Adolescents In Urban Communities In Ibadan, Nigeria

Purpose: During adolescence, a female child makes several decisions, and the choice to breastfeed in the near future is conceivably shaped. But in sub-Saharan Africa where teenage pregnancy and teenage motherhood is on the rise, there is a dearth of information on the intention of adolescents to exclusively breastfeed (EBF) in community settings. Therefore, this study assessed exclusive breastfeeding intentions, knowledge and attitude of adolescents in urban communities in Ibadan, Nigeria. Methods: A descriptive community-based cross-sectional study was carried out, selecting 271 respondents. Data were analysed with the aid of IBM SPSS version 21 at P ≤ .05. Results: Mean age of adolescents was 17.5 ± 1.3 years, and 96.3% would breastfeed their children later in future. However, only 37.6%, 22.5% and 50.2% had the intention to exclusively breastfeed, good knowledge score and positive attitude, respectively. There were significant relationships between respondents’ age, educational attainment, parents’ educational attainment, level of knowledge, attitude and intention. The coefficient of knowledge and attitude were significant predictors of good intention to practise EBF. Major predictors of good intention were good knowledge [OR = 36.5; 95% CI (9.2, 145.2)] and positive attitude toward EBF [OR = 9.7; 95% CI (3.6, 25.9)]. Conclusions: The EBF intention was influenced by multiple factors and should be considered in determining the effectiveness of interventions targeting this practice. Therefore, coherent EBF education interventions that commence from adolescence to promote the practice by adulthood are urgently needed to improve knowledge, attitude and intention about EBF rate and confer the cancer-risk reducing benefits.

Development, psychometric assessment, and predictive validity of the comprehensive breastfeeding knowledge scale

AIM

To develop a breastfeeding knowledge scale that aligns with the Baby Friendly Hospital Initiative and psychometrically test it among expectant parents.

BACKGROUND

Although breastfeeding is recommended by all leading health authorities, rates remain suboptimal with women often not achieving their breastfeeding goals. One factor found to positively influence infant feeding behaviours is increased maternal breastfeeding knowledge. However, little research has been conducted validating the dimensions of breastfeeding knowledge to guide interventions to promote positive breastfeeding outcomes.

DESIGN

Following an extensive literature review, the 28-item Comprehensive Breastfeeding Knowledge Scale (CBKS) was developed and psychometrically tested.

METHOD

A sample of 217 Canadian expectant parents (113 women and 104 coparents) was recruited and administered the CBKS with follow-up questionnaires at 4 and 12 weeks postpartum. Psychometric analyses included exploratory factor analysis, internal consistency, concurrent validity, and predictive validity.

RESULTS

Exploratory factor analysis resulted in three dimensions: (1) managing milk supply; (2) persisting through challenges; and (3) correcting misconceptions. Coefficient alpha for the total scale was 0.83 and support for concurrent validity was demonstrated through significant positive correlations with the Iowa Infant Feeding Attitude scale. Further, higher total and subscale scores in pregnancy were associated with exclusive breastfeeding at 4 and 12 weeks postpartum, providing good evidence for predictive validity.

CONCLUSION

Preliminary data suggest the CBKS is a valid and reliable measure of breastfeeding knowledge. Upon further testing, this self-report measure may be used to (1) identify women with low breastfeeding knowledge requiring targeted support, (2) individualize health professional care with breastfeeding women, and (3) evaluate the effectiveness of breastfeeding interventions and programs.

Knowledge, attitudes and peer influences related to pregnancy, sexual and reproductive health among adolescents using maternal health services in Ugu, KwaZulu-Natal, South Africa

Background

Knowledge and practices of sexual and reproductive healthcare is pivotal to the Safe Motherhood Initiative; however, only a few studies have investigated adolescent mothers’ knowledge of sexual and reproductive health in light of the above initiative. Research should thus focus on the knowledge and attitudes of adolescent girls as well as peer influences related to pregnancy and sexual and reproductive health among adolescents, as the findings may highlight vital health interventions that should be introduced. The aim of this study was thus to determine the knowledge, personal attitudes and peer influences related to pregnancy, sexual and reproductive health among adolescents who attended maternal health services in a district hospital in Ugu, KwaZulu-Natal, South Africa.

Methods

A cross sectional study was conducted. Data were collected from 326 adolescents who accessed maternal health services in a peri-urban district hospital during June 2017 and November 2017. The questionnaire surveyed the knowledge, personal attitudes and peer influences related to pregnancy, sexual and reproductive health. The questionnaire was administered by fieldworkers using mobile devices powered by the Mobenzi Researcher® technology. The completed surveys were uploaded to the Mobenzi server where it was stored and aggregated. The data was analysed using R software.

Results

Of the 326 participants, 65 (19.9%) experienced repeat pregnancies in adolescence. Overall, only 143 (43.9%) of the participants answered 50% or more of the knowledge questions on pregnancy and HIV/AIDS and STIs correctly, while 183 (56.1%) answered less than 50% of the knowledge questions correctly. There was no relationship between knowledge of pregnancy and HIV/STIs and repeat adolescent pregnancies.

Conclusion

Adolescents’ knowledge of pregnancy and sexual and reproductive health was deficient as, even with repeat pregnancies, these adolescents were evidently no better informed about pregnancy and sexual and reproductive health. This suggests that social determinants, modes and platforms regarding the delivery of adolescent sexual and reproductive health education are important. An innovative mode to the delivery of sexual and reproductive health education includes the emerging digital platform. The digital platform encompasses social media, multimedia and mobile phones which is growing popular among young people.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7242-y) contains supplementary material, which is available to authorized users.

BREASTFEEDING INTENTION AND KNOWLEDGE IN SECONDARY-SCHOOL STUDENTS

SUMMARY – Breast milk makes the world healthier and better. Deaths and suffering of thousands of children and mothers each year could be prevented through universal breastfeeding, along with enormous economic savings. The aim of this study was to examine the knowledge of breastfeeding and intention to breastfeed in third-year secondary school students from various high schools and to make a conclusion on the unique and structured education program on breastfeeding in secondary schools. A total of 252 third-year secondary school students from 4 high schools in Bjelovar, Kutina and Pakrac completed an online questionnaire on the knowledge and intention to breastfeed. The results were presented by descriptive statistics methods. Kruskal-Wallis test was conducted for intention scale and χ²-test for questions about knowledge. Logistic regression was used to predict probabilities of a response. The results showed the responses of students from individual schools to be statistically significantly different in some questions of knowledge and some items of intention of breastfeeding. Insufficient breastfeeding information in schools does not provide a basis to third-year secondary school students to make an informed decision about breastfeeding in adulthood. We propose development and use of a unique structured educational program on breastfeeding for secondary school students.

Educational intervention about breastfeeding among secondary school students

Purpose

Breastfeeding education in the school setting offers the opportunity to improve knowledge base and positively influence beliefs and intentions for students. The purpose of this paper is to analyze the effect of short education program among secondary school students on breastfeeding knowledge and intentions.

Design/methodology/approach

Total of 106 female and 155 male students from four different high schools in Bjelovar were given online questionnaire about intentions to breastfeed and test of knowledge about breastfeeding, both before and shortly after education. The effect of education and school on breastfeeding intentions and knowledge was examined using mixed design ANOVA. Univariate tests were used to examine relation of several independent variables to breastfeeding intention and knowledge scores before and after education.

Findings

Results showed statistically significant effect of education on both intentions and knowledge, whereas the effect of school was significant only for intentions. Students show more positive intentions and better knowledge about breastfeeding after education than before education.

Research limitations/implications

This paper does not entail validation of breastfeeding questionnaire and knowledge test. Due to comprehensiveness and report length, study on validity and reliability of measures is the subject of another paper.

Practical implications

The authors hope that results of the study will influence professional public in Croatia and encourage it to support implementation of breastfeeding education in curriculum.

Originality/value

This paper offers the first national intervention data in relation to breastfeeding intentions and knowledge among secondary school students. It provides an evidence for necessity of implementation of well-structured education module in regular curriculum of secondary education in Croatia.

Development and Validation of a Questionnaire on Breastfeeding Intentions, Attitudes and Knowledge of a Sample of Croatian Secondary-School Students

Background: Validating a questionnaire/instrument before proceeding to the field for data collection is important. Methods: An 18-item breastfeeding intention, 39-item attitude and 44-item knowledge questionnaire was validated in a Croatian sample of secondary-school students (N = 277). Results: For the intentions, principal component analysis (PCA) yielded a four-factor solution with 8 items explaining 68.3% of the total variance. Cronbach’s alpha (0.71) indicated satisfactory internal consistency. For the attitudes, PCA showed a seven-factor structure with 33 items explaining 58.41% of total variance. Cronbach’s alpha (0.87) indicated good internal consistency. There were 13 knowledge questions that were retained after item analysis, showing good internal consistency (KR20 = 0.83). In terms of criterion validity, the questionnaire differentiated between students who received breastfeeding education compared to students who were not educated in breastfeeding. Correlations between intentions and attitudes (r = 0.49), intentions and knowledge (r = 0.29), and attitudes and knowledge (r = 0.38) confirmed concurrent validity. Conclusions: The final instrument is reliable and valid for data collection on breastfeeding. Therefore, the instrument is recommended for evaluation of breastfeeding education programs aimed at upper-grade elementary and secondary school students.