Beyond Mothers: The Crucial Role of Family Caregivers' Knowledge on Exclusive Breastfeeding in Rural Western China.

Abstract

Background The exclusive breastfeeding rate in China remains quite low. Numerous studies have identified the impact of maternal characteristics on exclusive breastfeeding. However, how the family members’ characteristics, for example primary family caregivers’ health and nutrition knowledge, correlated with exclusive breastfeeding is still unclear. Methods A cross-sectional study was conducted in two prefecture-level cities from the Qinba Mountains area. Data on exclusive breastfeeding, knowledge of health and nutrition, breastfeeding practices, breastfeeding family support, breastfeeding self-efficacy, and conflict frequency were collected via structured questionnaires from 372 caregivers-infant pairs. The mother was interviewed first, and then the primary family caregiver was given a brief questionnaire. Each interview was conducted alone to avoid interruptions from other family members. Univariate and multivariate regressions were conducted to explore the correlation between knowledge of mothers and primary family caregivers and exclusive breastfeeding. Results The exclusive breastfeeding rate among infants aged 6 months in this sample was 15.7%. The average score for the mothers’ health and nutrition knowledge was 4.6 (SD = 1.4), while the average score for the primary family caregivers was 3.6 (SD = 1.4). The health and nutrition knowledge of both the mother (OR = 1.48, P = 0.002) and the primary family caregiver (OR = 1.34, P = 0.017) remained significantly positively associated with exclusive breastfeeding, and the odds ratios were relatively close. There was a significant positively correlation (OR = 1.98, P < 0.001) between the average health and nutrition knowledge of the mother and the primary family caregiver and exclusive breastfeeding. The primary family caregiver’s knowledge of health and nutrition showed a significant positive correlation with the family practical support perceived by the mother (OR = 1.23, P = 0.027), and it also had a significant positive correlation with the breastfeeding self-efficacy of the mother (β = 1.40, P = 0.013). Conclusions The characters of family primary caregiver play much role on exclusive breastfeeding. To promote exclusive breastfeeding, interventions should address the needs of the whole family instead of just mothers.