What Predicts Intent to Breastfeed Exclusively? Breastfeeding Knowledge, Attitudes, and Beliefs in a Diverse Urban Population

Abstract

Background: Maternal knowledge and comfort with breastfeeding affect prenatal feeding intentions, and these intentions are strong predictors of feeding outcomes. However, predictors of exclusive breastfeeding intention have not been well characterized. Methods: We measured the association between intentions to exclusively breastfeed and knowledge of infant health benefits, feeding guidelines, and comfort related to breastfeeding in social settings. Participants were lower-income, ethnically diverse women in two randomized, controlled trials of breastfeeding support. We compared results with data from the national Infant Feeding Practices Study II. Results: Among 883 women in our trials, exclusive breastfeeding, mixed feeding, and exclusive formula feeding intentions were 45.9%, 46.1%, and 8.0%, respectively. In multivariate-adjusted models, women who disagreed that ''Infant formula is as good as breastmilk'' were more likely to intend exclusive breastfeeding versus exclusive formula feeding (odds ratio 3.44, 95% confidence interval 1.80-6.59) compared with women who agreed with this statement. Increasing levels of agreement that breastfed infants were less likely to develop ear infections, respiratory infections, diarrhea, and obesity were positively associated with intentions to exclusively breastfeed ( p for trend < 0.001 for all). Compared with the national sample, our study participants were more likely to agree with all of these statements. Women who felt comfortable breastfeeding in public intended to exclusive breastfeed for 0.84 month longer (95% confidence interval 0.41-1.28) than those who felt uncomfortable. Conclusions: Maternal knowledge about infant health benefits, as well as comfort with breastfeeding in social settings, was directly related to intention to exclusively breastfeed. Prenatal interventions that address these issues may increase exclusive breastfeeding intention and duration.

Associations of Breastfeeding Knowledge, Attitude and Interest with Breastfeeding Duration: A Cross-sectional Web-based Study

“…Interestingly, we found that the paternal role, foods to avoid, body change in mothers, mothers' health and methods to prolong breastfeeding would be important elements for the development of web-based educational information program. These findings agree with those of previous studies on the association between knowledge and attitudes toward breastfeeding [8,9,23].…”

“…Also, previous studies have shown that maternal knowledge and attitudes toward breastfeeding may influence the personal decision and intention to breastfeed as well as the duration of breastfeeding [8,9].…”

Breastfeeding attitudes among adolescent mothers attending a nutrition breastfeeding support group

“…Stuebe and Bonuck studied low-income women and discovered feeling more comfortable with public breastfeeding and increased knowledge regarding the benefits of breastfeeding were direct predictors of exclusive breastfeeding intention. [33] Similar results are reflected in this study, which demonstrated a decrease in public embarrassment of breastfeeding as more meetings were attended. The embarrassment of breastfeeding in public is a common reported barrier to breastfeeding especially in the adolescent population.…”

“…Maternal breastfeeding knowledge, attitudes, and confidence have been shown to be a strong predictor of the method of infant feeding. [28,33] Mossman and associates found a significant correlation between high prenatal confidence and initiation and duration of breastfeeding among adolescent mothers based on initial scores from the BAQ. [28] A more recent study regarding breastfeeding knowledge found a positive correlation between awareness of the World Health Organization's recommendation to exclusively breastfeed for 6 months and breastfeeding initiation and duration rates.…”

Which factors influence women in the decision to breastfeed?

“…19 Finally, can be concluded that the woman's decision to breastfeed is a complex process that suffers influences of history of woman's life, of experiences of family and friends, demographic, cultural and social factors and also by her desire to breastfeed.…”