M-Poma: Innovative Technology for Boosting Exclusive Breastfeeding Practices

BackgroundExclusive breastfeeding means babies are given only breast milk and nothing else: no other milk, food, drink, not even water for one day (24 hrs) before the survey was conducted. It prevents 13% of childhood mortality; i.e, at least 1.2 million children worldwide would be saved every year. The objective of this study was to assess the prevalence exclusive breastfeeding (EBF) practice and its associated factor among mothers who have infants less than six months of age in Motta town, East Gojjam, Amhara Regional State, Ethiopia.MethodA community based quantitative cross-sectional study was conducted from April 7, 2015 to May 7, 2015. A simple random sampling technique was applied after taking all registered mothers who have infants less than six months old from local health extension workers of each kebele. A total of 423 mothers with infant less than six months old were included in this study.The data was collected using an interviewer administered questioaire. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with exclusive breastfeeding practice.ResultPrevalence of exclusive breastfeeding was 50.1%. Mothers with young infants aged 0-1 month (Adjusted Odds Ratio [AOR] 3.86: (1.64, 9.07), unemployed mothers (AOR 3.01: 1.46, 6.20), low income mothers (AOR 3.61: 1.75, 7.45), mothers who received breastfeeding counseling in pregnancy (AOR 2.76: 1.52, 4.99), fed colostrum (AOR 3.50: 1.45, 8.45), didn't give prelacteal feeds (AOR 4.48: 1.82, 11.03) and were supported by their husband (AOR 2.67: 1.04, 6.95) were more likely to practice exclusive breastfeeding than their counterparts.ConclusionsPrevalence of exclusive breastfeeding practice in study area was lower than country recommended level. Age of the child, maternal occupation, income, breastfeeding counseling during antenatal care, husband support of breastfeeding and colostrum feeding were independent predictors of exclusive breastfeeding practice. Recommendations to increase exclusive breastfeeding practice are revising postpartum maternity leave, increasing health professional's habit of breastfeeding counseling through training, involving husbands during counseling, educating mothers and the community as a whole to avoid traditional practices that hinder exclusive breastfeeding up to six months.

The aim of this study was to examine the relationship between knowledge levels of exclusive breastfeeding (EBF) and EBF practice among HIV-positive mothers, who had babies aged 0–6 months. A convenience sampling method was used to recruit 81 study participants. A structured interview schedule was used to question participants on practice and knowledge. A Pearson's correlation coefficient matrix was used to explore the relationship between knowledge and practice. Results showed a positive significant relationship between knowledge levels of EBF and EBF practice (r=.313, P=<.01), which suggests that as knowledge levels increase, EBF practice increases. A change in EBF knowledge explained a 9.8% change in EBF practice. Knowledge plays a critical role in the practice of EBF. A total of 54 (66.7%) of the participants strongly agreed that babies should be given milk for the first 6 months to reduce HIV transmission. This result supports the World Health Organization's policy, which advocates for EBF in HIV-positive mothers living in resource-restricted settings such as Zimbabwe.

Introduction: Based on data by Indonesia’s Minister of Health, the coverage of exclusive breastfeeding has decreased from 2018 – 2020 which is the coverage reach 66,06%. This coverage didn’t fulfill the target set by Minister of Health, aiming 80% coverage of exclusive breastfeeding. Factors associated with this matter, one of them is parity. This study aims to determine the relationship of parity with exclusive breastfeeding practice.
 Methods: The study used is a literature study with the type of Systematic Mapping Study. The articles were taken from the Google Scholar and Microsoft Academic databases which obtained a total 319 articles, then were screened using PEOS framework and based on with inclussion and exclussion criteria researcher succeed to earn ten final articles consisting seven national articles and tree international article.
 Results: The results of the analysis of 10 articles show that the majority of respondents are multipara mother which is 55%-62%, the majority of respondents gave exclusive breastfeeding to their babies which is 52,5%-69,8% and all articles shows p-value < α which means there is relationship between parity and exclusive breastfeeding practice.
 Discussion: Parity is a factor of exclusive breastfeeding practice. Health provider should give informations related to the benefit of exclusive breastfeeding to boost mother’s knowledge about the importance of exclusive breastfeeding practice.

BackgroundThe World Health Organization recommends exclusive breastfeeding for the first six months of life. A qualitative study was conducted to assess the factors that influence the practice of exclusive breastfeeding amongst mothers attending Wajir County Hospital, Kenya.MethodThis study was part of a cross-sectional study to compare the exclusive breastfeeding rates amongst primiparous and multiparous mothers with infants under 6 months old attending Wajir County Hospital. Focus group discussions and key informant interviews were conducted to collect information on exclusive breastfeeding and related factors. Four focus group discussions were conducted with mothers who exclusively breastfed and the same number with mothers who did not exclusively breastfeed their babies. Key informant interviews were conducted with nine healthcare providers. The data were transcribed, and a content analysis identified common themes and inferences.ResultsThe exclusive breastfeeding rate among the mothers in the larger study was 45.5%. There was no disparity between the practice of exclusive breastfeeding between primiparous and multiparous mothers. Despite the high knowledge and positive attitudes towards exclusive breastfeeding of most mothers, the practice of exclusive breastfeeding was unsatisfactory. The major hindrances identified were cultural barriers propagated by mothers-in-law and traditional birth attendants; the belief that babies cannot live without water; and a few unsupportive health workers. The uptake of exclusive breastfeeding was enhanced by Islamic teaching on breastfeeding, education from a few supportive healthcare providers; support from husbands; and positive deviance among some lactating mothers who practiced exclusive breastfeeding.ConclusionsDeeply rooted cultural factors were the major hindrance to the practice of exclusive breastfeeding. Most of the mothers did not practice exclusive breastfeeding, despite the majority being knowledgeable and having positive attitudes towards the practice. The influence of mother-in-law’s and traditional birth assistants were major barriers. Strengthening the Community Health Strategy through training traditional birth attendants on Infant Young Child Nutrition practices, designing mechanisms linking traditional birth assistants to existing health facilities for support, and capacity building and monitoring is critical in promoting exclusive breastfeeding. Behavior change and communication through multiple channels within the community should be utilized to maximize promotion of exclusive breastfeeding among all stakeholders.

INTRODUCTION Exclusive breastfeeding (EBF) practices during first six months of life are the most cost-effective intervention for reducing infant and child morbidity and mortality. However, adherence to EBF practices in developing countries remains unsatisfactory, where maternal employment has been identified as one of the influencing factor. The study aims to identify and compare EBF practices and its factors influencing among employed and unemployed mothers. MATERIALAND METHODS An institutional based comparative cross-sectional study was conducted among 362 mothers of infants visiting the immunization clinic of Universal College of Medical Sciences, Bhairahawa, Nepal, from December 2020 to March 2021 following ethical clearance (UCMS/IRC/114/20) and verbal consent from participants. Descriptive statistics was used to compare EBF practices and multivariate logistic regression to identify independent predictors of EBF. RESULTS Total 362 (181 employed and 181 unemployed) mothers were interviewed. Prevalence of EBF was 13.8% and 81.2% among employed and unemployed mothers respectively. Further EBF practice had significant association with working status of mothers (AOR= 15.44, 95% CI 6.76-35.25) and monthly family income (AOR=3.31, 95% CI 1.24-8.84). Among employed, EBF practice had significant association with carry infant to work place (AOR= 12.36, 95% CI 4.35-49.87) whereas type of delivery (AOR= 3.88, 95% CI 1.69-8.90) was significantly associated among unemployed mothers. CONCLUSION EBF practices among employed mothers were less than that of unemployed mothers. Provisions to provide additional supports, either by revising the period of maternity leave or adopting different alternatives to prolong the period of EBF may be beneficial for employed mothers and their children.

The practice of exclusive breastfeeding among teenage rural mothers is still low despite the associated benefits. This study investigates exclusive breastfeeding practices among teenage rural mothers selected agrarian communities in Southwest Nigeria. Using a concurrent mixed-method approach, a structured questionnaire was administered to 415 breastfeeding mothers. In-depth interviews were also held with breastfeeding mothers (11), nurses (10), and a focus group discussion session with grandmothers. The result reveals that 59.1% and 61.0% of the respondents were between the age range of 17 – 19 with the mean age of 19years and the majority (81.4% and 93.0) were Yoruba in Ogun and Oyo State respectively. The result showed that respondents in both Ogun and Oyo State receive information about exclusive breastfeeding (51.6% and 62.0%) and thus practice it (51.6% and 55.5%). The result showed a moderate level of awareness of breastfeeding (60.9% and 62.0%) among the teenage rural mothers was recorded and above half (51.6% and 55.5%) of the teenage rural mothers reveals that they practice exclusive breastfeeding, the majority (62.2%) of the respondents in Oyo State and almost half (46.9%) of the respondents in Ogun State practiced exclusive breastfeeding for over 8 weeks. Some of the factors influencing the adoption of exclusive breastfeeding were personal determination/experience, encouragement from their mothers, and nurse and midwife advice in the two states sampled. Problems encountered by teenage mothers in the practice of exclusive breastfeeding were maternal health problems, the baby continues to be hungry, fear of addicted to breast milk alone, pains in the breast. T-test result shows that there is a significant difference (t = 93.732) in the problems encountered by teenage rural mothers in the practice of exclusive breastfeeding in the study area. It was concluded that compliance to Exclusive Breastfeeding for six months was still minima in Ogun and Oyo State and still face multiple problems. The study, therefore, recommended that there is an urgent need for policies that will aim at providing acceptable food supplements that could aid the supply of breast milk among postpartum teenage rural mothers, especially those with low socioeconomic status. Keywords: Problems; Breastfeeding practices; Exclusive breastfeeding; teenage mothers; Yoruba people. DOI: 10.7176/JHMN/80-11 Publication date: September 30 th 2020

Background: Feeding a newborn infant with his or her mother's breast milk only or from a wet nurse without giving other liquids up to the age of 6 months is called exclusive breastfeeding (EBF). The promotion of EBF for the first 6 months of infant's life is the most effective way to reduce morbidity and mortality, especially in low- and medium-income countries. Despite several efforts to promote EBF, its practice has remained poor in many Sub-Saharan African countries including Nigeria. EBF practice is to a large extent influenced by the maternal knowledge and attitudes as well as sociodemographic and cultural factors. Objective: To determine the knowledge, acceptance, and practice of EBF among caregivers in Aminu Kano Teaching Hospital, Kano, Nigeria. Methods: This was a cross-sectional, descriptive study involving mothers who were currently breastfeeding at the time of the study or who had stopped breastfeeding not later than 2 years. Questionnaires were administered to breastfeeding mothers or fathers who knew the breastfeeding attitude of their wives during visits to the outpatient unit or immunization clinic. The age, sex, educational status, occupation, awareness, understanding of EBF, acceptance, practice, and benefits of EBF, and distance from health facility were explored from the caregivers. Results: Two hundred and seventy caregivers were studied of which 30 (11.1%) were male and 240 (88.9%) were female. The male-to-female ratio was 1:8 and the age ranges from 19 to 60 years with a mean of 29.4 and standard deviation of ±7.36. Majority of the caregivers (134, 49.6%) had tertiary level of education, while 79 (29.3%) had secondary education. Majority of the caregivers had good awareness and perception of EBF (77% and 51.5%, respectively). The EBF practice rate among the respondents was 68.52%. Caregivers with tertiary and secondary levels of education had good awareness and perception of EBF (χ 2 = 48.628, P = 0.000; and χ2 = 49.106, P = 0.000, respectively). They also had good acceptance and practice of EBF (χ 2 = 35.897, P = 0.000; and (χ 2 = 17.999, P = 0.001, respectively). There were more awareness and perception of EBF among health workers and teachers (χ 2 = 33.972, P = 0.000; and (χ 2 = 12.925, P = 0.005, respectively). They also accepted and practiced EBF significantly (χ 2 = 16.867, P = 0.001; and χ2 = 16.736, P = 0.001). Proximity to health facility had a significant impact on awareness, acceptance, and practice of EBF by the caregivers (χ 2 = 17.391, P = 0.002; χ 2 = 14.263, P = 0.007; and χ 2 = 9.802, P = 0.044, respectively). Conclusion: Educational level, occupation, and proximity to health facility have positive impact on awareness, perception, acceptance, and practice of EBF among caregivers in Kano. Therefore, there is need to educate and empower women and make health facilities accessible to them to support, promote, and protect EBF in our communities.

Background/Aims Exclusive breastfeeding is important for the growth and development of infants. Thus, it is important to examine the practice of exclusive breastfeeding and factors that may affect it. This study aimed to assess nursing mothers' knowledge on and practice of exclusive breastfeeding, the relationship between knowledge and practice and factors perceived to influence exclusive breastfeeding. Methods This cross-sectional study collected data using a self-designed questionnaire from mothers of children aged 0–6 months, at two primary health centres, Leslie and Igbogidi, in Ogun State, Nigeria. Participants were assessed on their knowledge and practice of exclusive breastfeeding, as well as their perceptions of factors that influence the practice of exclusive breastfeeding. Pearson's chi-squared test was used to assess the relationship between participants' knowledge and practice of exclusive breastfeeding. Results The majority (76.0%) of mothers had adequate knowledge on exclusive breastfeeding. However, only 58.5% practised exclusive breastfeeding for 6 months. There was a significant relationship between knowledge and practice of exclusive breastfeeding (P<0.000). Conclusions Participants' knowledge on exclusive breastfeeding did not coincide with its practice. Mothers should be supported through education and resources in order to improve rates of exclusive breastfeeding.

Background:Exclusive breastfeeding is an essential strategy to reduce infant morbidity and mortality rates. However, the exclusive breastfeeding coverage in Indonesia has not yet reached the national target. Low maternal knowledge and breastfeeding self-efficacy are factors that influence breastfeeding success. This study aimed to determine the effect of education on knowledge and breastfeeding self-efficacy among postpartum mothers in Karang Maritim Village, Panjang District, Bandar Lampung City.Methods:This study employed a pre-experimental design with a one-group pretest–posttest approach. The sample consisted of 25 postpartum mothers selected through consecutive sampling. The intervention involved promotive and preventive education on exclusive breastfeeding conducted in four sessions over eight weeks through group-based learning and individual mentoring. Research instruments included a breastfeeding knowledge questionnaire and the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF). The data were analyzed using the paired sample t-test with a significance level of p < 0.05.Results:The mean knowledge score increased from 4.65 to 7.58 (Δ = 2.93; p = 0.000), while the mean breastfeeding self-efficacy score increased from 43.80 to 63.88 (Δ = 20.08; p = 0.000). These findings indicate a significant effect of education on improving mothers' knowledge and confidence in breastfeeding.Conclusion:Structured, interactive, and family-based promotive–preventive education effectively enhances knowledge and breastfeeding self-efficacy among postpartum mothers. This intervention can be implemented in community-level breastfeeding education programs as a strategy to increase exclusive breastfeeding coverage.Suggestion: Future research should include additional variables such as workplace support and maternal psychological factors, and use a longitudinal design to examine the sustainability of exclusive breastfeeding practices

The decision of breastfeeding practices among parents attending primary health care facilities in suburban Malaysia

BackgroundEvidence of interventions that are effective in improving exclusive breastfeeding (EBF) practices is needed to help countries revise their strategies. To assess whether mothers who had participated in the Nutrition at the Centre (N@C) project effectively demonstrated better EBF practices than did those who did not participate, we documented the processes of this nutritional intervention in Benin.MethodsThis study was a cross-sectional design comparing the intervention group, namely, the Village Saving and Loan Association (VSLA-N@C), to the control group. The N@C project was an educational intervention based on behavioural and social changes related to nutrition. Through VSLA groups installed in communities, mothers were connected to the project; had weekly discussions around the process, benefits and challenges linked to EBF, and advocated during Breastfeeding Week celebrations. The study participants were mothers with children aged 4–5.5 months from the VSLA-N@C group (n = 53) and mothers (n = 50) from non-intervention areas who served as controls. With the deuterium oxide dose-to-mother technique, we quantified human milk intake (HMI) and non-milk oral intake (NMOI) and compared both groups using Student’s t-test. A child is considered to be exclusively breastfed if the NMOI is less than 86.6 g/day. Multivariate regression logistics adjusted for VSLA membership, mothers’ body mass index, and children’s age, weight-for-age and weight-for-length, thus enabling us to measure differences in EBF rates.ResultsChildren of mothers from the VSLA-N@C group consumed significantly more human milk than those of mothers in the control group (900.2 ± 152.5 g/day vs 842.2 ± 188.6 g/day, P = 0.044). Children in the VSLA-N@C group had significantly less non-milk oral intake than did those in the control group (difference: 148.2 g/day, P = 0.000). Therefore, the EBF rate was significantly higher in the VSLA group (38% vs 8%, P < 0.0001), and mothers in VSLAs were 14 times more likely to practise EBF than were those in the control group (adjusted odds ratio [AOR] = 13.9, 95% CI 1.9–116.5, P = 0.015).ConclusionThe EBF rate was significantly higher in the group of mothers who participated in the VSLA-N@C project than in those who did not receive the intervention. The N@C model could be promoted as a strategy for increasing EBF practices in poor and rural contexts, where it is possible to organize mothers into VSLA groups to discuss the process, benefits and challenges of EBF.

Breastfeeding practice is common in Malaysia. However, sustaining the duration of exclusive breastfeeding (EBF) practice for up to 6 months as recommended by World Health Organization (WHO) is a problem for mothers. Numerous factors are associated with this good practice and one of the important ones is the socio-demographic factors. The study examined the association of socio-demographic factors and duration of EBF practice among mothers in Kuching, East Malaysia. A cross-sectional study among 159 mothers of children in the age group of 6 - 24 months through purposive sampling attending Maternal and Child Health (MCH) clinics in Kuching division was conducted between April and Mei 2009. Data was collected using a set of supervised self-completed questionnaire on EBF practice and mother's socio-demographic factors. Factors related to duration of EBF practice were analysed using logistic regression analysis. 88.1% of mothers reported that they initiated and breastfeed their child exclusively. Only 44.3% of mothers breastfeed their child exclusively till 6 months and the others were not. Being unemployed (AOR = 2.96, (95% CI: (1.44, 6.06)) and Pribumi mothers (Malays and others ethnic groups in Sarawak namely Bidayuh, Iban and Melanau) (AOR = 4.53, (95% CI: (1.41, 14.50)) were independently associated with duration of EBF practice. The prevalence of EBF practice in Kuching division was higher than the national figures. Employed mothers were less likely to practice EBF up to 6 months, implying the need for longer maternity leave and to provide privacy to nursing mother in work places. Chinese mothers need to give more attention and to educate on benefits of EBF practice up to 6 months.

Exclusive breastfeeding in the first six months significantly prevents morbidity and mortality. However, the coverage of exclusively breastfed 6-month-old infants in several sub-districts of Situbondo remains low. Understanding the determinants of breastfeeding practices is necessary to ensure successful breastfeeding promotion strategies. Therefore, this study aimed to assess the prevalence of exclusive breastfeeding and determine the maternal factors that relate to exclusive breastfeeding practices. This cross-sectional study involved 74 mothers with infants aged 6-9 months, selected using a systematic random sampling technique. Data was collected from May to August 2023 using validated questionnaires in Mangaran Sub-district, Situbondo, Indonesia. Chi-square or Fisher's Exact test was employed to identify the factors associated with exclusive breastfeeding. The exclusive breastfeeding proportion was 18.9%. The maternal factors significantly associated with exclusive breastfeeding included parity (OR= 4.79; 95% CI= 1.21 to 18.96, p-value= 0.018), breastfeeding self-efficacy (OR= 8.66; 95% CI= 1.06 to 70.66), and maternal autonomy (OR= 6.41; 95% CI= 1.32 to 31.14; p-value= 0.011). A large proportion of infants were not exclusively breastfed during the first six months. The results highlighted the significance of maternal factors in exclusive breastfeeding practices, particularly the aspect of breastfeeding empowerment. Women with a high breastfeeding self-efficacy and autonomy are more likely to practice exclusive breastfeeding, which by then suggests the need for comprehensive long-term programs. Interventions should be designed to strengthen empowerment in breastfeeding to improve breastfeeding outcomes.

Background Exclusive breastfeeding has an irrepressible benefit to a child. However, the practice is still low with salient factors in Ethiopia. Therefore, this study aimed to assess exclusive breastfeeding practice and normative beliefs among mothers who have children less than two years of age in Ethiopia, 2019. Methods A community-based cross-sectional study was conducted with a sample size of 423 in Ethiopia from March 12 to December 18, 2019. An interviewer-administered questionnaire was used to collect the data. Gender-matched six Focus Group Discussions were conducted. Semistructured guiding questions were used to carry out the discussion. The binary logistic regression model was used to determine the association between dependent and independent variables of the quantitative part. Results The prevalence of exclusive breastfeeding practice was 77.5% (95% CI: 73.5, 81.5%). Married mothers (AOR = 2.57; 95% CI: 1.68, 5.65), mothers with antenatal care follow-up (AOR = 4.11; 95% CI: 2.66, 11.17), mothers who delivered at a health institution (AOR = 4.07; 95% CI: 2.99, 10.72), and mothers counseled during antenatal care (AOR = 1.96; 95% CI: 1.12, 4.73) had a positive association, whereas mothers who were unable to read and write (AOR = 0.11; 95% CI: 0.06, 0.99) and employed mothers (AOR = 0.22; 95% CI: 0.16, 0.56) were the variables that had a negative association with exclusive breastfeeding practice. Conclusions Although the prevalence of exclusive breastfeeding was good when compared with other studies, rigorous interventions are needed to achieve the WHO recommendation of all infants should exclusively be breastfed. Marital status, educational status, occupation, antenatal care service, place of birth, and counseling of mothers during ANC were factors associated with the exclusive breastfeeding practice.

Introduction: Until now, the practice of exclusive breastfeeding is still far from the national target. The success of exclusive breastfeeding is determined by many factors, including the mother’s education, knowledge, and awareness about the importance of breastfeeding for child growth. This study aims to determine the relationship between the mother’s level of education and knowledge on exclusive breastfeeding in ten stunting locus villages located in Pandeglang Regency, Banten, Indonesia. Methods: This study uses a cross-sectional design with data collection methods through interviews and direct observation. The population consists of mothers who have children under 2 years of age. The study was conducted for 6 months from November 2019. The variables studied included the mother’s age, occupation, number of children, education, and knowledge of exclusive breastfeeding. Result: As many as 99.6% of respondents have a good level of knowledge about exclusive breastfeeding. The level of education is low at 44.6%, medium at 50.9%, and high at 4.4%. The results showed there was no significant relationship between the mother’s last education and exclusive breastfeeding (p = 0.860) and there was no significant relationship between the mother's level of knowledge and exclusive breastfeeding (p = 0.558). Conclusion: No significant relationship was observed between the mother’s education and knowledge on exclusive breastfeeding in ten stunting locus villages located in Pandeglang Regency, Banten.