Feeding practices of mothers with infants and children attending preschools in a high socioeconomic area in Johannesburg

[摘要] Breastfeeding is the preferred feeding method, as it is not only nutritionally complete for thefirst four to six months but will also provide immunological, psychological, physiological, anddevelopmental benefits for the infant. In recognition of the benefits of breastfeeding, theWorld Health Assembly has set a target of 50% for all infants to be breastfed exclusivelyfrom birth up to six months. Despite the well-known benefits of exclusive breastfeeding(EBF), the exclusive breastfeeding rate at six months was 32% in South Africa (ZA) in 2016.The EBF rates mentioned above, published by the South African Department of Health, aresaid to be representative of the country, but do not distinguish between feeding practices ofmothers of different socioeconomic levels.The aim of this study was to determine breastfeeding practices and associations betweenbreastfeeding practices and demographics of mothers in a high socioeconomic area inJohannesburg. To achieve the aim, the following factors were assessed: mother andinfant/child's socio-demographic information, mothers' feeding practices, and factorsaffecting feeding practices.The majority of mothers were younger than 35 years of age (58.9%), were married orcohabiting (83.5%), and had an education level higher than Grade 12 (88.8%). Although mostof the mothers initiated breastfeeding at birth (n=102, 94%); however, the duration of EBFwas short. Thirty-four mothers (31.3%) breastfed their infants at four months, and 64mothers (58.7%) breastfed their infants at six months. Only two mothers (1.8%) exclusivelybreastfed their infants at six months. A statistically significant difference was not foundbetween breastfeeding duration at six months and the mothers' age (p=1.0000), highestlevel of education (p=1.0000), gross household income (p=0.3368), marital status(p=0.2825), and type of delivery (p=1.0000).In an effort to guide researchers in describing factors affecting breastfeeding practices,Hector and co-workers developed a conceptual framework of factors affecting breastfeedingpractices. They categorised these factors as individual-level, group-level and society-levelfactors. The most common factor (on group level) why mothers with a high socioeconomicstatus in this study decided not to breastfeed was that formula milk was more convenientwhen working and less time consuming (63%). The misperception of insufficient milk supply was a common individual-level factor (37%) why mothers in this study decided not tobreastfeed. The most common society-level factor why mothers did not breastfeed was thatit was culturally unacceptable to breastfeed in public or in front of others (29%).The majority of mothers (60.4%) based their choice of formula on the advice ofpaediatricians. The most common property that influenced the choice of infant formula usedby mothers was the brand name of the infant formula (42.5%). It is evident that advertisingof infant formula did not significantly affect mothers' decisions of formula to use. Rather,17.6% of mothers indicated that their own research on infant formula influenced theirdecision of which formula to use.This study supports the literature published that the feeding practices of mothers withdifferent demographics differ from one another. To compare feeding practices amongdifferent demographic statuses best, it is recommended that a validated screening tool bedeveloped. Future research should investigate the options to make breastfeeding moreconvenient and implement interventions for modifiable factors such as breastfeedingintention, social support (including work environment), and expression of breast milkconfidently. More research should be conducted on the infant formula information given onwebsites to determine if manufacturers comply with Article 4.1 of the World HealthOrganization (WHO) International Code of Marketing of Breast Milk Substitutes.

[发布机构] University of the Free State