Breastfeeding knowledge, attitude, and practices among mothers at EPI centers in the Northern part of Dhaka city
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Submitted
May 13, 2024
Published
October 12, 2024
Abstract
Background: Breastfeeding (BF) is crucial for newborns, providing immunization and strengthening the mother-infant bond. A study on breastfeeding knowledge, attitudes, and practices (KAP) at Expanded Program on Immunization (EPI) centers in our country is the first of its kind.
Aims: This study aimed to assess the KAP regarding BF among mothers visiting EPI centers
Subjects and Methods: This descriptive cross-sectional study was conducted among 400 mother-child pairs from June to December 2021 using purposive sampling. We used a semi-structured questionnaire from the Food and Agriculture Organization (FAO). We performed chi-squared tests and binary logistic regression analyses.
Results: Approximately 63%, 65%, and 69% of mothers demonstrated satisfactory knowledge, attitudes, and practices towards BF, respectively. Mothers' education level (p=0.0001), economic status (p=0.0001), and habitat (p=0.001) showed a significant relationship with their knowledge about BF. Of the participants, 85% received education on BF before delivery (p=0.0001), and 98% received it after delivery (p=0.03), both showing significant associations with good knowledge of BF. We observed a significant association (p=0.008) between economic status and mothers' attitudes toward breastfeeding. Among the sociodemographic variables examined, only the mother's age demonstrated a significant role (p=0.009) in breastfeeding practices, with about 38% of mothers aged over 25 exhibiting good breastfeeding practices. Using binary logistic regression analysis, mothers’ education, older age, monthly income, and education on BF during pregnancy and after delivery showed a significant (p≤0.05) association with KAP on BF.
Conclusion: Knowledge, attitudes, and practices towards breastfeeding among mothers in the EPI centers were satisfactory. Education, older age, monthly income, and receiving education on breastfeeding during and after pregnancy were found to be determinants of satisfactory knowledge, attitudes, and practices.
Keywords: Breastfeeding, Knowledge, Attitude, Practice, EPI center, Bangladesh
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References
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Appiah, P. K., Amu, H., Osei, E., Konlan, K. D., Mumuni, I. H., Verner, O. N., Maalman, R. S., Kim, E., Kim, S., Bukari, M., Jung, H., Kofie, P., Ayanore, M. A., Amenuvegbe, G. K., Adjuik, M., Tarkang, E. E., Alhassan, R. K., Donkor, E. S., Zotor, F. B., Kweku, M., … Kim, S. Y. (2021). Breastfeeding and weaning practices among mothers in Ghana: A population-based cross-sectional study. PloS One, 16(11), e0259442. https://doi.org/10.1371/journal.pone.0259442 [Crossref] [Google Scholar] [PubMed] [Publisher]
Ara, G., Khanam, M., Papri, N., Nahar, B., Haque, M. A., Kabir, I., & Dibley, M. J. (2018). Peer counselling improves breastfeeding practices: A cluster randomized controlled trial in urban Bangladesh. Maternal & Child Nutrition, 14(3), e12605. https://doi.org/10.1111/mcn.12605 [Crossref] [Google Scholar] [PubMed] [Publisher]
Azeem, Z., Qadir, U., Afzal, M. F., & Sultan, M. A. (2010). Knowledge, Attitude and Practice of Breastfeeding in Urban Community of Lahore: A Cross Sectional Study. Annals of King Edward Medical University, 16(4), 299-299. https://doi.org/10.21649/akemu.v16i4.250 [Crossref] [Google Scholar] [Publisher]
Bala, K., Sahni, B., Bavoria, S., & Narangyal, A. (2020). Knowledge, attitude, and breast-feeding practices of postnatal mothers in Jammu: A community hospital based cross sectional study. Journal of Family Medicine and Primary Care, 9(7), 3433–3437. https://doi.org/10.4103/jfmpc.jfmpc_333_20 [Crossref] [Google Scholar] [PubMed] [Publisher]
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Bass, J. L., Gartley, T., & Kleinman, R. (2016). Unintended consequences of current breastfeeding initiatives. JAMA Pediatrics, 170(10), 923-924. https://doi.org/10.1001/jamapediatrics.2016.1529 [Crossref] [Google Scholar] [PubMed] [Publisher]
Boccolini, C., Siqueira, Carvalho, M., Lazaro de, & Oliveira, M., Inês Couto de. (2015). Factors associated with exclusive breastfeeding in the first six months of life in Brazil: a systematic review. Revista de Saude Publica, 49. https://doi.org/10.1590/s0034-8910.2015049005971 [Crossref] [Google Scholar] [PubMed] [Publisher]
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Cacho, N. T., & Lawrence, R. M. (2017). Innate immunity and breast milk. Frontiers in Immunology, 8, 257783. https://doi.org/10.3389/fimmu.2017.00584 [Crossref] [Google Scholar] [PubMed] [Publisher]
Cascone, D., Tomassoni, D., Napolitano, F., & Di Giuseppe, G. (2019). Evaluation of knowledge, attitudes, and practices about exclusive breastfeeding among women in Italy. International Journal of Environmental Research Public Health, 16(12), 2118. https://doi.org/10.3390/ijerph16122118 [Crossref] [Google Scholar] [PubMed] [Publisher]
Chowdhury, R., Sinha, B., Sankar, M. J., Taneja, S., Bhandari, N., Rollins, N., . . . Martines, J. (2015). Breastfeeding and maternal health outcomes: a systematic review and meta‐analysis. Acta Paediatrica, 104, 96-113. https://doi.org/10.1111/apa.13102 [Crossref] [Google Scholar] [PubMed] [Publisher]
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Hamze, L., Mao, J., & Reifsnider, E. (2019). Knowledge and attitudes towards breastfeeding practices: A cross-sectional survey of postnatal mothers in China. Midwifery, 74, 68-75.https://doi.org/10.1016/j.midw.2019.03.009[Crossref] [Google Scholar] [PubMed] [Publisher]
Hanafi, M. I., Shalaby, S. A. H., Falatah, N., & El-Ammari, H. (2014). Impact of health education on knowledge of, attitude to and practice of breastfeeding among women attending primary health care centres in Almadinah Almunawwarah, Kingdom of Saudi Arabia: controlled pre–post study. Journal of Taibah University Medical Sciences, 9(3), 187-193. https://doi.org/10.1016/j.jtumed.2013.11.011 [Crossref] [Google Scholar] [Publisher]
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Hasan, M., Hassan, M. N., Khan, M. S. I., Tareq, M. A., & Afroj, M. S. (2021). Prevalence, knowledge, attitudes and factors associated with exclusive breastfeeding among mothers in Dhaka, Bangladesh: a cross-sectional study. Population Medicine, 3(September), 1-7. https://doi.org/10.18332/popmed/140132 [Crossref] [Google Scholar] [Publisher]
Horta, B. L., Loret de Mola, C., & Victora, C. G. (2015). Long‐term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta‐analysis. Acta Paediatrica, 104, 30-37. https://doi.org/10.1111/apa.13133 [Crossref] [Google Scholar] [PubMed] [Publisher]
Hossain, M., Islam, A., Kamarul, T., & Hossain, G. (2018). Exclusive breastfeeding practice during first six months of an infant’s life in Bangladesh: a country based cross-sectional study. BMC Pediatrics, 18(1), 1-9. https://doi.org/10.1186/s12887-018-1076-0 [Crossref] [Google Scholar] [PubMed] [Publisher]
Ishak, S., Adzan, N. A. M., Quan, L. K., Shafie, M. H., Rani, N. A., & Ramli, K. G. (2014). Knowledge and beliefs about breastfeeding are not determinants for successful breastfeeding. Breastfeeding Medicine, 9(6), 308-312. https://doi.org/10.1089/bfm.2013.0124 [Crossref] [Google Scholar] [PubMed] [Publisher]
Jamil, M., Khanum, A., Omer, M. T., & Hamid, M. H. (2018). Knowledge, attitude and breastfeeding practices of mothers of infants: an experience from a tertiary care hospital in Lahore. Proceedings SZPGMI, 32(3), 1-7. https://doi.org/10.47489/p000s323z6841-7mc [Crossref] [Google Scholar] [Publisher]
Joshi, P. C., Angdembe, M. R., Das, S. K., Ahmed, S., Faruque, A. S. G., & Ahmed, T. (2014). Prevalence of exclusive breastfeeding and associated factors among mothers in rural Bangladesh: a cross-sectional study. International Breastfeeding Journal, 9, 1-8. https://doi.org/10.1186/1746-4358-9-7 [Crossref] [Google Scholar] [PubMed] [Publisher]
Keja, K., Chan, C., Hayden, G., & Henderson, R. H. (1988). Expanded programme on immunization. World Health Statistics Quarterly. Rapport Trimestriel de Statistiques Sanitaires Mondiales, 41(2), 59-63. https://doi.org/10.1002/9780470693841.ch8 [Crossref] [Google Scholar] [Publisher]
Khasawneh, W., Kheirallah, K., Mazin, M., & Abdulnabi, S. (2020). Knowledge, attitude, motivation and planning of breastfeeding: a cross-sectional study among Jordanian women. International Breastfeeding Journal, 15, 1-9. https://doi.org/10.1186/s13006-020-00303-x [Crossref] [Google Scholar] [PubMed] [Publisher]
Leshi, O. O., & Amoo, S. A. (2023). Breastfeeding knowledge, attitude, intention and practice of women in Purdah in Ibadan, Nigeria. The North African Journal of Food Nutrition Research, 7(15), 9-19. https://doi.org/10.51745/najfnr.7.15.9-19 [Crossref] [Google Scholar] [Publisher]
Martínez Galiano, J. M., & Delgado Rodríguez, M. (2013). Early initiation of breastfeeding is benefited by maternal education program. Revista da Associação Médica Brasileira, 59, 254-257. https://doi.org/10.1016/s2255-4823(13)70465-x [Crossref] [Google Scholar] [PubMed] [Publisher]
Ministry of Health. (2011). Primary health care centres breastfeeding policy and procedure in Madinah region.
Murtaza, M., Ahmed, K. A., Abbasi, M., Farooq, A., Shafique, M., & Ahmed, N. (2022). The Knowledge, Attitude, and Practice of Mothers Regarding Breast Feeding and Factors Affecting It at A Tertiary Care Hospital. Annals of Punjab Medical College, 16(2), 123-127. https://doi.org/10.29054/apmc/2022.1237 [Crossref] [Google Scholar] [Publisher]
National Institute of Population Research and Training, Medical Education and Family Welfare Division, & Ministry of Health and Family Welfare Dhaka Bangladesh. (2023). Bangladesh Demographic and Health Survey 2022. [Publisher]
National Institute of Population Research and Training (NIPORT), Mitra and Associates, & ICF International. (2015). Bangladesh Demographic and Health Survey 2014: Key Indicators. [Publisher]
Ouyang, Y.-Q., Su, M., & Redding, S. R. (2016). A survey on difficulties and desires of breast-feeding women in Wuhan, China. Midwifery, 37, 19-24. https://doi.org/10.1016/j.midw.2016.03.014 [Google Scholar] [PubMed] [Publisher]
Peres, K. G., Cascaes, A. M., Nascimento, G. G., & Victora, C. G. (2015). Effect of breastfeeding on malocclusions: a systematic review and meta‐analysis. Acta Paediatrica, 104, 54-61. https://doi.org/10.1111/apa.13103 [Crossref] [Google Scholar] [PubMed] [Publisher]
Public Health and World Health Wing, & Ministry of Health & Family Welfare. (2017). Second National Plan of Action for Nutrition. In IPHN & BNNC (Eds.). Dhaka, Bangladesh: WHO, UNICEF, UNFPA, FAO, The World Bank, gain. [Publisher]
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Authors
Afroz, H. ., Mondal, S. ., Khatun, T., Saleh, F., & Hussain, M. A. . (2024). Breastfeeding knowledge, attitude, and practices among mothers at EPI centers in the Northern part of Dhaka city. The North African Journal of Food and Nutrition Research, 8(18), 96–105. https://doi.org/10.51745/najfnr.8.18.96-105
Copyright (c) 2024 Hasina Afroz, Supta Mondal, Taslima Khatun, Farzana Saleh, Md. Anower Hussain
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