Breastfeeding and complementary feeding practices of mothers exposed to the Baby-Friendly Hospital Initiative in Limpopo Province
Article Sidebar
Main Article Content
Abstract
Background. Appropriate infant feeding is crucial for growth and development of children in the first 5 years of their life. Despite the
implementation of the Baby-Friendly Hospital Initiative (BFHI), now known as Mother-Baby Friendly Hospital Initiative, exclusive
breastfeeding and complementary feeding practices remain barriers to optimal breastfeeding practices in South Africa.
Objectives. To explore the impact of the BFHI on breastfeeding and complementary feeding practices of mothers for second or subsequent pregnancies.
Methods. The study design was a cross-sectional survey and included 169 mother-baby pairs conveniently selected from clinics in
Limpopo Province. Data were collected using a validated questionnaire and analysed for 157 complete data sets using the Statistical
Package for Social Sciences version 26.0. Both univariable and multivariable logistic regression analyses were used to examine the impact of baby-friendly hospitals on breastfeeding practices of mothers.
Results. Few mothers in both groups practised exclusive breastfeeding for the recommended time (BFHI 22.2%; non- BFHI 30.6%). The
main reasons for introducing early complementary foods were that the child was hungry, crying or was not satisfied with breastmilk.
Mothers in the BFHI group were three times (odds ratio (OR) 3.53; 95% confidence interval (CI) 1.13 - 10.98) more likely to breastfeed
their infants, and two times (OR 2.22; 95% CI 1.08 - 4.58) more likely to initiate their infants on water with added glucose or salt before
the age of 6 months than mothers in the non-BFHI group.
Conclusion. Mothers from the non-baby-friendly group had better breastfeeding practices. Evidence showed that for second or subsequent pregnancies, exposure to a baby-friendly facility during first pregnancy did not sustain appropriate breastfeeding and complementary feeding practices. Whether mothers were exposed or not, practices were similar. Strengthening and continual evaluation of breastfeeding interventions might improve impact on child survival outcomes in the study area.
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The SAJCH is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
How to Cite
References
UNICEF. From the first hour of life: Making the case for improved infant and young child feeding everywhere. UNICEF. 2016, p.104. http://data.unicef.org/ topic/nutrition/infant-and-young-child-feeding/ (accessed 1 July 2018).
Bland R, Rollins N, Coutsoudis A, Coovadia H. Breastfeeding practices in an area of high HIV prevalence in rural South Africa. Acta Paediatr 2007;91(6):704-711. https://doi.org/10.1111/j.1651-2227.2002.tb03306.x
Gupta A, Henderson P, Kean YJ, et al. Celebrating the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding: Past achievements, present challenges and priority actions for infant and young child feeding. 2005. https://digitallibrary.un.org/record/604742?ln=en (accessed 19 April 2023).
Mushaphi LF, Mbhenyane XG, Khoza LB, Amey AKA. Infant-feeding practices of mothers and the nutritional status of infants in the Vhembe District of Limpopo Province. Afr J Clin Nutr 2008;21(2):36-41.
Akeredolu I, Osisanya JO, Seriki-Mosadolorun JS, Okorafor U. Mothers’ nutritional knowledge, infant feeding practices and nutritional status of infants (0-24 months) in Lagos State, Nigeria. Eur J Nutr Food Saf 2014;4(4):364-374.
Jemide J, Ene-Obong H, Edet EE, Udoh E. Association of maternal nutrition knowledge and child feeding practices with nutritional status of infants in Calabar South Local Government Area, Cross River State, Nigeria. Int J Home Sci 2016;2(1):293-298. https://pdfs.semanticscholar.org/2873/5932eb9aff68684 de69f6d2ea3b15709f5bf.pdf
Fallon A, Crepinsek M, Hegney D, O’Brien M. The Baby-Friendly Hospital Initiative and breastfeeding duration: Relating the evidence to the Australian context. Birth Issues 2005;14(3):90-95.
Wright AI, Hurst NM. Personal infant feeding experiences of postpartum nurses affect how they provide breastfeeding support. J Obstet Gynecol Neonatal Nurs 2018;47(3):342-351. https://doi.org/10.1016/j.jogn.2018.02.011
Munn AC, Newman SD, Mueller M, Phillips SM, Taylor SN. The impact in the United States of the Baby-Friendly Hospital Initiative on early infant health and breastfeeding outcomes. Breastfeed Med 2016;11(5):222-230. https://doi. org/10.1089/bfm.2015.0135
Broadfoot M, Britten J, Tappin D, MacKenzie J. The Baby Friendly Hospital Initiative and breastfeeding rates in Scotland. Arch Dis Child Fetal Neonatal Ed 2005;90(2). https://doi.org/10.1136/adc.2003.041558
Feldman-Winter L, Ustianov J. Lessons learned from hospital leaders who participated in a national effort to improve maternity care practices and breastfeeding. Breastfeed Med 2016;11(4):166-172. https//doi.org/10.1089/ bfm.2016.0003
Ahmed AE, Salih OA. Determinants of the early initiation of breastfeeding in the Kingdom of Saudi Arabia. Int Breastfeed J 2019;14(1):1-13. https://doi. org/10.1186/s13006-019-0207-z
Mushaphi LF, Mahopo TC, Nesamvuni CN, et al. Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results from the MAL-ED Birth Cohort. Food Nutr Bull 2017;38(3):428-440. https://doi. org/10.1177/0379572117696662
WHO, UNICEF, UNAIDS. Global Strategy for Infant and Young Child Feeding. Geneva: WHO, 2003.
World Health Organization. Implementation Guidance 2018. Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: The revised Baby-Friendly Hospital Initiative. 2018. http:// apps.who.int/bookorders (accessed 1 March 2023).
Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR. Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 2006;117(3):e380-e386. https://doi.org/10.1542/peds.2005-1496
Crenshaw JT. Healthy Birth Practice #6: Keep mother and newborn together – it’s best for mother, newborn, and breastfeeding. J Perinat Educ 2019;28(2):108- 115. https://doi.org/10.1891/1058-1243.28.2.108
World Health Organization. Advocacy brief: breastfeeding and family-friendly policies. No. WHO/NMH/NHD/19.23. Geneva: WHO, 2019.
National Department of Health (DoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC) and ICF. South African Demographic and Health Survey 2016: Key Indicators. 2017. https://www. statssa.gov.za/publications/Report%2003-00-09/Report%2003-00-092016.pdf (accessed 19 April 2023).
Kakute PN, Ngum J, Mitchell P, et al. Cultural barriers to exclusive breastfeeding by mothers in a rural area of Cameroon, Africa. J Midwifery Womens Health 2005;50(4):324-328. https://doi.org/10.1016/j.jmwh.2005.01.005
Jung S, Nobari TZ, Whaley SE. Breastfeeding outcomes among WIC- participating infants and their relationships to baby-friendly hospital practices. Breastfeed Med 2019;14(6):424-431. https://doi.org/10.1089/bfm.2019.0004
Khokhar S, Hashmat A J, Zohra S L. Prevalence of timely introduction of complementary feeding and its related factors in children 6–24 months of age in Hyderabad, Pakistan. Nursing and Midwifery Studies 2017:6(3):115. https://
doi.org/10.4103/nms.nms_19_17
Hunter-Adams J, Myer L, Rother HA. Perceptions related to breastfeeding and the early introduction of complementary foods amongst migrants in Cape Town, South Africa. Int Breastfeed J 2016;11(1):29. https://doi.org/10.1186/ s13006-016-0088-3
Zhang Y, Jin Y, Vereijken C, Stahl B, Jiang H. Breastfeeding experience, challenges and service demands among Chinese mothers: A qualitative study in two cities. Appetite 2018;128:263-270.
Bartington S, Griffiths LJ, Tate AR, Dezateux C. Are breastfeeding rates higher among mothers delivering in baby friendly accredited maternity units in the UK? Int J Epidemiol 2006;35(5):1178-1186. https://academic.oup.com/ije/ article-abstract/35/5/1178/762253 (accessed July 2016)
Pérez-Escamilla R, Putnik P. The role of acculturation in nutrition, lifestyle, and incidence of type 2 diabetes among Latinos. J Nutr 2007;137(4):860-870.
Mohajan HK. Qualitative research methodology in social sciences and related subjects. J Econ Dev Environ People 2018;7(1):23-48.