Assuntos
Notificação de Doenças/legislação & jurisprudência , Notificação de Doenças/métodos , Saúde Global/legislação & jurisprudência , Sistemas de Informação em Saúde/instrumentação , Sistemas de Informação em Saúde/legislação & jurisprudência , Estatísticas Vitais , Atestado de Óbito , Saúde Global/estatística & dados numéricos , Programas Governamentais , Conhecimentos, Atitudes e Prática em Saúde , Programas Gente Saudável/legislação & jurisprudência , Humanos , Cooperação Internacional , Instituições Filantrópicas de SaúdeAssuntos
Humanos , Saúde Global/legislação & jurisprudência , Notificação de Doenças/legislação & jurisprudência , Notificação de Doenças/métodos , Sistemas de Informação em Saúde/instrumentação , Sistemas de Informação em Saúde/legislação & jurisprudência , Cooperação Internacional , Instituições Filantrópicas de Saúde , Atestado de Óbito , Conhecimentos, Atitudes e Prática em Saúde , Saúde Global/estatística & dados numéricos , Programas Gente Saudável/legislação & jurisprudência , Programas GovernamentaisRESUMO
OBJECTIVE: To assess the relationships between maternal breast-feeding intention, attitudes, self-efficacy and knowledge at 7 months' gestation with exclusive or full breast-feeding at 3 months postpartum. DESIGN: Prospective cohort study with structured home interviews during pregnancy and 3 months after delivery. SETTING: Two rural sub-districts of Kishoreganj district, Bangladesh. SUBJECTS: Mother-infant dyads. RESULTS: Over 80 % of 2178 pregnant women intended to exclusively breast-feed (EBF). Maternal positive attitudes, self-efficacy and knowledge about breast-feeding were positively associated with EBF intention (all P<0.05). All mothers except one reported initiating breast-feeding and 99.6 % of children were still breast-fed at 3 months. According to 24 h dietary recalls, we categorized 985 (45.2 %) infants as EBF at 3 months (47.8 % among mothers with EBF intention; 31.7 % among mothers with no EBF intention; P<0.05) and 551 (25.3 %) infants as predominantly breast-fed at 3 months (24.2 % among mothers with EBF intention; 30.8 % among mothers with no EBF intention; P<0.05). Prenatal EBF intention was associated with EBF (OR=1.48, 95 % CI 1.14, 1.91) and with full breast-feeding (OR=1.34, 95 % CI 1.04, 1.72) at age 3 months. EBF at age 3 months was not associated with maternal breast-feeding knowledge, attitudes or self-efficacy. CONCLUSIONS: Despite widespread expressed maternal EBF intention and universal breast-feeding initiation, prevalence of both exclusive and full breast-feeding at 3 months remains lower than WHO recommendations. EBF intention predicts breast-feeding behaviours, suggesting the importance of prenatal counselling to improve infant feeding behaviours.
Assuntos
Aleitamento Materno/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Período Pós-Parto/psicologia , Terceiro Trimestre da Gravidez/psicologia , Adolescente , Adulto , Bangladesh , Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Intenção , Pessoa de Meia-Idade , Gravidez , Estudos Prospectivos , População Rural , Autoeficácia , Adulto JovemRESUMO
Achieving optimal exclusive breastfeeding (EBF) remains a challenge. Because intention is a precursor of practice, we examined factors associated with EBF intention during pregnancy in two rural sub-districts of Kishoreganj district, Bangladesh. We studied 2,400 pregnant women in their third trimester (26-32 weeks gestation). We assessed knowledge (6 items, scale range 0-6), attitudes (15 items, scale range 15-75) and self-efficacy (6 items, scale range 6-30) by interview using a standardized questionnaire. 83.9 % of pregnant women reported EBF intention. Mean breastfeeding knowledge was 3.5 (SD 1.3), mean attitude was 55.8 (SD 8.1) and mean self-efficacy was 25.6 (SD 3.4). Knowledge was associated with EBF intention (OR 2.47, 95 % CI 1.74, 3.51), attitudes toward EBF (OR 1.68, 95 % CI 1.31, 2.16) and self-efficacy (OR 1.72, 95 % CI 1.23, 2.40) were independently associated with EBF intention in the model in which all three constructs were entered simultaneously. Receipt of breastfeeding counseling during pregnancy and being literate were each associated with EBF knowledge and EBF intention (all p < 0.05). Increasing maternal knowledge, positive attitudes, and self-efficacy regarding EBF were associated with prenatal EBF intention. These results reinforce the importance of appropriate counseling to increase EBF prevalence .