Feeding practices of mothers with infants and children attending preschools in a high socioeconomic area in Johannesburg
Rust, Annica Madeleen
MetadataShow full item record
Breastfeeding is the preferred feeding method, as it is not only nutritionally complete for the first four to six months but will also provide immunological, psychological, physiological, and developmental benefits for the infant. In recognition of the benefits of breastfeeding, the World Health Assembly has set a target of 50% for all infants to be breastfed exclusively from 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, are said to be representative of the country, but do not distinguish between feeding practices of mothers of different socioeconomic levels. The aim of this study was to determine breastfeeding practices and associations between breastfeeding practices and demographics of mothers in a high socioeconomic area in Johannesburg. To achieve the aim, the following factors were assessed: mother and infant/child’s socio-demographic information, mothers’ feeding practices, and factors affecting feeding practices. The majority of mothers were younger than 35 years of age (58.9%), were married or cohabiting (83.5%), and had an education level higher than Grade 12 (88.8%). Although most of the mothers initiated breastfeeding at birth (n=102, 94%); however, the duration of EBF was short. Thirty-four mothers (31.3%) breastfed their infants at four months, and 64 mothers (58.7%) breastfed their infants at six months. Only two mothers (1.8%) exclusively breastfed their infants at six months. A statistically significant difference was not found between breastfeeding duration at six months and the mothers’ age (p=1.0000), highest level 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 breastfeeding practices. They categorised these factors as individual-level, group-level and society-level factors. The most common factor (on group level) why mothers with a high socioeconomic status in this study decided not to breastfeed was that formula milk was more convenient when 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 to breastfeed. The most common society-level factor why mothers did not breastfeed was that it 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 of paediatricians. The most common property that influenced the choice of infant formula used by mothers was the brand name of the infant formula (42.5%). It is evident that advertising of 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 their decision of which formula to use. This study supports the literature published that the feeding practices of mothers with different demographics differ from one another. To compare feeding practices among different demographic statuses best, it is recommended that a validated screening tool be developed. Future research should investigate the options to make breastfeeding more convenient and implement interventions for modifiable factors such as breastfeeding intention, social support (including work environment), and expression of breast milk confidently. More research should be conducted on the infant formula information given on websites to determine if manufacturers comply with Article 4.1 of the World Health Organization (WHO) International Code of Marketing of Breast Milk Substitutes.