|dc.description.abstract||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.||en_ZA