Associations between knowledge of breastfeeding with cultural factors and maternal characteristics pf [i.e. of] pregnant women attending the ante-natal clinic at MUCCP
The main aim of this study was to determine the associations between knowledge of breastfeeding with cultural factors and maternal characteristics of pregnant women attending the ante-natal clinic at the Mangaung University Community Partnership Programme (MUCPP). A sample of 646 pregnant women with a gestational age of between 28 and 32 weeks and who attended the ante-natal clinic at MUCPP was randomly selected for the study. The socio-demographic composition of the subjects was determined by means of a standardized questionnaire, which included identifiable details of each subject, the family composition, household and economics. Anthropometric measurements obtained from each respondent included weight and height. Knowledge about breastfeeding and breastfeeding practices as well as cultural factors that would influence the mother to breastfeed was obtained by means of standardized questionnaire. The majority of the participants’ home language was Sotho (55.73%), while Tswana was spoken by 23.99%. The majority of respondents were unmarried (63.16%). Although Grade 10 was the average level of education achieved by the respondents, and 75.54% of respondents were unemployed. In most households only 1 person contributed to the household’s monthly income, with 44.58% of households receiving between R501 to R1000 per month, and only 1% of households earned more than R5000 per month. In 45.67% of households the parent was the head of the household, and 87.77% of respondents lived in a brick house. Ninety percent of women had a BMI of 25kg/m2 or more, indicating that they were overweight. Only 8.68% of respondents had a BMI in the normal range of 20 <25kg/m2 and very few women (only 8) were underweight. The majority of respondents (97.98%) were planning to breastfeed their child, while only 1.40% did not want to breastfeed (table 4.2). Of this 1.40%, a maximum of 33.33% mentioned that their reason for not planning to breastfeed was illness. Almost 46% of respondents had received breastfeeding education before the interview, and 54.74% of these received it from the local clinic sister. The majority of pregnant women (83.90%) reported that breastfeeding could not prevent them from falling pregnant again. Most of the mothers (92.72%) believed that they could go back to work when they are breastfeeding. Most mothers did not think that breastfeeding should continue when the baby has diarrhea (53.80%), and most believed that they should stop breastfeeding if they fall pregnant again (58.29%). Most women believed that one could not reintroduce breastfeeding after ceasing it for a while (79.69%). The majority of the mothers also believed that the size of their breasts determined the efficacy of their breastfeeding practices (67.03%). Most respondents (64.40%) believed that breastfeeding has advantages, and only 3.26% of respondents believed that breastfeeding has disadvantages. Most of the mothers (90.25%) did not believe they should continue to breastfeed when they have mastitis, but 81.89% reported that one should continue breastfeeding when engorgement is present. A large percentage (59.29%) believed that the mother will need special types of food to ensure that she breastfeeds successfully. Almost all respondents (99.84%) knew that breast milk is the best food for a newborn baby. The average age, however, at which respondents planned to give their babies water in combination with breast milk was 4 months (n=370). Most (67.34%) of the respondents also reported that they would add extra food to the diet of the breastfed baby before the recommended age of 6 months. Almost three quarters (72.91%) of mothers reported that a mother should breastfeed her baby even if she is HIV infected, while 15.33% believed that the HIV infected mother should not breastfeed her baby. Of these, 25.56% said that the main reason a Human Immunodeficiency Virus (HIV) positive mother should not breastfeed is that the baby will be infected with HIV. When associations between variables were determined. Significantly more overweight women had received breastfeeding education (49.80%) compared to normal and underweight women. Overweight women were also more likely to know that breastfeeding has numerous advantages (67.61%) compared to women with a BMI <25kg/m2 (53.64%). Normal and underweight women were significantly more likely to think that breastfed babies need water (66.89%) compared to overweight women (54.66%). More overweight women (76.16%) thought that one should add additional food to the babies’ diet before six months of age, compared to the 64.78% of normal and underweight women. Most normal weight and underweight women (96.36%) also believed that expressed breast milk should not be given to their babies, compared to 92% of overweight women. Significantly more married mothers had received breastfeeding education before (59.53%), compared to single mothers (38.84%). Married mothers were also more likely to know that there were advantages to breastfeeding. However, more single mothers knew that the baby will need other food including breast milk after 6 months of age. The results of the study confirm that women need accurate information, encouragement, and support to enable them to practice optimal breastfeeding. This includes timely initiation of breastfeeding; exclusive breastfeeding for six months; introduction of adequate, safe, and appropriate complementary foods from six months; and continued breastfeeding up to two years of beyond.