Attitudes of Mothers on Infant Nutrition and Affecting Factors

Year 2023, Volume: 8 Issue: 3, 925 - 932, 08.10.2023

Emine Kurtbeyoglu , Zeynep Caferoğlu

https://doi.org/10.61399/ikcusbfd.1211903

Abstract

Objective: The aim of this study is to assess the infant feeding attitudes of mothers who have infants aged 0 to 6 months and to determine the factors associated with these attitudes.
Material and Method: Mothers, aged 18 years and older and who have infants aged 0 to 6 months, were included in the study. A three-part online questionnaire was applied to the participants. Sociodemographic characteristics and anthropometric measurements were asked in the first part, and in the second and third parts, the Iowa Infant Feeding Attitude Scale (IIFAS) and the Edinburgh Postpartum Depression Scale were applied, respectively.
Results: The median age of 417 mothers participating in the study was 28 years, and their mean IIFAS score was 65.08 ± 6.83. In the multiple linear regression models created to determine the factors associated with mothers’ infant feeding attitudes, it was found that mothers’ having high school or higher level of education was associated with an increase of 3.60 points, and having income less than expenses was associated with a decrease of 1.97 points in IIFAS. In addition, an increase of 2.82 points in IIFAS is associated with feeding the infant with exclusively breast milk within the last 24 hours, while a decrease of 2.09 points is associated with infant’s being overweight. When these factors were analyzed according to whether the mother had a risk of postpartum depression or not, having high school or higher level of education and breastfeeding exclusively within the last 24 hours were associated with an increase of 4.01 and 2.96 points in IIFAS, respectively in those without depression risk. Having income less than expenses and infant’s being overweight were related to a decrease of 1.69 and 2.76 points in IIFAS, respectively. However, no factors associated with IIFAS scores were found in mothers at risk of depression.
Conclusion: The infant feeding attitude of mothers is affected by many factors such as educational status, socioeconomic level, week of birth, and depression. In particular, the presence of the postpartum depression risk may negatively affect the infant feeding attitudes of mothers on its own, as well as change the possible effect of other factors.

Keywords

Breast milk, breastfeeding, attitude, postpartum depression

Annelerin Bebek Beslenmesi Tutumları ve İlişkili Faktörler

Abstract

Amaç: Bu çalışmanın amacı, 0-6 aylık bebeği olan annelerin bebek beslenmesi tutumlarının değerlendirilmesi ve bu tutum ile ilişkili faktörlerin belirlenmesidir.
Gereç ve Yöntem: Çalışmaya 18 yaş ve üstü, 0-6 aylık bebeği olan anneler dâhil edilmiştir. Katılımcılara üç bölümden oluşan çevrimiçi anket uygulanmıştır. İlk bölümde sosyodemografik özellikler ve antropometrik ölçümler sorgulanırken, ikinci bölümde Iowa Bebek Beslenmesi Tutum Ölçeği (Iowa Infant Feeding Attitude Scale, IIFAS), üçüncü bölümde ise Edinburgh Postpartum Depresyon Ölçeği uygulanmıştır.
Bulgular: Araştırmaya katılan 417 annenin yaş ortanca değeri 28 yıl, IIFAS puan ortalamaları 65,08 ± 6,83’tür. Bebek beslenmesi tutumları ile ilişkili faktörleri belirlemek için oluşturulan çoklu doğrusal regresyon modellerinde, annelerin lise ve üzeri eğitim almış olması IIFAS’ta 3,60 puan artış, gelirinin giderinden az olması ise 1,97 puan azalış ile ilişkili bulunmuştur. Ayrıca IIFAS’taki 2,82 puan artış, bebeğini son 24 saatte sadece anne sütüyle besleme ile ilişkili iken, 2,09 puan azalış ise bebeğin hafif şişman olması ile ilişkilidir. Bu faktörler annede postpartum depresyon riski olup olmamasına göre incelendiğinde, risk olmayanlarda lise ve üzeri eğitim almış olmak ve son 24 saatte sadece anne sütü alımı IIFAS’ta sırasıyla 4,01 ve 2,96 puan artışla, gelirinin giderinden az olması ve bebeğin hafif şişman olması ise sırasıyla 1,69 ve 2,76 puan azalışla ilişkilidir. Bununla birlikte, depresyon riski olan annelerde IIFAS puanları ile ilişkili herhangi bir faktör saptanmamıştır.
Sonuç: Annelerin bebek beslenmesi tutumu eğitim durumu, sosyoekonomik düzey, doğum haftası ve depresyon gibi birçok faktörden etkilenmektedir. Özellikle postpartum depresyon riskinin varlığı, bebek beslenmesi tutumunu tek başına olumsuz etkileyebildiği gibi diğer faktörlerin olası etkisini de değiştirebilir.

Keywords

Anne sütü, emzirme, postpartum depresyon, tutum

References

• World Health Organization (WHO) [Internet]. World Health Organization; 2022 [cited 2022 Nov 27]. Available from: https://www. who.int/health-topics/breastfeeding#tab=tab_1
• World Health Organization (WHO) [Internet]. World Health Organization; 2022 [cited 2022 Nov 27]. Available from: https://www. who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-under-5-mortality-in-2020
• Wojcicki JM, Gugig R, Tran C, Kathiravan S, Holbrook K, Heyman MB. Early Exclusive Breastfeeding and Maternal Attitudes Towards Infant Feeding in a Population of New Mothers in San Francisco, California. Breastfeed Med [Internet]. 2010 Feb;5(1):9–15. Available from: http:// www.liebertpub.com/doi/10.1089/bfm.2009.0003
• Meedya S, Fahy K, Yoxall J, Parratt J. Increasing breastfeeding rates to six months among nulliparous women: A quasi-experimental study. Midwifery [Internet]. 2014 Mar;30(3):e137–44. Available from: https:// linkinghub.elsevier.com/retrieve/pii/S0266613813003574
• Raheem RA, Binns CW, Chih HJ, Sauer K. Determinants of the Introduction of Prelacteal Feeds in the Maldives. Breastfeed Med [Internet]. 2014 Nov;9(9):473–8. Available from: http://www.liebertpub. com/doi/10.1089/bfm.2014.0028
• Bozkurt G, Tanrıverdi FŞ, Tanrıverdi D. Postpartum Dönemde Annelerin Bebek Beslenmesi Tutumlarını Etkileyen Faktörler. J Contemp Med [Internet]. 2021 May 30;11(4):543-9. Available from: https://dergipark. org.tr/tr/doi/10.16899/jcm.758144
• Dennis C-L. Breastfeeding Initiation and Duration: A 1990-2000 Literature Review. J Obstet Gynecol Neonatal Nurs [Internet]. 2002 Jan;31(1):12–32. Available from: https://linkinghub.elsevier.com/ retrieve/pii/S0884217515339526
• Scott JA, Binns CW, Oddy WH, Graham KI. Predictors of Breastfeeding Duration: Evidence From a Cohort Study. Pediatrics [Internet]. 2006 Apr 1;117(4):e646–55. Available from: https://publications.aap.org/ pediatrics/article/117/4/e646/70951/Predictors-of-Breastfeeding- Duration-Evidence-From
• Ibanez G, Martin N, Denantes M, Saurel-Cubizolles M-J, Ringa V, Magnier A-M. Prevalence of breastfeeding in industrialized countries. Rev Epidemiol Sante Publique [Internet]. 2012 Aug;60(4):305–20. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0398762012005068
• Cox KN, Giglia RC, Binns CW. The influence of infant feeding attitudes on breastfeeding duration: evidence from a cohort study in rural Western Australia. Int Breastfeed J [Internet]. 2015 Dec 21;10(1), Article 25. Available from: http://www.internationalbreastfeedingjournal.com/ content/10/1/25
• Chambers JA, McInnes RJ, Hoddinott P, Alder EM. A systematic review of measures assessing mothers’ knowledge, attitudes, confidence and satisfaction towards breastfeeding. Breastfeed Rev [Internet]. 2007 Nov;15(3):17–25. Available from: http://www.ncbi.nlm.nih.gov/ pubmed/18062138
• Pope CJ, Mazmanian D, Bédard M, Sharma V. Breastfeeding and postpartum depression: Assessing the influence of breastfeeding intention and other risk factors. J Affect Disord [Internet]. 2016 Aug;200:45–50. Available from: https://linkinghub.elsevier.com/retrieve/ pii/S0165032715313999
• Annagur B, Annagur A. The Relationship Between Postpartum Mental Status and Breastfeeding. Psikiyatr Guncel Yaklasimlar - Curr Approaches Psychiatry [Internet]. 2012;4(3):279-92. Available from: https://dergipark. org.tr/en/pub/pgy/issue/11153/133367
• Duran S, Kaynak S, Karadaş A. The relationship between breastfeeding attitudes and perceived stress levels of Turkish mothers. Scand J Caring Sci [Internet]. 2020 Jun 5;34(2):456–63. Available from: https://onlinelibrary.wiley.com/doi/10.1111/scs.12749
• Mora A de la, Russell DW, Dungy CI, Losch M, Dusdieker L. The Iowa Infant Feeding Attitude Scale: Analysis of Reliability and Validity1. J Appl Soc Psychol [Internet]. 1999 Nov;29(11):2362–80. Available from: https:// onlinelibrary.wiley.com/doi/10.1111/j.1559-1816.1999.tb00115.x
• Eksioğlu A, Yeşil Y, Çeber Turfan E. The Translation and Validation of the Iowa Infant Feeding Attitude Scale into Turkish. Hemşirelikte Eğitim ve Araştırma Derg [Internet]. 2016;13(3): 209-15. Available from: https:// jer-nursing.org/en/the-translation-and-validation-of-the-iowa-infant-feeding-attitude-scale-into-turkish-161370
• Cox JL, Holden JM, Sagovsky R. Detection of Postnatal Depression. Br J Psychiatry [Internet]. 1987 Jun 2;150(6):782–6. Available from: https:// www.cambridge.org/core/product/identifier/S0007125000214712/ type/journal_article
• Aydin N, Inandi T, Yigit A, Sahin Hodoglugil N.N. Validation of the Turkish version of the Edinburgh Postnatal Depression Scale among women within their first postpartum year. Soc Psychiatry Psychiatr Epidemiol [Internet]. 2004 Jun;39(6):483-6. Available from: http://link. springer.com/10.1007/s00127-004-0770-4
• World Health Organization (WHO) [Internet]. World Health Organization; 2022 [cited 2022 Nov 27]. Available from: https://www. who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations
• World Health Organization (WHO) [Internet]. World Health Organization; 2022 [cited 2022 Nov 27]. Available from: https://www. who.int/tools/child-growth-standards/s.
• Anderson LN, Carsley S, Lebovic G, Borkhoff CM, Maguire JL, Parkin PC, et al. Misclassification of child body mass index from cut-points defined by rounded percentiles instead of Z-scores. BMC Res Notes [Internet]. 2017 Dec 28;10(1):639. Available from: https://bmcresnotes. biomedcentral.com/articles/10.1186/s13104-017-2983-0
• Inano H, Kameya M, Sasano K, Matsumura K, Tsuchida A, Hamazaki K, et al. Factors influencing exclusive breastfeeding rates until 6 months postpartum: the Japan Environment and Children’s Study. Sci Rep [Internet]. 2021 Dec 25;11(1):6841. Available from: http://www.nature. com/articles/s41598-021-85900-4
• Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Türkiye Nüfus ve Sağlık Araştırması. Ankara; 2018. Available from: http://www.sck.gov.tr/ wp-content/uploads/2020/08/TNSA2018_ana_Rapor.pdf.
• Bień A, Kulesza-Brończyk B, Przestrzelska M, Iwanowicz-Palus G, Ćwiek D. The Attitudes of Polish Women towards Breastfeeding Based on the Iowa Infant Feeding Attitude Scale (IIFAS). Nutrients [Internet]. 2021 Nov 30;13(12):4338. Available from: https://www.mdpi.com/2072- 6643/13/12/4338
• Akın B, Demir E, Gürdal A, Yılmaz S. Attitudes of Mothers with Babies of 0-6 Months of Age Regarding Infant Nutrition and Transition Times to Complementary Feeding. Acibadem Univ Saglik Bilim Derg [Internet]. 2021 Apr 1;12(2), 472-78. Available from: https://dergipark.org.tr/en/ doi/10.31067/acusaglik.849205
• Kös Aksin G, Kayhan Tetik B. The Effect of Breastfeeding Education Given to Mothers in the Accompanying Mother Unit on the Attitude and Knowledge of Feeding. Turkish J Fam Med Prim Care [Internet]. 2021 Dec 20;15(4):793-9. Available from: https://dergipark.org.tr/en/doi/10.21763/ tjfmpc.883156
• Topal S, Yuvaci HU, Erkorkmaz U, Cinar N, Altinkaynak S. The determination of infant feeding attitudes among Turkish mothers using the Iowa Infant Feeding Attitude Scale. J Pak Med Assoc [Internet]. 2017 Oct;67(10):1567–73. Available from: http://www.ncbi.nlm.nih.gov/ pubmed/28955076
• Altamimi E, Al Nsour R, Al dalaen D, Almajali N. Knowledge, Attitude, and Practice of Breastfeeding Among Working Mothers in South Jordan. Workplace Health Saf [Internet]. 2017 May 28;65(5):210–8. Available from: http://journals.sagepub.com/doi/10.1177/2165079916665395
• Bbaale E. Determinants of early initiation, exclusiveness, and duration of breastfeeding in Uganda. J Health Popul Nutr [Internet]. 2014 Jun;32(2):249–60. Available from: http://www.ncbi.nlm.nih.gov/ pubmed/25076662
• Mizrak Sahin B, Ozerdogan N, Ozdamar K, Gursoy E. Factors affecting breastfeeding motivation in primiparious mothers: An application of breastfeeding motivation scale based on self-determination theory. Health Care Women Int [Internet]. 2019 Jun 3;40(6):637–52. Available from: https://www.tandfonline.com/doi/full/10.1080/07399332.2018.1 526289
• Ogunlesi TA. Maternal Socio-Demographic Factors Influencing the Initiation and Exclusivity of Breastfeeding in a Nigerian Semi-Urban Setting. Matern Child Health J [Internet]. 2010 May 21;14(3):459–65. Available from: http://link.springer.com/10.1007/s10995-008-0440-3
• TC Sağlık Bakanlığı. Anne sütü. Ankara; 2008. Available from: https:// docplayer.biz.tr/2629072-Anne-sutu-hazirlayan-doc-dr-gulhan-eroglu-hacettepe-universitesi-saglik-bilimleri-fakultesi-beslenme-ve-diyetetik-bolumu-subat-2012-2008-ankara.html
• Atif N, Lovell K, Rahman A. Maternal mental health: The missing “m” in the global maternal and child health agenda. Semin Perinatol [Internet]. 2015 Aug;39(5):345–52. Available from: https://linkinghub.elsevier.com/ retrieve/pii/S0146000515000543
• Abuchaim E de SV, Caldeira NT, Lucca MM Di, Varela M, Silva IA. Depressão pós-parto e autoeficácia materna para amamentar: prevalência e associação. Acta Paul Enferm [Internet]. 2016 Dec;29(6):664– 70. Available from: http://www.scielo.br/scielo.php?script=sci_ arttext&pid=S0103-21002016000600664&lng=pt&tlng=pt
• Dias CC, Figueiredo B. Breastfeeding and depression: A systematic review of the literature. J Affect Disord [Internet]. 2015 Jan;171:142– 54. Available from: https://linkinghub.elsevier.com/retrieve/pii/ S016503271400576X
• Borra C, Iacovou M, Sevilla A. New Evidence on Breastfeeding and Postpartum Depression: The Importance of Understanding Women’s Intentions. Matern Child Health J [Internet]. 2015 Apr 21;19(4):897–907. Available from: http://link.springer.com/10.1007/s10995-014-1591-z
• Tavoulari E-F, Benetou V, Vlastarakos P V, Psaltopoulou T, Chrousos G, Kreatsas G, et al. Factors affecting breastfeeding duration in Greece: What is important? World J Clin Pediatr [Internet]. 2016;5(3):349-57. Available from: http://www.wjgnet.com/2219-2808/full/v5/i3/349.htm
• Didarloo A, Rahmatnezhad L, Sheikhi S, Khodai F. Relationship of spiritual health and perceived stress with breastfeeding self-efficacy: A survey on mothers with hospitalized neonates. Int J Pediatr. 2017;5(12):6179–88.
• Mercan Y, Tari Selcuk K. Association between postpartum depression level, social support level and breastfeeding attitude and breastfeeding self-efficacy in early postpartum women. PLoS One [Internet]. 2021 Apr 2;16(4):e0249538. Available from: https://dx.plos.org/10.1371/journal. pone.0249538