Knowledge Levels of Mothers Regarding Baby Feeding: A Single- Center Experience

Year 2024, , 43 - 48, 07.05.2024

Emel Ekşi Alp , Nafiye Urgancı , Hasan Yanık

https://doi.org/10.26650/jchild.2024.1367183

Abstract

Objective: The acquaintance period with complementary foods is an essential period for infants in terms of the determination of both their development and short- and long-term health conditions. The method of introduction of complementary foods to the infant, the order in which they are introduced, and the repetitive introduction of foods to the infant are vital for determining the eating behavior and food preferences.

Methods: We designed as a single-center, cross sectional, descriptive study. Written and verbal consent was obtained from the mothers, and face-to-face interviews were conducted with the family by the doctors involved in the study. The survey comprised 33 open-ended and closed-ended questions that evaluated the experiences of mothers regarding breastfeeding and complementary feeding.

Results: The mothers of 100 infants presenting to the pediatric emergency department participated in the questionnaire survey. The mean age of the infants was 10.48 ± 6.37 months, and 52% of them were boys. Mothers with an educational level higher than elementary school started breastfeeding after waiting for a longer time (p = 0.03). Mothers with elementary school and secondary school graduate education levels exclusively breastfed their infants for a period over 10 months significantly higher than mothers with undergraduate and postgraduate education level (p = 0.0072, RR = 0.44). Among the participants, 53.1% responded that they used formula milk in baby nutrition.

Conclusions: Mothers’ knowledge levels regarding the duration of exclusive breastfeeding and the timing of transitioning to complementary feeding were insufficient and inversely proportional to their education level. Moreover, the lack of education on the initiation of formula milk, except for medical indications, in our country was striking. Therefore, all physicians, especially pediatricians, should allocate time for explaining the importance of breastfeeding, timing, and diversity of complementary feeding and seek support from the media.

Keywords

Breastfeeding, complementary feeding, feeding knowledge

References

• Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382(9890):427-51. google scholar
• Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, et al. Early childhood development coming of age: science through the life course. Lancet 2017;389(10064):77-90. google scholar
• Nicklaus S. The role of food experiences during early childhood in food pleasure learning. Appetite 2016;104:3-9. google scholar
• Nicklaus S. Children’s acceptance of new foods at weaning. Role of practices of weaning and of food sensory properties. Appetite 2011;57(3):812-5. google scholar
• Maier-Nöth A, Schaal B, Leathwood P, Issanchou S. The lasting influences of early food-related variety experience: A longitudinal study of vegetable acceptance from 5 months to 6 years in two populations. PLoS One 2016;11(3):1-17. google scholar
• Switkowski KM, Gingras V, Rifas-Shiman SL, Oken E. Patterns of complementary feeding behaviors predict diet quality in early childhood. Nutrients 2020;12(3):1-13. google scholar
• Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet 2016;387(10017):475-90. google scholar
• World Health Organization. Report of the expert consultation of the optimal duration of exclusive breastfeeding, Geneva, Switzerland, 28-30 March 2001. World Health Organization. Avaliable from URL: https://apps.who.int/iris/ handle/10665/67219 google scholar
• Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, et al. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2008;46(1):99-110. google scholar
• Fewtrell M, Bronsky J, Campoy C, Domellöf M, Embleton N, Mis NF, et al. Complementary feeding: A position paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) committee on nutrition. J Pediatr Gastroenterol Nutr 2017;64(1):119-32. google scholar
• Castenmiller J, de Henauw S, Hirsch-Ernst KI, Kearney J, Knutsen HK, Maciuk A, et al. Appropriate age range for introduction of complementary feeding into an infant’s diet. EFSA J. 2019:17(9):e05780 google scholar
• Alder EM, Williams FLR, Anderson AS, Forsyth S, Florey C du V, van der Velde P. What influences the timing of the introduction of solid food to infants? Br J Nutr 2004;92(3):527-31. google scholar
• Costantini C, Harris G, Reddy V, Akehurst L, Fasulo A. Introducing Complementary Foods to Infants: Does Age Really Matter? A Look at Feeding Practices in Two European Communities: British and Italian. Child Care Pract 2019;25(3):326-41. google scholar
• Foterek K, Hilbig A, Alexy U. Breast-feeding and weaning practices in the DONALD study: Age and time trends. J Pediatr Gastroenterol Nutr 2014;58(3):361-7. google scholar
• World Health Organization. Infant and young child feeding. World Health Organization Avaliable from URL: https://www.who.int/ news-room/fact-sheets/detail/infant-and-young-child-feeding google scholar
• Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. 2018 Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı ve TÜBİTAK; 2019 Yayın No: NEE-HÜ.19.01 google scholar
• World Health Organization. Caesarean section rates continue to rise, amid growing inequalities in access. World Health Organization Avaliable from URL: https://www.who.int/news/ item/16-06-2021caesarean-section-rates-continue-to-rise-amid-growing-inequalities-in-access google scholar
• Li L, Wan W, Zhu C. Breastfeeding after a cesarean section: A literature review. Midwifery 2021;103:103117. google scholar
• World Health Organization & United Nations Children’s Fund (UNICEF). Global Strategy for Infant and Young Child Feeding. World Health Organization 2003. Avaliable from URL: https:// apps.who.int/iris/handle/10665/42590 google scholar
• World Health Organization. Infant and young child feeding odel chapter for textbooks for medical students and allied health professionals. World Health Organization Avaliable from URL: https://apps.who.int/iris/handle/10665/44117 google scholar
• Gülümser Şişko S, Bağ O, Kondolot M, Nalbantoğlu B, Gökcay G. Breastfeeding and infant nutrition knowledge, attitude, and practices of parents. Turk Arch Pediatr 2022;57(4):441-447. google scholar
• Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century:epidemiology, mechanisms, and lifelong effect. Lancet 2016;387(10017):475-90. google scholar
• UNICEF calls for the narrowing of “breastfeeding gaps” between rich and poor worldwide. WHO. Avaliable from URL: https:// www.unicef.org/eca/press-releases/unicef-calls-narrowing-breastfeedinggaps-between-rich-and-poor-worldwide. google scholar
• Duan Y, Yang Z, Lai J, Yu D, Chang S, Pang X, et al. Exclusive breastfeeding rate and complementary feeding indicators in China: A national representative survey in 2013. Nutrients 2018;10(2):1-9. google scholar Obbagy JE, English TL, Psota YP, Butte NF, Dewey KG, Fox MK, et al. Complementary feeding and bone health: A systematic review. Am J Clin Nutr 2019;109:872-78. google scholar
• Ventura AK, Mennella JA. An Experimental Approach to Study Individual Differences in Infants’ Intake and Satiation Behaviors during Bottle-Feeding. Child Obes 2017;13(1):44-52. google scholar
• Piwoz EG, Huffman SL. The impact of marketing of breast-milk substitutes on WHO-recommended breastfeeding practices. Food Nutr Bull 2015;36(4):373-386. google scholar
• Arikpo D, Edet ES, Chibuzor MT, Odey F, Caldwell DM. Educational interventions for improving primary caregiver complementary feeding practices for children aged 24 months and under. Cochrane Database Syst Rev. 2018;5(5):CD011768. google scholar
• Beauchamp GK, Mennella JA. Early flavor learning and its impact on later feeding behavior. J Pediatr Gastroenterol Nutr 2009;48(1):25-30. google scholar
• Switkowski KM, Gingras V, Rifas-Shiman SL, Oken E. Patterns of complementary feeding behaviors predict diet quality in early childhood. Nutrients 2020;12(3):810. google scholar
• Fewtrell M, Bronsky J, Campoy C, Domellöf M, Embleton N, Fidler Mis N, et al. Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017 ;64(1):119-132. google scholar
• EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA), Castenmiller J, de Henauw S, Hirsch-Ernst K. I., Kearney J., Knutsen H. et al. Appropriate age range for introduction of complementary feeding into an infant’s diet. EFSA J. 2019;17(9):e05780. google scholar