Impact of attitude and knowledge on intention to breastfeed: Can mHealth based education influence decision to breastfeed exclusively?

Abstract

Background: Exclusive breastfeeding has been endorsed as the healthiest feeding choice for newborns. This study aims to assess impact of expecting mothers' knowledge and attitude toward intention to breastfeed exclusively. Utilizing mobile health (mHealth) as educational tool can offer a widely distributed and affordable platform to promote exclusive breastfeeding.

Research aims and questions: This study aims to assess impact of expecting mothers' knowledge, attitude and beliefs on decision to breastfeed exclusively. Furthermore, it purposes mobile health (mHealth) as educational tool offering a widely distributed, affordable and accessible platform to promote exclusive breastfeeding.

Methods: The study was conducted in prenatal clinics' waiting areas to interview expecting mothers utilizing a translated version of Infant Feeding Practices Survey II (IFPS II, CDC). After completing the survey, an educational video was shown utilizing a tablet and the question was re-asked about intention toward breastfeeding exclusively.

Results: Most expecting mothers indicated having some awareness about breastfeeding (67%) but only 46.1% intended to initiate exclusive breastfeeding early in life prior to the intervention. Moreover, only 53.7% believed breastfeeding is the best nutritional choice. Actually, 39.5% of participants considered breastfeeding equal to formula. Most working mothers complained of lack of workplace support to breastfeed. Also, they were not comfortable breastfeeding in front of others except spouse. Additionally, most participants found nurses and media as poor information resources. Resources utilizing social media and Internet were found useful. After watching the educational video, the majority expressed positive intention to breastfeed exclusively (80.8%). Positive intentions were associated with advance maternal age, prior breastfeeding knowledge and willingness to hear experts' opinions.

Conclusion: Saudi women have limited knowledge about exclusive breastfeeding and early initiation. They feel unprepared, unsupported, lack resources and socially challenged. An educational material utilizing mHealth can alter intentions to breastfeed exclusively.

Fig. 1

Despite a big proportion of expecting mothers perceived breast milk is equal to formula, the majority of participants showed good awareness of breastfeeding health benefits to their babies.

Fig. 2

Prior to being exposed to mHealth based educational video, 47.3% of participating expecting mothers intended to use mixed feeding while 46.1% anticipated exclusive breastfeeding. Among all participants, 4.9% had not made a decision on their babies nutrition with 1.6% planned to use formula.

Fig. 3

Intentions to breastfeed exclusively grow parallel to age and reached a maximum mean score of 26 out of 30 total for those older than 30 years old.

Fig. 4

mHealth based education augmented and altered intentions toward exclusive breastfeeding mainly in those were in its favor or planned mixed feeding. Although it helped in formulate a decision among formula and undecided groups toward exclusive breastfeeding, the findings were not statistically significant.