Determinants of Knowledge and Attitude Towards Breastfeeding Using Validated Instruments in Pregnant Women From a Rural Setting in Ethiopia

Abstract BackgroundUnderstanding the important underlying determinants of maternal knowledge and attitude towards breastfeeding guides the development of context-specific interventions aimed at increasing the rates of optimal breastfeeding practices. However, studies that used validated instruments to assess breastfeeding knowledge and attitude are nonexistent in Ethiopia.ObjectiveTo assess the level and determinants of breastfeeding knowledge and attitude using validated instruments in pregnant women who participated in breastfeeding education and support intervention in a rural district in Ethiopia.Methods468 pregnant women in their second or third trimester were interviewed at baseline to assess their knowledge and attitude towards breastfeeding practices using locally adapted and validated instruments. We used the Afan-Oromo versions of the Breastfeeding Knowledge Questionnaire (BFKQ-AO) and the Iowa Infant Feeding Attitude Scale (IIFAS-AO). Breastfeeding knowledge and attitude scores were standardized based on the distribution of the population and multiple linear regression models were fitted to identify the independent determinants knowledge and attitude.Results52.4% of the mothers had a high level of knowledge while 60.9% of the women had a neutral attitude towards breastfeeding. In a multiple linear regression model, the maternal occupation was the only predictor of the overall BFKQ-AO score (0.56 SD; 95% CI, 1.28, 4.59 SD; P=0.009). Age (0.57 SD; 95% CI, 0.24, 0.90 SD; P=0.001), parity (-0.24 SD; 95%CI, -0.47, -0.02SD; P=0.034), antenatal care visits (0.41 SD; 95% CI, (0.07, 0.74 SD; P=0.017) and the BFKQ score (0.08 SD; 95% CI, 0.06, 0.09 SD; P<0.000) were predictors of the IIFAS-AO score.ConclusionsAlthough more than half of the respondents had adequate knowledge about breastfeeding, most women had a neutral attitude towards breastfeeding. Occupation of mothers was an independent predictor of breastfeeding knowledge, whereas age, parity, antenatal care visits, and breastfeeding knowledge score were predictors of breastfeeding attitude. Thus, policymakers and managers should address these factors when planning educational interventions on breastfeeding to improve knowledge and attitude thereby improving breastfeeding practices.