Attitudes and practice of Turkish mothers with babies between 0-24 months regarding infant nutrition: the Iowa Infant Feeding Attitude Scale

ESKICI, Günay; KARAHAN YILMAZ, Sevil

doi:10.1590/1678-9865202134e210097

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ORIGINAL • Rev Nutr 35 • 2022 • https://doi.org/10.1590/1678-9865202134e210097 copy

Attitudes and practice of Turkish mothers with babies between 0-24 months regarding infant nutrition: the Iowa Infant Feeding Attitude Scale

Atitudes e aplicações de mães turcas sobre a nutrição do bebê entre 0-24 meses: Iowa Nutrição do Bebê Atitude

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

This study aims to evaluate the behaviors and attitudes of mothers with 0-24-month-old babies towards infant feeding, depending on their sociodemographic characteristics.

Methods

This is a cross-sectional study, which was carried out with 300 mothers. Demographic characteristics of the mothers, breastfeeding and complementary feeding practices, and the Iowa Infant Feeding Attitude Scale were collected. As for the statistical evaluation, Statistical Package for the Social Sciences version 22 statistical package program was used. For the statistical analysis; percentages, mean values, Independent T-Test, One-Way ANOVA, Chi-Square test, and multinomial regression models analysis were used.

Results

79.7% of the mothers gave human milk to their infants as the first food after delivery, 36.9% gave only human milk for the first 6 months, 52.0% started complementary feeding at 4-6 months. Of the mothers with a mean The Iowa Infant Feeding Attitude Scale score of 64.38±8.43, 54.0% were positive towards breastfeeding. A significant relationship was found between education and income levels and Iowa Infant Feeding Attitude Scale scores level of the mothers, respectively (χ²=10.001, χ²=10.421, p<0.05). The mothers with a postgraduate degree as educational status (AOR=1.27, 95%CI:1.06-1.53) and mothers who had more income than expenditures (AOR=1.19, 95%CI:1.03-1.63) were associated with a higher positive towards of breastfeeding.

Conclusion

Although most of the mothers say that they have a positive attitude towards breastfeeding, the rate of those who only breastfeed for the first 6 months is low. As the education and income level of mothers increase, their positive attitude towards breastfeeding increases. Mothers should be informed to initiate and maintain successful breastfeeding.

Keywords
Breastfeeding; Complementary feeding; Human milk; Infant

Variables		n	%	IIFAS Score X	SD	p
Age^b b One-Way ANOVA. IIFAS: Iowa Infant Feeding Attitude Scale.
	19-24	93	31.0	65.24	13.85	0.802
	25-34	133	44.3	63.80	17.15
	≥35	74	24.7	64.38	16.04
Educational Status^b b One-Way ANOVA. IIFAS: Iowa Infant Feeding Attitude Scale.
	Primary school	69	23.0	62.34	14.92	0.037^* * p<0.05.
	High/Secondary school	167	52.4	62.45	19.40
	Faculty	44	14.6	64.87	15.01
	Postgraduate	30	10.0	67.87	13.02
Employment Status^a a Independent T-Test;
	Employment	66	22.0	65.78	14.33	0.434
	Not employment	234	78.0	63.81	16.43
Income level^b b One-Way ANOVA. IIFAS: Iowa Infant Feeding Attitude Scale.
	Less income than expenditures	57	19.0	64.61	16.72	0.023^* * p<0.05.
	Equal income and expenditure	213	71.0	64.21	14.82
	More Income than Expenditures	30	10.0	69.16	16.71
The number of children^b b One-Way ANOVA. IIFAS: Iowa Infant Feeding Attitude Scale.
	1	114	38.0	64.50	14.18	0.056
	2	116	38.7	65.42	17.07
	≥3	70	23.3	67.23	13.58
Family type^a a Independent T-Test;
	Nuclear Family	223	74.3	64.61	17.63	0.672
	Extended Family	77	25.7	63.71	17.00

Variables	Strong Disagreement		Disagreement		Neutral		Agreement		Strong Agreement
Variables	n	%	n	%	n	%	n	%	n	%
1. The nutritional benefits of breast milk last only until the baby is weaned from breast milk.	65	21.6	34	11.3	56	18.6	87	29.0	58	19.5
2. Formula-feeding is more convenient than breast-feeding.	102	34.0	86	28.6	32	10.6	45	15.0	35	11.8
3. Breastfeeding increases mother-infant bonding.	7	02.3	6	02.0	12	04.0	45	15.0	230	76.6
4. Breast milk is lacking in iron.	108	36.0	45	15.0	80	26.6	24	08.0	43	14.4
5. Formula-fed babies are more likely to be overfed than are breastfed babies.	28	09.3	56	18.6	67	22.3	104	34.8	45	15.0
6. Formula-feeding is the better choice if a mother plans to work outside the home.	110	36.6	85	28.3	70	23.3	25	08.3	10	03.5
7. Mothers who formula-feed miss one of the great joys of motherhood.	42	14.0	68	22.6	37	12.3	55	18.3	98	18.8
8. Women should not breastfeed in public places such as restaurants.	108	36.0	72	24.0	65	21.6	35	11.4	20	07.0
9. Babies fed breast milk are healthier than babies who are fed formula.	167	55.5	56	18.6	29	09.6	28	09.3	20	07.0
10. Breastfed babies are more likely to be overfed than formula-fed babies.	32	10.7	43	14.3	60	20.0	123	41.0	42	14.0
11. Fathers feel left out if a mother breastfeeds.	112	37.2	106	35.3	48	16.0	24	8.0	10	03.5
12. Breast milk is the ideal food for babies.	12	04.1	13	04.3	16	05.3	76	25.3	183	61.0
13. Breast milk is more easily digested than formula.	5	01.8	15	05.0	16	05.3	88	29.3	176	58.6
14. Formula is as healthy for an infant as breast milk.	145	48.3	103	34.3	38	12.6	4	01.9	10	03.5
15. Breastfeeding is more convenient than formula feeding.	220	73.3	38	12.6	12	04.0	16	05.3	14	04.8
16. Breast milk is less expensive than formula.	8	02.8	12	04.0	17	05.6	76	25.3	187	62.3
17. A mother who occasionally drinks alcohol should not breastfeed her baby.	90	30.0	87	29.0	75	25.0	28	09.3	20	06.7
Mean IIFAS scores X±SD: 64.38±16.04

Practices		n	%
The first food is given to the infant after birth
	Human milk	239	79.7
	Formula	61	20.3
Infant’s first breastfeeding
	First 1 Hour	132	44.0
	Between 1-6 hours	115	38.3
	Between 7-24 hours	44	14.7
	Not remembered	9	03.0
Frequency of breastfeeding
	Between 1-2 hours	195	65.0
	Between 3-4 hours	74	24.7
	≥5 hours	4	01.3
	Every time the infant wants	27	09.0
Duration of breastfeeding
	<5 minutes	4	01.3
	5 minutes	8	02.6
	Between 6-10 minutes	105	35.1
	Between 11-15 minutes	69	23.0
	>15 minutes	114	38.0
Duration of exclusive breastfeeding
	Between 0-1 month	59	19.7
	Between 2-3 months	47	15.7
	Between 4-5 months	83	27.7
	≥6 months	111	36.9
The total duration of breastfeeding
	<1 months	12	04.0
	Between 1-3 months	85	28.3
	Between 4-6 months	46	15.3
	Between 6-12 months	106	35.3
	Between 12-18 months	30	10.0
	Between 18-24 months	21	07.1
Timely introduction of complementary feeding (months)
	Between 0-3 months	128	42.7
	Between 4-6 months	156	52.0
	≥7 months	16	5.3
Fist complementary food^* * Complementary food starter. (n=208)
	Vegetables	12	05.8
	Yogurt	72	34.6
	Fruits	35	16.8
	Soup	23	11.1
	Custard	5	02.4
	Cow milk	10	04.8
	Formula	49	24.5

IIFAS scores level
	Variables	Positive towards breastfeeding		Neutral		Positive towards formula feeding		Total		χ²	p
	Variables	n	%	n	%	n	%	n	%	χ²	p
General distribution		162	54.0	94	31.3	44	14.7	300	100
Age (year)
	19-24	47	29.0	36	38.3	10	22.7	93	31.0	06.951	0.138
	25-34	77	47.5	32	34.0	24	54.6	133	44.3
	≥35	38	23.5	26	27.7	10	22.7	74	24.7
Educational Status
	Primary school	30	18.5	29	30.8	10	22.7	69	23.0	10.001	0.016^* * Pearson Chi-square test (p<0.05). IIFAS: Iowa Infant Feeding Attitude Scale.
	High/Secondary school	100	61.7	44	46.8	23	52.3	167	52.4
	Faculty	23	14.1	13	13.8	8	18.2	44	14.6
	Postgraduate	19	05.7	8	8.6	3	06.8	30	10.0
Employment Status
	Employment	38	23.4	22	23.9	6	13.6	66	22.0	02.425	0.658
	Not employment	124	76.6	72	76.1	38	86.4	234	78.0
Income level
	Less ıncome than expenditures	18	11.1	7	7.4	5	11.4	30	19.0	10.421	0.041^* * Pearson Chi-square test (p<0.05). IIFAS: Iowa Infant Feeding Attitude Scale.
	Equal ıncome and expenditure	114	70.4	67	71.3	32	72.7	213	71.0
	More ıncome than expenditures	30	18.5	20	21.3	7	15.9	57	10.0
The number of children
	1	53	32.7	37	39.3	24	54.6	114	38.0
	2	71	43.8	35	37.2	10	22.7	116	38.7	11.756	0.302
	≥3	38	23.5	22	23.5	10	22.7	70	23.3
Family type
	Nuclear Family	121	74.7	72	76.1	30	68.2	223	74.3	01.136	0.567
	Extended Family	41	25.3	22	23.9	14	31.8	77	25.7

Variables		IIFAS scores level
Variables		AOR	95% CI
Age (year)
	19-24	1.00
	25-34	0.85	0.63-1.80
	≥ 35	0.93	0.61-1.98
Educational Status
	Primary school	1.00
	High/Secondary school	1.18	1.11-1.59
	Faculty	1.13	1.07-1.54
	Postgraduate	1.27	1.06-1.53^* * p<0.05. AOR: Adjusted Odds Ratio.
Employment Status
	Employment	1.00
	Not employment	0.98	0.69-1.48
Income level
	Less ıncome than expenditures	1.00
	Equal ıncome and expenditure	1.04	0.89-1.38
	More ıncome than expenditures	1.19	1.03-1.63^* * p<0.05. AOR: Adjusted Odds Ratio.
The number of children
	1	1.00
	2	1.09	0.87-1.36
	≥3	1.08	0.86-1.35
Family type
	Nuclear Family	1.00
	Extended Family	0.65	0.39-1.28

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[1] Correpondence to: G ESKICI. E-mail: gunayeskici@comu.edu.tr.