title: Maternal prenatal attitudes and postnatal breast-feeding behaviours in rural Bangladesh.
abstract: OBJECTIVE
  To assess the relationships between maternal breast-feeding intention, attitudes, self-efficacy and knowledge at 7 months' gestation with exclusive or full breast-feeding at 3 months postpartum.
  
  
  METHODS
  Prospective cohort study with structured home interviews during pregnancy and 3 months after delivery.
  
  
  METHODS
  Two rural sub-districts of Kishoreganj district, Bangladesh.
  
  
  METHODS
  Mother-infant dyads.
  
  
  RESULTS
  Over 80 % of 2178 pregnant women intended to exclusively breast-feed (EBF). Maternal positive attitudes, self-efficacy and knowledge about breast-feeding were positively associated with EBF intention (all P<0.05). All mothers except one reported initiating breast-feeding and 99.6 % of children were still breast-fed at 3 months. According to 24 h dietary recalls, we categorized 985 (45.2 %) infants as EBF at 3 months (47.8 % among mothers with EBF intention; 31.7 % among mothers with no EBF intention; P<0.05) and 551 (25.3 %) infants as predominantly breast-fed at 3 months (24.2 % among mothers with EBF intention; 30.8 % among mothers with no EBF intention; P<0.05). Prenatal EBF intention was associated with EBF (OR=1.48, 95 % CI 1.14, 1.91) and with full breast-feeding (OR=1.34, 95 % CI 1.04, 1.72) at age 3 months. EBF at age 3 months was not associated with maternal breast-feeding knowledge, attitudes or self-efficacy.
  
  
  CONCLUSIONS
  Despite widespread expressed maternal EBF intention and universal breast-feeding initiation, prevalence of both exclusive and full breast-feeding at 3 months remains lower than WHO recommendations. EBF intention predicts breast-feeding behaviours, suggesting the importance of prenatal counselling to improve infant feeding behaviours.
authors.affiliation: 1Hubert Department of Global Health,Emory University,Rollins School of Public Health,1518 Clifton Road NE,Mailstop 1518-002-7BB,Atlanta,GA 30322,USA.
authors.forename: Elaine A
authors.initials: EA
authors.lastname: Yu
authors.affiliation: 1Hubert Department of Global Health,Emory University,Rollins School of Public Health,1518 Clifton Road NE,Mailstop 1518-002-7BB,Atlanta,GA 30322,USA.
authors.forename: Joan S
authors.initials: JS
authors.lastname: Thomas
authors.affiliation: 1Hubert Department of Global Health,Emory University,Rollins School of Public Health,1518 Clifton Road NE,Mailstop 1518-002-7BB,Atlanta,GA 30322,USA.
authors.forename: Aatekah
authors.initials: A
authors.lastname: Owais
authors.affiliation: 2CARE USA,Atlanta,GA,USA.
authors.forename: Noor
authors.initials: N
authors.lastname: Tirmizi
authors.affiliation: 3iccdr,b (International Centre for Diarrhoeal Disease Research, Bangladesh),Clinical Sciences Division,Dhaka,Bangladesh.
authors.forename: Asg
authors.initials: A
authors.lastname: Faruque
authors.affiliation: 3iccdr,b (International Centre for Diarrhoeal Disease Research, Bangladesh),Clinical Sciences Division,Dhaka,Bangladesh.
authors.forename: Sumon K
authors.initials: SK
authors.lastname: Das
authors.affiliation: 4CARE Bangladesh,Dhaka,Bangladesh.
authors.forename: Shahed
authors.initials: S
authors.lastname: Rahman
authors.affiliation: 2CARE USA,Atlanta,GA,USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schwartz
authors.affiliation: 1Hubert Department of Global Health,Emory University,Rollins School of Public Health,1518 Clifton Road NE,Mailstop 1518-002-7BB,Atlanta,GA 30322,USA.
authors.forename: Aryeh D
authors.initials: AD
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D033182:Intention; D008875:Middle Aged; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000523:psychology*; D011446:Prospective Studies; D012424:Rural Population; D020377:Self Efficacy; D055815:Young Adult
keywords: Knowledge