title: Predictors of appropriate breastfeeding knowledge among pregnant women in Moshi Urban, Tanzania: a cross-sectional study.
abstract: BACKGROUND
  Knowledge on infant feeding among pregnant women is essential when promoting optimal breastfeeding practices. This study aimed to assess the knowledge of women on optimal breastfeeding during pregnancy and associated factors as well as performance of the health system in reaching women with information on breastfeeding and infant feeding issues.
  
  
  METHODS
  A cross-sectional study was conducted from October 2013 to April 2014 among pregnant women, in their third trimester, attending for routine care at two primary health care facilities in Moshi urban, northern Tanzania.
  
  
  RESULTS
  A total of 536 women were enrolled, with mean age of 25.9 (SD 5.7) years. Only 51% (n= 274) reported to have received counselling on breastfeeding from their healthcare providers during the current pregnancy. More than seven out of ten pregnant women were knowledgeable about key issues regarding appropriate breastfeeding practices: importance of colostrum (95%), time of breastfeeding initiation (71%), exclusive breastfeeding (EBF) (81%), and time of introducing complementary feeding (83%). Receiving counselling on breastfeeding during the current pregnancy (Adjusted Odds Ratio [AOR] 3.7; 95% Confidence Interval [CI]: 2.4, 5.7), having two children (AOR 2.6; 95% CI: 1.5, 4.4), having three or more children (AOR 3.5; 95% CI: 1.8, 6.9) and intention to breastfeed the child exclusively (AOR 3.6; 95% CI: 2.0, 6.5) were significantly associated with appropriate breastfeeding knowledge.
  
  
  CONCLUSIONS
  The health system failed to reach the 49% of women who did not receive counselling on infant feeding. Pregnant women who had received counselling on optimal breastfeeding and women with more than one child were more likely to have knowledge of optimal breastfeeding practices.
authors.affiliation: Better Health for African Mother and Child, Box 8418, Moshi, Tanzania.|Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Tamara H
authors.initials: TH
authors.lastname: Hashim
authors.affiliation: Better Health for African Mother and Child, Box 8418, Moshi, Tanzania.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Melina
authors.initials: M
authors.lastname: Mgongo
authors.affiliation: Ocean Road Cancer Institute, Directorate of Cancer Prevention Services, PO Box 3592, Dar es Salaam, Tanzania.|Kilimanjaro Christian Medical University College (KCMUCo), PO Box 2240, Moshi, Tanzania.
authors.forename: Johnson
authors.initials: J
authors.lastname: Katanga
authors.affiliation: Better Health for African Mother and Child, Box 8418, Moshi, Tanzania.|Division of Gynaecology & Obstetrics, Oslo University Hospital, University of Oslo, Oslo, Norway.
authors.forename: Jacqueline G
authors.initials: JG
authors.lastname: Uriyo
authors.affiliation: Community Health Department, KCMC Hospital, Po Box 3010, Moshi, Tanzania.|Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMU Co), Box 2240, Moshi, Tanzania.
authors.forename: Damian J
authors.initials: DJ
authors.lastname: Damian
authors.affiliation: Division of Gynaecology & Obstetrics, Oslo University Hospital, University of Oslo, Oslo, Norway.
authors.forename: Babill
authors.initials: B
authors.lastname: Stray-Pedersen
authors.affiliation: Division of Gynaecology & Obstetrics, Oslo University Hospital, University of Oslo, Oslo, Norway.
authors.forename: Margareta
authors.initials: M
authors.lastname: Wandel
authors.affiliation: Better Health for African Mother and Child, Box 8418, Moshi, Tanzania.|Community Health Department, KCMC Hospital, Po Box 3010, Moshi, Tanzania.|Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMU Co), Box 2240, Moshi, Tanzania.
authors.forename: Sia E
authors.initials: SE
authors.lastname: Msuya
keywords: Breastfeeding knowledge; Exclusive breastfeeding; Infant feeding; Optimal breastfeeding practices; Predictors; Tanzania