1. Knowledge and practices of mothers regarding exclusive breastfeeding in the Mahwelereng local area of Limpopo Province in South Africa
Frans R.A, Malema R.N & Sogo. F. Matlala
Department of Public Health, University of Limpopo, South Africa
Second World Breastfeeding Conference 2016
Birchwood Hotel and Conference Centre, South Africa
11 – 14 December 2016

2. Child Rights Awareness Creation Organisation (CRACO)
Introduction
Exclusive breastfeeding (EBF) is a practice where a baby receives only breast milk, not even water. Oral rehydration solution (ORS), or drops/syrups of vitamins, minerals or medicines may be given (WHO 2016).
Breastfeeding has many health benefits for both the mother and infant
In South Africa, all pregnant women attending ANC are given information on EBF.
Information on breastfeeding including EBF is given to the public through various means.
Child Rights Awareness Creation Organisation (CRACO)

3. Child Rights Awareness Creation Organisation (CRACO)
Research Problem
Observed that some mothers appeared reluctant to exclusively breastfeed their babies for 6 months after delivery.
Appeared to think that it was not possible to breastfeed their babies exclusively for 6 months as the babies would starve.
This is concerning as it was expected that pregnant women should have made up their minds about their feeding choices by the time they were admitted for delivery.
Child Rights Awareness Creation Organisation (CRACO)

4. Aim and Objectives
The aim of this study was to determine the knowledge and practices of mothers regarding to exclusive breastfeeding for six months.
The objectives were:
To determine socio-demographic profile
To determine EBF knowledge
To determine EBF practices
To determine association between demographic profile and knowledge & practices

5. Study site
The study was conducted in the Mahwelereng Local Area in the Waterberg District of the Limpopo Province in South Africa.
The area is made up of a mixture of rural villages, semi-urban areas & an urban area (Mokopane town).
There were six PHC clinics & two hospitals all of which were run by the government in the local area.
There were also several private health practitioners in the area charging user fees for health services, which included maternal & child health.

6. Population and Sampling
The population of the study were all mothers who consulted at the 6 PHC clinics & who had babies 6 months old or younger at the time of the study.
A total number of 327 mothers met the inclusion criteria & a simple random sampling method was used
Mothers were approached while sitting in the waiting areas at each of the 6 PHC clinics to establish whether they met the criteria for inclusion in the study.
Those meeting the criteria were allocated numbers that were then written on square pieces of paper.
Random drawing or the hat method was used where the numbered pieces of paper were placed in a container.
Members of the research team then mixed the pieces of paper thoroughly followed by withdrawing of numbered pieces of paper until the desired sample size of 175 mothers was reached, as suggested by Brink (2009).
Krejcie and Morgan’s (1970) table was used to determine the sample size.

7. Data collection
A researcher-administered questionnaire adapted from Tan (2011) was used to collect data.
It had 5 sections namely: demographic data, medical history, feeding practices, knowledge on exclusive breastfeeding & challenges regarding the practice of exclusive breastfeeding.
The questionnaire was translated from English to Northern Sotho which is the local language
A pilot study with 10 respondents was conducted at one PHC clinic that was not part of the PHC clinics selected for the main study.
A question about the challenges faced by mothers who were practicing exclusive breastfeeding was added to the questionnaire after the pilot study.
Research ethics were observed: consent, permission, etc.

8. Data analysis
The questionnaires were manually numbered & grouped according to clinics to ensure that no questionnaire data were captured more than once.
Data were then captured on a Microsoft Excel spreadsheet before being transferred to the Statistical Package for Social Sciences (SPSS) software programme, version 21, for analysis.
Frequency distribution, percentages and Chi-Square were used to analyse data with the assistance of a statistician.

9. The person who cares for the baby most of the time
61.7% were taking care of their babies by themselves
29.7% of babies cared for by family members.
6.3% of the babies were cared for by babysitters
2.3% of the babies were cared for outside the family at a day-care centre.
Child Rights Awareness Creation Organisation (CRACO)

10. ANC attendance & HIV Testing
Almost all the respondents (98.9%) had attended ANC during pregnancy whilst only 1.1% did not attend.
89.1% attended ANC 4 times & more, while 9.7% attended 2 or 3 times.
All the respondents indicated that they had tested for HIV and 68.6% tested HIV-negative while about a third (31.4%) had tested HIV- positive.
Child Rights Awareness Creation Organisation (CRACO)

11. Counselling on feeding practices
The majority (85.7%) of the respondents were counselled on feeding practices & only 14.3% were not counselled.
About 42.3% were exclusively breastfeeding their babies for 6 months, 48.6% mothers were mix-feeding their babies while only 9.1% were feeding their babies with formula.
The majority of mothers who were practising exclusive breastfeeding did so for less than 6 months (97.3%) as compared to only 2.7% who practiced it for 6 months.
On the question of who influenced the choice of the feeding method, 40% were influenced by health workers, 37.7% indicated it was a personal choice while 22.3% were influenced by family members.

12. Age of babies in months
Age of babies in months Frequency Percentage (%) 0 – 1 month – 3 months – 6 months Total

13. Age of mothers in years Age in years Frequency Per cent (%)
Total

14. Marital status of respondents
Marital status Frequency Percentage (%)
Single
Married
Total

15. Level of education Educational level Frequency Percentage (%)
Never been to school
Primary (Grade1 – Grade 7)
Secondary (Grade 8 – Grade 12)
Tertiary
Total

16. Duration of exclusive breastfeeding
42.3% were exclusively breastfeeding, 48.6% were mix-feeding, while 9.1% were feeding formula milk
Duration of breastfeeding Frequency Percentage (%)
Less than 6 months
6 months
Total

17. Time when the mothers started breastfeeding their babies
The majority, 95.4% started feeding their babies immediately after birth
2.9% started a day or more after birth,
1.7% started between 3 & 24 hours after birth
The majority, 84.9% breastfed their babies more than 6 times a day (on demand)
15.1% of them breastfed 6 times or less a day
About 3% delivered outside of the health care services

18. Who influenced the mothers’ choice of feeds
Family, 22.3
Personal choice, 37.7
Health workers (Nurses/Doctors), 40.0

19. Knowledge of EBF
Those who received information on exclusive breastfeeding were more, (78.3%) than those (21.7%) who did not receive any information on exclusive breastfeeding.
More than three quarters, (76%) knew what exclusive breastfeeding was,
18.9% said it was mixing breast milk & water,
Whilst 5.1% believed that it was giving the baby breast & a combination of milk, porridge & water
56.6% of mothers were knowledgeable about exclusive breastfeeding, 14.3% were not sure of what it referred to while 29.1% did not have knowledge on exclusive breastfeeding.

20. Challenges that prevented mothers from exclusively breastfeeding
18.9% were experiencing work related challenges that prevented them from exclusively breastfeeding for 6 months,
13.7% reported health related issues,
11.4% were experiencing family pressure to mix-feed,
17.4% indicated school related challenges,
5.7% reported lack of knowledge,
42.9% said they had no challenges that hindered them from exclusively breastfeeding

21. Association between variables
There was an association between being married & having knowledge about exclusive breastfeeding.
There was an association between having knowledge about exclusive breastfeeding & feeding practice.
Child Rights Awareness Creation Organisation (CRACO)

22. Recommendations
Pregnant women should be encouraged to attend ANC & health professionals should be trained on exclusive breastfeeding in order to intensify counselling.
Expressing breast milk by mothers should be emphasised to ensure that exclusive breastfeeding is maintained even in the absence of the mother while carers are taught how to store it, when & how to feed the baby.
One-on-one counselling on exclusive breastfeeding during each antenatal visit is recommended in addition to group counselling to ensure a thorough understanding of the importance of exclusive breastfeeding.
Maternity leave for employed mothers should be extended to 6 months in order to ensure that mothers exclusively breastfeed for the recommended 6months.

23. Thank you