Sociodemographic characteristics
A total of 128 expectant couples participated. About half (46%) of the participants were first-time parents. Almost half (47%) of mothers did not have paid employment, and only one-quarter (26%) of mothers and nearly one- third (30%) of fathers had been educated beyond secondary school. (Table-1).
Table 1 Sociodemographic and economic characteristics of fathers and mothers
Variables
|
Mothers
n=128
|
Fathers
n=128
|
Age (years)
|
Mean (26.8+4.7)
|
Mean (34+7.3)
|
Religion
|
|
|
Orthodox Christian
|
121(94.5%)
|
Other
|
7(5.5%)
|
Educational Status
|
|
|
Primary school
|
39(30.4%)
|
42(32.8%)
|
Secondary school
|
56(43.8%)
|
48(37.5%)
|
Tertiary
|
33(25.8%)
|
38(29.7%)
|
Household income
|
Mean (3629.5+2170.9)
|
Employment
|
|
|
No job
|
60(46.9%)
|
14(10.9%)
|
Own job
|
41(32%)
|
67(53.9%)
|
Employed
|
27(21.1%)
|
47(35.2%)
|
Number of Children
|
|
|
0
|
58(46%)
|
1
|
35(27%)
|
2 and above
|
35(27%)
|
Pregnancy and breastfeeding
Among the 128 expectant couples more than half 56% (n=71) received their first antenatal care (ANC) for the current pregnancy at four to six months of gestation, and 57% (n=73) of them made two or three ANC visits to the health centre. Among the 55% (n=70) of mothers who had previous breastfeeding experience, three-quarters (75%) had breastfed their last baby for more than two years. Almost all (98%) of mothers intended to exclusively breastfeed their babies for the first six months (Table-2).
Table-2: Pregnancy and previous breastfeeding experience of mothers
Variable
|
Frequency (%)
|
Months of pregnancy during first ANC visit
|
|
1st to 3rd months
|
57(44.5)
|
4th to 6th month
|
71(55.5)
|
Place ANC received
|
|
Health center
|
114(89.1)
|
Other
|
14(10.9)
|
ANC service provider for the current pregnancy
|
|
Doctor
|
8(6.3)
|
Midwife
|
80(62.5)
|
Nurse
|
65(50.8)
|
Health officer
|
20(15.6)
|
Health extension worker
|
7(5.5)
|
Number of ANC visits for the current pregnancy
|
|
2-3
|
73(57)
|
4 and above
|
55(43)
|
Have you received breastfeeding information at ANC
|
|
Yes
|
90(70.3)
|
No
|
38(29.7)
|
Do you have previous breastfeeding experience
|
|
Yes
|
70(54)
|
No
|
58(46)
|
How long did you breastfeed your last child
|
|
< 2yrs
|
17(24.6)
|
>= 2yrs
|
52(75.4)
|
Do you have maternity leave (employed mothers)
|
|
Yes
|
25(92.6)
|
No
|
2(7.4)
|
How much maternity leave (employed mothers)
|
|
1 Month
|
1(3.8)
|
3 Months
|
6(26.9)
|
4 Months
|
18(69.3)
|
How do you intend to breastfeed your baby
|
|
Breastmilk
|
125(97.7)
|
Breastmilk + Formula
|
3(2.3)
|
How long should a baby be exclusively breastfed
|
|
6 months
|
101(79.9)
|
Others
|
27(20.1)
|
Up to what age should a baby breastfeed
|
|
Before 2yrs
|
5(3.9)
|
2 yrs and above
|
123(96.1)
|
Breastfeeding knowledge, attitudes, and breastfeeding support of expectant couples
Table-3 presents the mean scores for breastfeeding knowledge, attitudes, and support. There were significant differences between fathers and mothers in the mean score for intention to discuss breastfeeding information (breastfeeding savvy), appreciation, presence during breastfeeding, and responsiveness during breastfeeding. Comparing the intention to provide breastfeeding support, fathers had higher intention scores regarding supporting their partners compared to the mothers’ perception scores of the support their husband would provide (breastfeeding appreciation (p=0.02), presence during breastfeeding (p=0.002), and responsiveness during breastfeeding (p=0.04)) (Table-3). One in five fathers (20%) and 13% of mothers had good breastfeeding knowledge, with scores above 70%. In addition, mothers’ and fathers’ mean attitude scores were favourable towards breastfeeding (Table-4). Table-5 describes the differences in mean scores between multiparous and primiparous mothers in breastfeeding knowledge, attitudes, self-efficacy, and breastfeeding support. Multiparous mothers had better mean scores for breastfeeding savvy, breastfeeding helping, and breastfeeding appreciation perceptions with regard to their partners’ support, but there were no differences in the other variables compared to the primiparous mothers (Table-5).
Fathers intention to support their partners during breastfeeding was positively affected by the BF information they received during ANC (savvy β=4, p<0.005; help β=-2.8, p=0.006; information β=-2.3, p<0.005; presence β=-2.5, p<0.005; responsiveness β=-1.5, p=0.02). A father’s positive BF attitude was also associated with better intention to support their partners prior to delivery (savvy β=0.19, p=0.01; help β=0.18, p<0.005; information β=0.12, p=0.02; presence β=0.2, p=0.006 ).In the case of mothers, BF information during ANC (savvy β=-7.7, p<0.005; help β=-5.4, p<0.005; information β=-3.9, p<0.005; presence β=-3, p<0.005; responsiveness β=-2.9, p<0.005) was associated with their positive perceptions regarding partner support of their breastfeeding. In addition, mother’s previous BF experience (savvy β=-2.8, p=0.03; help β=-2.2, p<0.02; information β=-1.9, p<0.02), and positive BF self-efficacy (savvy β=0.5, p<0.005; help β=0.4, p<0.005; information β=0.3, p<0.005; presence β=0.2, p<0.005; responsiveness β=0.2, p<0.005) were also associated with positive perceptions of their partner ability to support breastfeeding.
Table 3: Breastfeeding knowledge, attitude, and support of expectant couples
Breastfeeding construct
|
Mothers
|
Fathers
|
P-value
|
Knowledge
|
Mean (61.5+14.4)
|
Mean (61.4+17.0)
|
0.66
|
Attitude
|
Mean (62+7.4)
|
Mean (61.4+8.5)
|
0.54
|
Support
|
|
|
|
Savvy
|
Mean (36.4+7.6)
|
Mean (38+8)
|
0.05
|
Helping
|
Mean (29.0 +5.4)
|
Mean (29.0+6.0)
|
0.15
|
Appreciation
|
Mean (24.9+4.9)
|
Mean (26+5.0)
|
0.02
|
Presence
|
Mean (24.4+4.8)
|
Mean (26+4.7)
|
0.002
|
Responsiveness
|
Mean (20+3.9)
|
Mean (21+4.0)
|
0.04
|
Table 4: Comparison of fathers’ and mothers’ knowledge of exclusive breastfeeding
Variables
|
Mothers Frequency (%)
|
Fathers Frequency (%)
|
First food for the newborn is breastmilk
|
125(97.7)
|
126(98.4)
|
Exclusive breastfeeding is giving the child breastmilk for the first 6 months
|
78(60.9)
|
81(63.3)
|
Babies should take only breastmilk for the first 6 months of their life
|
101(78.9)
|
105(82)
|
Breastmilk only is sufficient for the baby’s first 6 months of life
|
64(50)
|
48(37)
|
The baby should be breastfed on demand
|
22(17.2)
|
32(25)
|
Has knowledge on the benefits of exclusive breastfeeding to the baby
|
117(91.4)
|
118(92.2)
|
Exclusive breastfeeding is beneficial to the mother
|
48(37.5)
|
53(41.4)
|
Breastmilk supply can be sustained by having good nutrition/eating well
|
117(91.4)
|
107(83.6)
|
In times of absence the baby can continue to be exclusively breastfed by expressing breastmilk and storing
|
44(34.4)
|
51(39.8)
|
Health personnel can assist in overcoming breastfeeding difficulties
|
71(55.5)
|
61(47.7)
|
Knowledge category indicative of urgent intervention*
Good score (>70%)
|
17(13.3)
|
25(19.5)
|
*According to FAO guideline score <=70% indicates urgent need for nutritional intervention.
Table-5: Mean score difference between multiparous and primiparous mothers
Variables
|
Multiparous
|
Primiparous
|
P-value
|
Attitude
|
63
|
60.8
|
0.09
|
Knowledge
|
67.9
|
60.3
|
0.23
|
Self-efficacy
|
69.6
|
56.3
|
0.08
|
Savvy
|
70.9
|
66.8
|
0.03
|
Help
|
30
|
27.8
|
0.02
|
Appreciation
|
70.1
|
57.6
|
0.05
|
Presence
|
67.8
|
60.4
|
0.25
|
Responsiveness
|
20
|
19
|
0.69
|