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Context: Tribal population is vulnerable to all inequities of the society and less penetrated by the service providers. Breastfeeding, 0–23 months old children is important for their development and is boon for their health. Objective: The objective of this study is to estimate the prevalence of optimal breastfeeding practices (OBFs) and elicit its predictors. Materials and Methods: This descriptive cross-sectional study was conducted in the tribal area of Sunderbans, West Bengal, among mothers having children 0–23 months of age, from May 2021 to September 2021. Participants were selected by the cluster sampling technique. OBFs were assessed by initiation of breastfeeding within 1 h of birth, exclusive breastfeeding till 6 months of age, and continuation of breastfeeding along with complementary feed till 23 months of age. Iowa Infant Feeding Attitude Scale was administered to assess attitude toward breastfeeding. Statistical analysis was done using multivariable logistic regression. Results: The mean age of the study participants was 24.8 ± 4.1 years. Early initiation of breastfeeding was done by 76.5% of the participants, but continuation beyond 6 months of age by 70.9%. OBFs were shown by 25.5% of the participants, which has a significant association with the knowledge about the breastfeeding practices (adjusted odds ratio [aOR]: 2.14; 95% confidence interval [CI]: 1.52–3.01) and maternal education (aOR: 3.78; 95% CI: 1.17–12.17). Conclusion: This study showed that only one-fourth of the participants have OBFs. This situation must be addressed with imparting proper knowledge about the importance of breastfeeding. Support group of women in the community should be formulated to aid mothers in continuation of breastfeeding.

Objectives: Breastfeeding is important to infant health and survival in sub-Saharan Africa. To promote breastfeeding effectively, understanding of psychological factors associated with infant feeding choices is required. This study investigated breastfeeding attitudes and health locus of control (HLoC) in a Nigerian community sample. Methods: Men and women (N = 400) (71% female; mean age 34.2 years/ range 18–86 years) were recruited through community groups in Nigeria. Self-report survey by questionnaire measured breastfeeding attitudes using the Iowa Infant Feeding Attitude Scale (IIFAS) and health locus of control using the Multidimensional Health Locus of Control Scale (MHLoCs). Results Mean: IIFAS scores (mean = 57.7; sd = 7.8) became less favourable with increasing age (p = 0.02). Men had higher IIFAS scores (mean = 58.6; sd = 7.6) than women (mean = 56.6; sd = 8.0) indicating more favourable attitudes toward breastfeeding (p = 0.02). Women scored higher than men on external chance HLoC (ECHLoC) (p = 0.003) and external powerful others HLoC (EPHLoC) (p = 0.02). Increasing age was associated with higher scores on ECHLoC (p < 0.01) and EPHLoC (p < 0.01). Multiple linear regression analysis was significant (p < 0.001) and explained 7.8% of variance in breastfeeding attitude. Lower IIFAS scores, reflecting more negative attitudes to breastfeeding, were associated with higher ECHLoC (p < 0.01) and EPOHLoC (p < 0.05). Higher IIFAS scores, reflecting more positive attitudes to breastfeeding, were associated with greater IHLoC (p < 0.01). Neither age nor gender were associated with IIFAS scores in the final model. Conclusions: This implies a need to explore health locus of control when promoting positive attitudes to breastfeeding and supporting families in breastfeeding advocacy. [ABSTRACT FROM AUTHOR]

Tribal population is vulnerable to all inequities of the society and less penetrated by the service providers. Breastfeeding, 0--23 months old children is important for their development and is boon for their health. Objective: The objective of this study is to estimate the prevalence of optimal breastfeeding practices (OBFs) and elicit its predictors. Materials and Methods: This descriptive cross-sectional study was conducted in the tribal area of Sunderbans, West Bengal, among mothers having children 0--23 months of age, from May 2021 to September 2021. Participants were selected by the cluster sampling technique. OBFs were assessed by initiation of breastfeeding within 1 h of birth, exclusive breastfeeding till 6 months of age, and continuation of breastfeeding along with complementary feed till 23 months of age. Iowa Infant Feeding Attitude Scale was administered to assess attitude toward breastfeeding. Statistical analysis was done using multivariable logistic regression. Results: The mean age of the study participants was 24.8 ± 4.1 years. Early initiation of breastfeeding was done by 76.5% of the participants, but continuation beyond 6 months of age by 70.9%. OBFs were shown by 25.5% of the participants, which has a significant association with the knowledge about the breastfeeding practices (adjusted odds ratio [aOR]: 2.14; 95% confidence interval [CI]: 1.52--3.01) and maternal education (aOR: 3.78; 95% CI: 1.17--12.17). Conclusion: This study showed that only one-fourth of the participants have OBFs. This situation must be addressed with imparting proper knowledge about the importance of breastfeeding. Support group of women in the community should be formulated to aid mothers in continuation of breastfeeding. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding (BF) is the cornerstone of infant and young child survival, nutrition, development and maternal health. Covid-19 pandemic has led to fears, anxiety and psychological stress among postnatal mothers that can potentially affect their practices and attitude towards BF Objectives: To assess the knowledge, practices and attitude towards BF and the knowledge and practice towards respiratory hygiene among Covid-19 positive postnatal mothers. Method: A descriptive cross-sectional study was done on Covid-19 positive postnatal mothers admitted To McGann District Teaching Hospital, Shimoga, India, between April 2020 and September 2020. A pre-tested semi-structured questionnaire was used for data collection. Iowa Infant Feeding Attitude Scale (UFAS) was used to assess the attitude towards BF. Results: Among study participants, 90.7% were aware of the duration of exclusive breast feeding (EBF). Practice of EBF and initiation of complementary feeding at 6 months was done by 73.3% and 84% respectively; 74.7%, 84.7% and 84.7% of mothers had knowledge of continued BF till the age of 2 years, wearing mask during BF and washing hands with soap before and after touching the baby respectively. Respiratory hygiene was practiced by 58%; 100% of mothers agreed BF was less expensive than formula feeding; 34.7% mothers opined that nutritional benefit of the milk last only until the baby is weaned from breast milk. Statistically significant difference (p=0.008) was noted between low income and better attitude score. Average score of UFAS (60.08+5.76) lay in the range of neutral attitude towards BF. Conclusions: The present study demonstrated the neutral attitude towards BF among Covid-19 positive postnatal mothers. It also demonstrated a gap between knowledge and practice of good respiratory hygiene. An overview of COVID-19 infection during Pregnancy in a tertaiary care centre. [ABSTRACT FROM AUTHOR]

Objective We will clarify the factors that determine the intention of breastfeeding based on the theory of planned behavior including the Japanese version of IIFAS. Subjects and Methods The subjects were women in the third trimester of pregnancy who were visiting maternity hospitals or clinics in Akita Prefecture. A self-administered, anonymous survey conducted by mail included 16 IIFAS items, measuring the intention to breastfeed along with the knowledge and attitudes toward nursing and lactation: 3 items on subjective norms; 4 items on behavioral control; and 12 items on the subjects' attributes. Results Effective responses were obtained from 285 women (52.9% response rate) whose mean age was 31.3 (±4.6) years. There were 157 primiparous women (55.1%) and 128 multiparous women (44.9%). The mean IIFAS score was 58.4 (±5.9). Measuring the level of intention, the 15 women (5.3%) who said they "definitely want to breastfeed" scored 63.7. Furthermore, 181 women (63.7%) who said they "want to breastfeed if possible" scored 59.1, 15 women (5.3%) who said "either is acceptable" scored 54.7, 68 women (23.9%) who said they "want to use mixed feeding" scored 56.1, and 5 women (1.8%) who said "want to use milk substitutes" scored 57.2. In intergroup comparisons, the women who chose breastfeeding had significantly higher scores. When the women were divided based on those who wanted to breastfeed and those who preferred other options, the former group scored higher on the IIFAS, subjective regulation, and behavioral control. Choosing to breastfeed also significantly correlated with higher education, being a health care professional, not being self-employed, having a family business, or working for wages, receiving maternal counseling, having breastfed in the past, and the satisfaction with past nursing methods. A logistic regression analysis proved that the IIFAS correlated with the intention to breastfeed ( p<.001). Conclusion The intention to breastfeed could be explained by the theory of planned behavior. In order to support the willingness to breastfeed, midwives should not only use IIFAS to understand their own perceptions and values of breastfeeding, but also understand the employment situation and past breastfeeding experience for multiparous women. Needs individual support. [ABSTRACT FROM AUTHOR]

Background: The provision of human milk and breastfeeding is essential in the neonatal intensive care unit (NICU) population. However, recent national research has demonstrated very low percentages of NICU nurses providing lactation-based support and care to patients and families, and less than half of all NICUs have an International Board Certified Lactation Consultant (IBCLC) on staff.Purpose: The purpose of this study was to describe how NICU bedside nurses are providing lactation-based support and care during their shifts and the frequency of that support. The secondary aim was to gain an understanding of the NICU nurses' attitudes toward human milk and breastfeeding.Methods: Through a prospective descriptive cohort design, the authors of this study created and disseminated a web-based survey (SurveyMonkey) of 21 questions including the Iowa Infant Feeding Attitude Scale (IIFAS) to a Northeastern urban hospital staff of bedside nurses.Results: A total of 140 of the 389 eligible NICU bedside nurses responded to the survey. Between 50.7% and 72.9% of nurses reported to providing lactation-based support and care during the previous shift worked and during the previous week worked, respectively. The participants' responses to the IIFAS resulted in an overall score of 69.1, indicating an attitude of "positive to breastfeeding."Implications For Practice: The study demonstrates that the majority provide lactation-based support and care on every shift and hold very positive attitudes toward the provision of human milk and breastfeeding. Hospitals should be encouraged to promote educational and training programs in their respective institutions.Implications For Research: Researchers should examine NICU nurses' attitudes and beliefs about human milk and breastfeeding on a national scale. [ABSTRACT FROM AUTHOR]

Background: The Iowa Infant Feeding Attitude Scale (IIFAS) was developed to measure maternal attitudes toward infant feeding, but a number of validated studies on the IIFAS found that it was subject to methodological limitations. Objective: The purpose of this study was to evaluate the psychometric properties of the IIFAS among a multiethnic population in Singapore. Methods: A cross-sectional research design was used on a sample of 417 antenatal women. The internal consistency and stability of the IIFAS were evaluated using Cronbach’s α and test–retest reliability. Known-group comparisons discriminated certain group differences in a predictable way. A series of exploratory factor analyses (EFAs) was conducted to test the factor structure of the IIFAS using the maximum likelihood and principal axis factoring. The number of factors was selected according to theoretical and statistical considerations. A confirmatory factor analysis (CFA) was further performed to validate the factor structure constructed in the prior EFA. Results: The IIFAS had a Cronbach’s α and Pearson correlation of 0.79 and 0.85, respectively. The known-group comparisons among certain groups were supported. The EFA results showed that the 3-factor structure produced the most interpretable and theoretical sense. A second-order CFA was conducted to confirm the construct dimensionality of the 15-item IIFAS, with satisfactory fit indices found. Conclusion: The 15-item IIFAS is a psychometrically sound measurement tool that health care professionals can use to understand the diverse infant feeding attitudes and knowledge among different ethnic groups in order to provide breastfeeding interventions that are culturally sensitive. [ABSTRACT FROM AUTHOR]

Background There is wide variation in the duration of breastfeeding across Europe which may in part be due to the between-country differences in mothers' and societal attitudes towards breastfeeding in public. The objective of this study was to quantify and compare the maternal attitudes to, and practice of, breastfeeding in public in four European centers and investigate the association with duration of breastfeeding. Methods Participants ( n = 389) were mothers recruited from maternity wards of hospitals in Glasgow (Scotland), Stockholm (Sweden), Granada (Spain), and Reggio-Emilia (Italy). Results Among those who had breastfed, Scottish (adjOR 0.25 [95% CI 0.12-0.50]) and Italian mothers (adjOR 0.30 [95% CI 0.14-0.63]) were significantly less likely than Swedish mothers to have ever breastfed in public. Mothers who had a negative attitude toward breastfeeding in public were less likely to have ever breastfed in public (adjOR 0.05 [95% CI 0.02-0.17]), and those who had never breastfed in public were in turn more likely to discontinue breastfeeding earlier. Conclusions Perceived social norms may exert a stronger influence on breastfeeding outcomes than a woman's breastfeeding attitudes and knowledge. Differences between European countries in the duration of breastfeeding may be explained in part by differences in societal attitudes to breastfeeding in public. [ABSTRACT FROM AUTHOR]

This study aimed to translate and validate a Chinese (simplified) version of the Iowa Infant Feeding Attitude Scale (IIFAS) and compare the infant feeding attitudes of Chinese mothers living in Perth Australia and in Chengdu P.R. China. A survey was undertaken on 200 Chinese mothers living in Perth and 1620 mothers living in Chengdu. The simplified Chinese version of IIFAS had a moderate level of internal consistency with a Cronbach's alpha of 0.69 for mothers in Australia and 0.55 for mothers in China. The mean IIFAS scores in both country groups lay in the range of neutral breastfeeding attitudes'. Higher IIFAS scores were significantly associated with the likelihood of both breastfeeding initiation (OR: 3.85; CI: 2.49-5.96; p<0.001) and longer (≥ 8 months) breastfeeding duration (OR: 2.52; CI: 1.87-3.40; p<0.001). Chinese mothers in Perth (mean IlFAS score=60.0 ± 6.3) tended to have more positive attitudes towards breastfeeding than mothers in Chengdu (mean IIFAS score=57.7 ± 5.1, p<0.001), and had a longer duration of any breastfeeding' (10.0 ± 6.2 months in Perth compared to 7.4 ± 4.3 months in Chengdu, p<0.001). In conclusion, higher scores on the IIFAS in simplified Chinese are associated with breastfeeding initiation and duration in Chinese populations. [ABSTRACT FROM AUTHOR]

This research explores the early infant feeding practice of gypsy and traveller women and their attitudes towards breast and formula feeding in one primary care trust. This research was undertaken using a quantitative research approach. Two structured questionnaires were administered. The first questionnaire was completed by all health visitors employed by the trust. This questionnaire established that most gypsy and traveller women choose to formula feed their infants and the breastfeeding rate in this community is very low. The second questionnaire was completed by 50% of the gypsy and traveller community who met the inclusion criteria. The Iowa Infant Feeding Attitude Scale (IIFAS) was completed as part of this questionnaire. This questionnaire showed that gypsy and traveller women had a more neutral attitude towards early infant feeding than was expected. This is significant as previous research suggests that women with neutral attitude scores are not fixed in their early infant feeding intentions. This therefore implies that the infant feeding practice of these women could potentially be influenced. This study, therefore, concludes that implementing focused interventions aimed at promoting breastfeeding could potentially increase the breastfeeding initiation rate in this community. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine maternal attitudes and sociodemographic variables associated with Taiwanese mothers' continuation of breastfeeding at 6 weeks postpartum. A sample of 140 in-hospital breastfeeding mothers was recruited in Taiwan. Participants completed the Iowa Infant Feeding Attitude Scale (IIFAS) in the hospital prior to discharge. Postdischarge participants were contacted by telephone at 3 and 6 weeks postpartum to obtain information regarding their feeding method and duration. Findings revealed that in-hospital maternal breastfeeding attitudes are predictive of breastfeeding duration. Insufficient milk supply was the reason most often given for discontinuing breastfeeding. Women's husband/partner was found to be the main source of breastfeeding support. We recommend health-care professionals add the IIFAS to their assessment to identify mothers at high risk for discontinuing breastfeeding and to develop and better evaluate breastfeeding promotion programs. [ABSTRACT FROM AUTHOR]

Abstract: Background: To achieve the goal of increasing the proportion and duration of breastfeeding in Taiwan, it is essential to assess the role of attitudes in determining which method of infant feeding will be chosen. Understanding maternal attitudes toward infant feeding methods may have utility in the development and implementation of public health policy and interventions facilitating increasing breastfeeding rates. However, no validated instrument to assess breastfeeding attitudes is available in Chinese for use in Taiwan. Objective: To translate the Iowa Infant Feeding Attitude Scale (IIFAS) into Chinese and assess its psychometric properties among Taiwanese breastfeeding women. Design: Methodological study. Setting: One public hospital in Taichung city, Taiwan. Participants: A convenience sample of 140 in-hospital breastfeeding women was recruited. Methods: The IIFAS was translated into Chinese using forward translation, back-translation, semantic equivalence, and pilot testing. Predict validity and internal consistency was assessed. The final sample consisted of 120 women (14% attrition) that were interviewed by telephone at 6 weeks postpartum to record the breastfeeding duration and infant feeding method. Results: One item was modified to better reflect the item content. In-hospital IIFAS scores significantly predicted breastfeeding duration as well as exclusive breastfeeding at 6 weeks postpartum. The Cronbach''s alpha coefficient for internal consistency was 0.74. Conclusions: This study provides evidence that the Chinese version of the IIFAS can be considered valid and reliable scale for assessing attitudes toward breastfeeding among breastfeeding women in Taiwan. [Copyright &y& Elsevier]

Background: The Iowa Infant Feeding Attitude Scale (IIFAS), which is used for the assessment of attitudes towards breastfeeding, has been found to be reliable and valid in a number of countries, but has not yet been psychometrically tested in Polish women. The purpose of the study was to report on the cultural adaptation of the IIFAS to Polish settings and on its validation, to evaluate the breastfeeding attitudes in Polish women who recently gave birth, and to identify the determinants of these attitudes. Methods: The study was performed in a group of 401 women in their first postpartum days. Results: Cronbach's α for the scale was 0.725. Discriminative power coefficients of all questionnaire items were higher than 0.2. Subscales were strongly correlated with the total score, with a correlation coefficient of 0.803 for the "favorable toward breastfeeding" subscale (p < 0.001), and 0.803 for the "favorable toward formula feeding" subscale (p < 0.05). For the item "A mother who occasionally drinks alcohol should not breastfeed her baby", the factor loading did not reach the criterion value, and so the item was not included in further analyses. The mean IIFAS score was 63.12 (±7.34). Conclusions: The Polish version of the IIFAS is a reliable and appropriate measure of women's attitudes towards infant feeding in Polish settings, with acceptable psychometric properties and construct validity. [ABSTRACT FROM AUTHOR]

Introduction: A modifiable factor related to breastfeeding is breastfeeding attitudes. The Iowa Infant Feeding Attitude Scale (IIFAS) is used to evaluate this factor. Although the breastfeeding rates in Greece are declined there is not available any validated instrument to evaluate infant feeding attitudes., Aim: to determine the psychometric properties of the Greek adaptation of the IIFAS in a sample of pregnant women., Materials and Methods: Pregnant women (N=203) from a University Hospital in Athens, Greece, were administered the Greek version of the IIFAS, while being in hospital, and their infant feeding mode at six months postpartum was recorded by telephone. The reliability of the scale was assessed by using corrected item-total correlations and Cronbach's alpha. Construct validity of the scale was assessed by using confirmatory factor analysis and predictive validity by using t-tests. Multiple linear regression analyses in a stepwise method (p for removal was set at 0.1 and p for entry was set at .05) was performed in order to find variables independently associated with IIFAS total score., Results: The mean IIFAS score was 70.0 (SD=7.6). The corrected item-total correlation ranged from 0.22 to 0.51. Cronbach's alpha was equal to 0.71. The confirmatory factor analysis indicated an adequate fit of the one-factor model. Concerning the predictive validity of IIFAS it was significant for breastfeeding at six months. The mean IIFAS score was significantly greater (p=0.001) for women that had exclusive breastfeeding at six months (mean (SD): 68.4(6.6)) as compared with those that did not (mean (SD): 64.0(7.5)). Higher IIFAS scores were found in older women, with higher educational level and in those that had breastfed children in their social environment., Conclusion: The Greek version of the IIFAS demonstrated satisfying reliability and validity for measuring women's infant feeding attitudes in the Greek context. Also, the results of the present study provide further evidence of the international applicability of the IIFAS., Competing Interests: The authors declare no conflict of interest., (© 2019 Maria Iliadou, Katerina Lykeridou, Panagiotis Prezerakos, Chara Tzavara, Styliani G. Tziaferi.)

The Iowa Infant Feeding Attitude Scale (IIFAS) has been shown to have good psychometric properties for English-speaking populations, but it has not been validated among low-risk pregnant women in Spain. The aim of this study was to assess the reliability and validity of the translated version of the IIFAS in order to examine infant feeding attitudes in Spanish women with an uncomplicated pregnancy. Low-risk expectant women (n = 297) were recruited from eight primary public health care centres in Galicia (Spain). Questionnaires including both socio-demographic and breastfeeding characteristics and items about infant feeding were administered during the third trimester. Participants were contacted by telephone during the postpartum period to obtain information regarding their infant feeding status. Prediction validity and internal consistency were assessed. The translated IIFAS (69.76 ± 7.75), which had good psychometric properties (Cronbach’s alpha = 0.785; area under the curve (AUC) of the receiver operating characteristic (ROC) curve = 0.841, CI95% = 0.735–0.948), showed more positive attitudes towards breastfeeding than towards formula feeding, especially among mothers who intended to exclusively breastfeed. This scale was also useful for inferring the intent to breastfeed and duration of breastfeeding. This study provides evidence that the IIFAS is a reliable and valid tool for assessing infant feeding attitudes in Spanish women with an uncomplicated pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To translate the Iowa Infant Feeding Scale (IIFAS) into Spanish, to test its psychometric properties, and to explore item reduction for the Spanish version., Design: Instrumental study., Setting: Six hospitals in eastern Spain., Participants: A convenience sample of 1,354 pregnant women was recruited., Methods: The IIFAS was translated using forward and back translation. Dimensional structure, internal consistency, and construct validity of the Spanish IIFAS version were assessed. Criteria to improve the reliability of the scale and the predictive power of the items were used to reduce the scale., Results: Statistics on the psychometric properties suggested the need for item reduction. Cronbach's alpha coefficient of the nine-item final version of the Spanish IIFAS (IIFAS-S) was 0.792. The confirmatory factor analysis showed a unidimensional structure. Demographic response patterns and correlations with the IIFAS-S scale provided further evidence of construct validity. Pregnancy IIFAS-S scores significantly predicted breastfeeding rates and exclusivity., Conclusion: The results of this study indicated that the Spanish translation of the IIFAS is a valid and reliable measure of women's attitudes toward breastfeeding., (Copyright © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

Background: The 17-item Iowa Infant Feeding Attitude Scale (IIFAS) has shown good reliability and validity to measure attitudes toward infant feeding in various countries. It is also known to be associated with breastfeeding intention and exclusivity. However, the IIFAS has not been psychometrically tested among Japanese women., Objective: This study aimed to develop the Japanese version of the IIFAS (IIFAS-J) and assess its reliability and validity., Methods: This longitudinal study was conducted with 781 women at 4 hospitals in Japan. The translated IIFAS was administered to participants during their third trimester. Infant feeding status was self-reported at 4 and 12 weeks postpartum using follow-up questionnaires. The predictive validity was determined by examining the association between the IIFAS-J score during pregnancy and infant feeding status at 4 and 12 weeks postpartum., Results: One item was removed after a principal components analysis. Therefore, the IIFAS-J consisted of 16 items. Cronbach's alpha of the IIFAS-J was 0.66. A higher IIFAS-J score during the third trimester was associated with a higher postdischarge exclusive breastfeeding rate at 4 weeks postpartum (B = 0.05; adjusted odds ratio = 1.05; 95% confidence interval, 1.01-1.10)., Conclusion: The 16-item Japanese version of the IIFAS is a reliable and valid scale for measuring maternal infant-feeding attitudes during pregnancy., (© The Author(s) 2014.)

The purpose of this study was to examine maternal attitudes and sociodemographic variables associated with Taiwanese mothers' continuation of breastfeeding at 6 weeks postpartum. A sample of 140 in-hospital breastfeeding mothers was recruited in Taiwan. Participants completed the Iowa Infant Feeding Attitude Scale (IIFAS) in the hospital prior to discharge. Postdischarge participants were contacted by telephone at 3 and 6 weeks postpartum to obtain information regarding their feeding method and duration. Findings revealed that in-hospital maternal breastfeeding attitudes are predictive of breastfeeding duration. Insufficient milk supply was the reason most often given for discontinuing breastfeeding. Women's husband/partner was found to be the main source of breastfeeding support. We recommend health-care professionals add the IIFAS to their assessment to identify mothers at high risk for discontinuing breastfeeding and to develop and better evaluate breastfeeding promotion programs.