Background: Mothers experience significant barriers to breastfeed in public spaces, which could result in a detrimental impact on the World Health Organization’s recommendation of exclusive breastfeeding. Failure to support and accept breastfeeding in public spaces could lead to mixed feeding or even abandonment of breastfeeding. Objective: The current study aimed to identify the knowledge of breastfeeding benefits and perceptions about it among mothers and community members in Alexandra, Gauteng Province, South Africa. Methods: A quantitative, non-experimental descriptive study was deployed using two structured questionnaires, which were distributed among mothers (n=96) and community members (n=96). All 192 questionnaires were completed and returned, although two questionnaires of mothers could not be used due to incompleteness. An excel spread sheet and Statistical Package for Social Sciences version 25 was used to analyze the data. Results: The findings of the current study revealed a positive correlation between the knowledge level about breastfeeding benefits [infants (r=0.45, p≤0.000) and mothers (r=0.29, p≤0.000)] and perceptions in public spaces. Community members and mothers who were knowledgeable regarding breastfeeding benefits exhibited supportive attitudes towards breastfeeding in public spaces. Conclusion: Altogether, the majority of mothers (69%) were comfortable to breastfeed in public spaces, and community members (84%) were supportive. Limited knowledge of breastfeeding benefits was associated with unsupportive attitudes towards breastfeeding in public spaces. Health messages that target these factors are essential to encourage support and acceptance of breastfeeding in public spaces. This could be executed through public education via posters in public spaces and during community health outreaches.
Background Cultural practices are an integral part of childrearing and remain a significant aspect for healthcare professionals to ensure culturally sensitive care, particularly in the neonatal intensive care unit. Objective To synthesise literature on the cultural determinants that can be integrated into care of preterm infants admitted into the neonatal intensive care unit. Methods The current review followed the integrative literature review steps proposed by Lubbe and colleagues. The registration of the review protocol was in PROSPERO. There was a literature search conducted in the EBSCOhost, PubMed, ScienceDirect and Scopus databases using the search string developed in collaboration with the librarian. Three reviewers employed a three-step screening strategy to screen the articles published in English between 2011 and 2021 that focused on culturally sensitive care. The Johns Hopkins Nursing Evidence-Based Practice Evidence critical appraisal toolkit assessed the methodological quality of the articles included at the full-text screening level. Results There were 141 articles retrieved, and 20 included on the full-text screening level; the exclusion of one article was due to a low critical appraisal grade. Four topical themes emerged from 19 articles: spiritual care practices, intragenerational infant-rearing practices, infant physical care practices, and combining treatment practices. Conclusion Overall, the findings indicated that parental cultural beliefs and practices mostly influenced infant-rearing practices, emphasising the significance of integrating cultural practices when rendering healthcare services. The recommendation is that healthcare professionals understand various cultural determinants, mainly those specific to the community they serve, to provide culturally sensitive care.
Background In 2009, the World Health Organization and the United Nations Children’s Fund issued a revised Baby-friendly Hospital Initiative (BFHI) package to encourage all healthcare facilities to promote the advice of exclusive breastfeeding. The scope of the BFHI was expanded to include neonatal units by the Nordic and Quebec Working Group. Aim To determine the level of compliance with the recommendations outlined in the “Baby-friendly Hospital Initiative for neonatal wards” (Neo-BFHI) in the South African neonatal wards. Method In this cross-sectional survey, the sample included neonatal wards (N = 33) from public and private hospital facilities. Using EasyTrial software, the Neo-BFHI self-assessment questionnaire was utilized to collect the data. The data was transferred to MS Excel (version 15.0.5127.1000) and analysed with the Statistical Package for Social Sciences version 24. Results The South African median score for Neo-BFHI compliance was 77. Neonatal wards in public hospitals scored higher (85) than those in private hospitals (73). Neonatal wards in hospitals that were accredited Baby-friendly had higher compliance scores than those without accreditation. The country had the highest compliance scores (100, 90) on Guiding Principle 1 (respect towards mothers) and step 5 (breastfeeding support), respectively. However, it scored low (71, 58) on steps 4 (enhancing kangaroo mother care) and 7 (maternal infant “togetherness”), respectively. Level 1 and 2 care facilities scored significantly higher than level 3. Conclusion Although South Africa successfully implemented the Neo-BFHI recommendations, private hospitals had a smaller number of BFHI-accredited facilities and lower compliance than public hospitals. Strategies should be developed to strengthen and improve BFHI accreditation and compliance, particularly in private hospitals.
Background: Breastfeeding in public spaces remains a challenge for mothers globally. This review aims to synthesise the available published evidence to understand factors that affect breastfeeding in public spaces globally. Methods: The current review was conducted using a systematic review methodology guided by Whittemore and Knafl's integrative literature review steps. The relevant studies were digitally searched on EBSCOhost, Google Scholar, and PubMed databases. The review included literature from 2013 to 2018 to ascertain the factors affecting breastfeeding in public spaces. The screening concerned three rounds, including studying topics, abstract scrutinising, and ultimately checking content. Included studies were critically appraised by two reviewers using the Critical Appraisal Skill Programme checklist. Data were pooled from included studies using a matrix. Finally, the data were synthesised and analysed to identify new themes relevant to the review topic. Results: There were 224 studies retrieved that discussed breastfeeding. However, only six research studies met the inclusion requirements and were subjected to the review procedure. The included studies were reviewed and integrated into four themes: lack of support, sexualisation of breasts, media, and culture. Conclusion: The findings indicated that mothers are unsupported to breastfeed in public spaces, posing a barrier to exclusive breastfeeding. Therefore, the main focus should be on educating community members regarding the advantages of breastfeeding to support, encourage, and promote breastfeeding whenever and wherever inclusive of public spaces.
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