Impact of personal and environmental factors affecting exclusive breastfeeding practices in the first six months during the COVID-19 pandemic in Thailand: a mixed-methods approach

Abstract

Background Exclusive breastfeeding (EBF) for six months is recommended as one of the most important ways to support child health and survival, particularly during the COVID-19 pandemic. However, breastfeeding women encountered several obstacles during the pandemic. The purpose of this study was to conduct a survey to document breastfeeding practices, EBF rates and associated factors with six month exclusive breastfeeding during the second wave of the coronavirus outbreak in Thailand. Methods A mixed-methods design that included a cross-sectional survey (n = 390) and semi-structured in-depth interviews (n = 15) was carried out between August and November 2021. Participants were women aged ≥ 15 years who had given birth within 6–12 months before data collection and delivered in three public hospitals in the top three provinces with the most severe COVID-19 outbreaks. Results The median duration of EBF was four months (interquartile range, IQR: 1–6 months) and 37.4% of women exclusively breastfed for six months. From binary logistic regression models, several personal factors were associated with exclusive breastfeeding for six months including being a housewife (AOR 2.848; 95% CI 1.512, 5.367), perceived sufficiency of family income (AOR 2.502; 95% CI 1.362, 4.594), working from home/business (AOR 2.071; 95% CI 1.074, 3.995), breastfeeding intention (AOR 1.162; 95% CI 1.116, 1.210), and maternal age (AOR 0.932; 95% CI 0.882, 0.986). From qualitative interviews, women who were able to exclusively breastfed during the outbreak explained five themes that were a protective shield; I have to save money, I could spend all my time with my baby and breastfeed, spousal support is valuable, and opportunity to avoid the obstructed beliefs about exclusive breastfeeding. Conclusions Mothers with higher socioeconomic status and who were unemployed/worked from home and had support structures in place were able to successfully EBF during the COVID-19 outbreak. Healthcare providers can better support breastfeeding if they provide informational support and allow family members to participate in breastfeeding programs, especially spouses who provided key emotional and tangible support during pandemic.

Information, attitudes and behaviors of mothers about breastfeeding behavior during the COVID-19 pandemic process

“…In a study conducted with 390 mothers in Thailand, breastfeeding behaviors of mothers were questioned during the epidemic, while the duration of breastfeeding increased as the education and economic status increased, while in our study there was no significant difference according to education level, it was observed that mothers who defined their economic status as poor had a longer breastfeeding period [10]. It has been interpreted that this may be due to the fact that breastfeeding is an economical feeding method and the food costs cannot be met.…”

“…It was determined in our survey study that the rate of mothers who confidently look after the breastfeeding of COVID-19 positive mothers decreases as the maternal age increases. In a study conducted in Thailand, it was observed that the duration of breastfeeding shortened with increasing maternal age [10].…”

Pengetahuan Kader Posyandu dan Ibu Balita Tentang Pemberian Asi Pada Masa Pandemi Covid-19 di Wilayah Kerja Puskesmas Campalagian

“…Asupan gizi yang adekuat dari ASI selama masa 6 bulan pertama hingga usia dua tahun akan mendukung pertumbuhan dan perkembangan balita (Latorre et al, 2021). Hal ini karena menyusui merupakan salah satu cara paling efektif untuk memastikan kesehatan dan kelangsungan hidup anak (Jama et al, 2020;Nuampa et al, 2022).…”

Estudo comparativo sobre o Aleitamento Materno na realidade da pandemia de COVID-19 em Hospital Amigo da Criança no Nordeste brasileiro

“…Apesar de ser natural e fisiológico, o processo de amamentação sofre grande impacto de práticas culturais, sociais, influências familiares, e do nível de informação que a família lactante possui a respeito da temática. Com efeito, a atuação de profissionais de saúde desde o pré-natal e da orientação dada por serviços de saúde são condições relevantes para a adoção do aleitamento materno pela família da criança (Nuampa, 2022).…”