Introduction: Breastfeeding is the best way to provide ideal nutrition for optimal infant growth and development. Objectives: The aim of our work was to assess the knowledge, attitudes and practices of mothers of children aged 0 - 24 months on exclusive breastfeeding in the Central African Republic. Methods: This was a cross-sectional, descriptive and analytical study conducted from September 15 to October 15, 2024 among mothers of infants aged 0 to 24 months. Sociodemographic, obstetric and breastfeeding-related data were collected through individual interviews conducted during sensitizations on good feeding practices organized by the Tina Touadera Foundation. The chi2 test was used to test for relationships between variables, and the p significance level was set at 0.05. Results: The average age of the mothers surveyed was 27.67 years. 65.69% (n = 247) of mothers lived in urban areas and 55.85% (n = 210) were Muslim. 56.38% (n = 212) were living common-law and 34.04% (n = 128) were poor. Secondary-school mothers (44.42%, n = 167) and housewives (53.72%, n = 202) were in the majority. Exclusive breastfeeding (EBF) was correctly defined by 79.26% (n = 298) of mothers and actually practised in 24.20% (n = 91) of cases. The main source of information was a health professional in 75.36% (n = 304) of cases. Among the 285 mothers who practised mixed breastfeeding, lack of time (33.33%) was the main reason. They acknowledged having given water (100%), corn porridge (75.09%) and/or artificial milk (24.91%) before the first 6 months of life. The average time for introducing water was 2.2 months, and for porridge/formula 2.79 months. More than half the mothers (55.05%) said they did not know their infants’ weaning age. Factors positively influencing the use of EBF were age under 29, residence in an urban area, primiparity, having been informed about AME by a health professional, and being a housewife or shopkeeper (p < 0.001). Conclusion: Mothers’ level of knowledge was heterogeneous but insufficient overall. An effective system of information and education from pregnancy to the first six months of life is needed to promote breastfeeding.
References
[1]
World Health Organization (2014) Every Newborn: An Action Plan to End Preventable Deaths.
[2]
Fonds des Nations Unies pour l’enfance (UNICEF) (2010) Protéger l’allaitement maternel en Afrique de l’Ouest et du Centre, 25 Années d’application du Code International sur la Commercialisation des Substituts du Lait Maternel.
[3]
Noirhomme-Renard, F. and Noirhomme, Q. (2009) Les facteurs associés à un allaitement maternel prolongé au-delà de trois mois: Une revue de la littérature. Journal de Pédiatrie et de Puériculture, 22, 112-120. https://doi.org/10.1016/j.jpp.2009.03.006
[4]
Loras-Duclaux, I. (2000) Conseils pratiques aux mères qui souhaitent allaiter. Archives de Pédiatrie, 7, 541-548. https://doi.org/10.1016/s0929-693x(00)89012-0
[5]
Victora, C.G., Bahl, R., Barros, A.J.D., França, G.V.A., Horton, S., Krasevec, J., et al. (2016) Breastfeeding in the 21st Century: Epidemiology, Mechanisms, and Lifelong Effect. TheLancet, 387, 475-490. https://doi.org/10.1016/s0140-6736(15)01024-7
[6]
Section on Breastfeeding (2005) Breastfeeding and the Use of Human Milk. Pediatrics, 115, 496-506. https://doi.org/10.1542/peds.2004-2491
[7]
Walters, D.D., Phan, L.T.H. and Mathisen, R. (2019) The Cost of Not Breastfeeding: Global Results from a New Tool. HealthPolicyandPlanning, 34, 407-417. https://doi.org/10.1093/heapol/czz050
[8]
OMS, UNICEF (2020) Mettre fin aux décès de nouveau-nés et aux mortinaissances évitables d’ici 2030: Accélérer la mise en place d’une couverture sanitaire universelle de qualité en 2020-2025.
[9]
Traoré, M., Sangho, H., Camara Diagne, M., Faye, A., Sidibé, A., Koné, K., et al. (2014) Facteurs associés à l’allaitement maternel exclusif chez les mères d’enfants de 24 mois à Bamako. SantéPublique, 26, 259-265. https://doi.org/10.3917/spub.138.0259
[10]
Sépou, A., Yanza, M.C., Nguémbi, E., Tekpa, G. and Ngbalè, R. (2001) How Is Breast-Feeding Valued in the Urban and Semi-Urban Central African milieu? Sante, 11, 85-89.
[11]
Alamirew, M.W., Bayu, N.H., Birhan Tebeje, N. and Kassa, S.F. (2017) Knowledge and Attitude Towards Exclusive Breast Feeding among Mothers Attending Antenatal and Immunization Clinic at Dabat Health Center, Northwest Ethiopia: A Cross-Sectional Institution Based Study. NursingResearchandPractice, 2017, Article 6561028. https://doi.org/10.1155/2017/6561028
[12]
Laamiri, F.Z., Barich, F., Bennis, A., Redouani, M.A., Azzaoui, S., Bentahila, N., et al. (2019) Connaissances et pratiques des mères en matière d’allaitement maternel. Journal de Pédiatrie et de Puériculture, 32, 128-139. https://doi.org/10.1016/j.jpp.2019.02.006
[13]
Gueye, B., Bassoum, O., Bassoum, D., Diagne, N.M., Bop, M.C., Tall, A.B., et al. (2023) Facteurs associés à la pratique de l’allaitement maternel exclusif chez les mères d’enfants âgés de 6 à 12 mois dans la commune de Kaolack (Sénégal). PanAfricanMedicalJournal, 45, Article 55.
[14]
Mohapatra, I. and Roy, A. (2018) Breastfeeding Awareness and Perception among Antenatal Mothers: A Cross-Sectional Study in Urban Slum Population of Bhubaneswar, Odisha. JournalofEducationandHealthPromotion, 7, 60. https://doi.org/10.4103/jehp.jehp_98_17
[15]
Kouassi, K.F. (2014) Approche anthropologique de l’allaitement maternel exclusif en côte d’Ivoire: Connaissances, attitudes et pratiques des mères. RevueAfricained’Anthropologie, Nyansa-Pô, 16, 44-55.
[16]
Sacko, K., Maiga, B., Konaté, D., Diakité, F.L., Diakité, A.A., Doumbia, S. and Traoré, F. (2019) Pratique de l’Allaitement Maternel au CHU Gabriel Touré de Bamako, Mali. Health Sciences, 20, 43-47.
[17]
Mundagowa, P.T., Chadambuka, E.M., Chimberengwa, P.T. and Mukora-Mutseyekwa, F. (2019) Determinants of Exclusive Breastfeeding among Mothers of Infants Aged 6 to 12 Months in Gwanda District, Zimbabwe. InternationalBreastfeedingJournal, 14, Article No. 30. https://doi.org/10.1186/s13006-019-0225-x
[18]
Rabevazaha, N.A., Ranivoson, A.H., Rakotoarisoa, L.A. and Robinson, A.L. (2019) Connaissances, attitudes et pratiques des mères sur l’allaitement maternel exclusif à Antananarivo. Revue Malgache de Pédiatrie, 2, 102-109.
[19]
Takassi, O.E., Djadou, K.E., Agbeko, F., Mihesso, A.Y.A., Temanou-Fiogbe, E. and Atakouma, D.Y. (2023) Facteurs associes a la pratique de l’allaitement maternel exclusif a 6 mois en milieu rural au Togo. Journal of African Neonatology, 2, 60-64.
[20]
Ambuj, S., Sanya, G., Pooja, T., et al. (2019) Knowledge, Attitude and Practices Regarding Breast-Feeding amongst Antenatal and Postnatal Females of Theog, Himachal Pradesh. Journal of Medical Science and Clinical Research, 7, 378-382.
[21]
Cardoso, A., e Silva, A.P. and Marín, H. (2017) Pregnant Women’s Knowledge Gaps about Breastfeeding in Northern Portugal. OpenJournalofObstetricsandGynecology, 7, 376-385. https://doi.org/10.4236/ojog.2017.73039
[22]
Mecheri-Touati, D., Bensalem, A. and Oulamara, H. (2014) P249: Allaitement maternel et facteurs associes a constantine (Algérie). Nutrition Clinique et Métabolisme, 28, S199. https://doi.org/10.1016/s0985-0562(14)70891-x
[23]
Atimati, A. and Adam, V. (2018) Breastfeeding Practices among Mothers of Children Aged 1-24 Months in Egor Local Government Area of Edo State, Nigeria. SouthAfricanJournalofClinicalNutrition, 33, 10-16. https://doi.org/10.1080/16070658.2018.1493071
[24]
Drali, O., Lamdjadani, N., Berrah, H. and Arrada, Z. (2019) Étude des connaissances et pratiques des mères sur l’allaitement maternel. RevueMédicaleAlgérienne, 17, 3-6.
[25]
Sidibe, A., Diarra, A., Danioko, Y., Sangare, Y., Kone, K., Guindou, M., et al. (2018) Connaissances, Attitudes et Pratiques des mères d’enfants sur l’allaitement exclusif. MaliSantéPublique, 8, 7-12. https://doi.org/10.53318/msp.v8i01.1461
[26]
Musa Aliyu, A. and Shehu, M. (2016) Knowledge, Attitude and Practice of Exclusive Breastfeeding among Multigravid Women Attending Antenatal Clinic in Aminu Kano Teaching Hospital. IOSRJournalofNursingandHealthScience, 5, 59-74.
[27]
Cascone, D., Tomassoni, D., Napolitano, F. and Di Giuseppe, G. (2019) Evaluation of Knowledge, Attitudes, and Practices about Exclusive Breastfeeding among Women in Italy. InternationalJournalofEnvironmentalResearchandPublicHealth, 16, Article 2118. https://doi.org/10.3390/ijerph16122118
[28]
Gurung, R., Silwal, M., Gurung, A., Sah, I., Koirala, D., Paudel, S., et al. (2018) Knowledge, Attitude and Practice Towards Exclusive Breastfeeding among Mothers in Pokhara-Lekhnath. JournalofGandakiMedicalCollege-Nepal, 11, 40-45. https://doi.org/10.3126/jgmcn.v11i1.20793
[29]
Al-Binali, A.M. (2012) Breastfeeding Knowledge, Attitude and Practice among School Teachers in Abha Female Educational District, Southwestern Saudi Arabia. InternationalBreastfeedingJournal, 7, Article No. 10. https://doi.org/10.1186/1746-4358-7-10
[30]
Coulibaly, A., Ake Tano, O., Bénie Bi Vroh, J., Traoré, Y. and Dagnan, N.S. (2014) Facteurs socioprofessionnels et pratique de l’allaitement exclusif par les primipares à Abidjan (Côte d’Ivoire). SantéPublique, 26, 555-562. https://doi.org/10.3917/spub.144.0555
[31]
Nwali, M.I., Agboeze, J., Ejikeme, B.N., Anozie, O.B. and Onwe, B. (2016) Breastfeeding Awareness and Practices in Abakaliki, Southeast, Nigeria. OpenJournalofObstetricsandGynecology, 6, 861-873. https://doi.org/10.4236/ojog.2016.613104
[32]
Adedemy, J.D., Bagnan-Tossa, L., Noudamadjo, A., Agossou, J. and Hounhakou, P. (2014) Fréquence et facteurs associés à la pratique de l’allaitement maternel exclusif de 0 à 6 mois à l’hôpital de la mère et de l’enfant Lagune (Homel) de Cotonou. Journal de la Société de Biologie Clinique du Bénin, 21, 38-44.
[33]
Afrose, L., Banu, B., Ahmed, K. and Khanom, K. (2012) Factors Associated with Knowledge about Breastfeeding among Female Garment Workers in Dhaka City. WHOSouth-EastAsiaJournalofPublicHealth, 1, 249-255. https://doi.org/10.4103/2224-3151.207021
[34]
Nukpezah, R.N., Nuvor, S.V. and Ninnoni, J. (2018) Knowledge and Practice of Exclusive Breastfeeding among Mothers in the Tamale Metropolis of Ghana. ReproductiveHealth, 15, Article No. 140. https://doi.org/10.1186/s12978-018-0579-3
[35]
Mallik, D.S. (2013) Knowledge of Breast Feeding and Timely Initiation of It Amongst Post Natal Mothers: An Experience from a Baby Friendly Teaching Hospital of a Metropolitan City. IOSRJournalofDentalandMedicalSciences, 4, 25-30. https://doi.org/10.9790/0853-0412530
[36]
C. Pal, A. and Mukhopadhyay, D. K. (2014) Knowledge, Attitude and Practice of Breastfeeding in a Rural Community of Bankura District, West Bengal, India. IOSRJournalofDentalandMedicalSciences, 13, 24-28. https://doi.org/10.9790/0853-131172428
[37]
Ayari, F., Sdiri, Y., Cherifi, E., Khemiri, S., Chourou, H., Cheour, M., et al. (2022) Niveau de connaissance des mères vis-à-vis de l’allaitement maternel à la sortie de la maternité. Gynécologie Obstétrique Fertilité & Sénologie, 50, 164-172. https://doi.org/10.1016/j.gofs.2021.10.002
[38]
Khoushabi, F., Reza Shadan, M., Chenar, S.F. and Bagheri, S. (2018) Knowledge and Attitude Evaluation of Mothers Regarding Exclusive Breastfeeding Referring to Health Care Centers. LaPrensaMedica, 104, 1-8.
[39]
Mohamed, M.J., Ochola, S. and Owino, V.O. (2018) Comparison of Knowledge, Attitudes and Practices on Exclusive Breastfeeding between Primiparous and Multiparous Mothers Attending Wajir District Hospital, Wajir County, Kenya: A Cross-Sectional Analytical Study. InternationalBreastfeedingJournal, 13, Article No. 11. https://doi.org/10.1186/s13006-018-0151-3
[40]
Butte, N.F., Lopez-Alarcon M.G. and Garza, C. (2002) Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant during the First Six Months of Life. World Health Organization.
[41]
World Health Organization (2003) United Nations Children’s Fund: Global Strategy for Infant and Young Child Feeding. World Health Organization.
[42]
UNICEF, WHO (2006) Baby-Friendly Hospital Initiative, Revised, Updated and Expanded for Integrated Care. Section 3.2: Breastfeeding, a Promotion and Support in a Baby-Friendly Hospital, a 20-Hour Course for Maternity Staff, Preliminary Version. UNICEF, WHO.
[43]
Aké-Tano, S.O.P., Ekou, F., Tetchi, E.O., Konan, Y.E., Kpébo, D.O., Sablé, P., etal. (2014) SFP P-081—Alimentation de l’enfant de 0 à 2 ans à Abidjan (Côte d’Ivoire). Archives de Pédiatrie, 21, 791. https://doi.org/10.1016/s0929-693x(14)72051-2
[44]
Arts, M., Geelhoed, D., De Schacht, C., Prosser, W., Alons, C. and Pedro, A. (2010) Knowledge, Beliefs, and Practices Regarding Exclusive Breastfeeding of Infants Younger than 6 Months in Mozambique: A Qualitative Study. JournalofHumanLactation, 27, 25-32. https://doi.org/10.1177/0890334410390039
[45]
Diarra, I. and Yarro, F. (2013) Prévalence et facteurs associés à l’allaitement exclusif chez les enfants de 0 à 6 mois dans la ville de Ouidah au Benin en 2009. MaliSantéPublique, 3, 88-91.
[46]
Demmouche, A., Beddek, F. and Moulessehoul, S. (2013) Les déterminants du choix de l’allaitement chez une population de l’ouest de l’Algérie (ville de Sidi Bel Abbes). Antropo, 30, 61-69.
[47]
Labarere, J., Gelbert, N., Ayral, A.S., Duc, C., Berchoteau, M., Bouchon, N., et al. (2006) Efficacité d’une consultation spécialisée dans les quinze jours du postpartum sur la durée d’allaitement maternel. Médecine&Enfance. 26, 591-599.
[48]
Lubala, T.K., Mutombo, A.M., Nyenga, A.M., Makinko, P.I., Wakamb, G.A. and Momat, F.K. (2013) Allaitement maternel et diversification alimentaire à Lubumbashi (République Démocratique du Congo): Besoin urgent d’éducation des mères pour le changement des habitudes. PanAfricanMedicalJournal, 14, Article 2436. https://doi.org/10.11604/pamj.2013.14.142.2436
[49]
Mascarenhas, M.L.W., Albernaz, E.P., de Silva, M.B. and de Silveira, R.B. (2006) Prevalence of Exclusive Breastfeeding and Its Determiners in the First 3 Months of Life in the South of Brazil. JornaldePediatria, 82, 289-294.
[50]
Mecheri-Touati, D., Bensalem, A. and Oulamara, H. (2014) P249: Allaitement maternel et facteurs associes a constantine (Algérie). Nutrition Clinique et Métabolisme, 28, S199. https://doi.org/10.1016/s0985-0562(14)70891-x
[51]
UNICEF (2016) La situation des enfants dans le monde 2016: l’égalité des chances pour chaque enfant.
[52]
Bouanene, I., ElMhamdi, S., Sriha, A., Bouslah, A. and Soltani, M. (2010) Connaissances et pratiques des femmes de la région de Monastir (Tunisie) concernant l’allaitement maternel. Eastern Mediterranean Health Journal, 16, 879-885.
[53]
Siret, V., Castel, C., Boileau, P., Castetbon, K. and Foix l’Hélias, L. (2008) Facteurs associés à l’allaitement maternel du nourrisson jusqu’à 6 mois à la maternité de l’hôpital Antoine-Béclère, Clamart. Archives de Pédiatrie, 15, 1167-1173. https://doi.org/10.1016/j.arcped.2008.04.014
[54]
Ghwass, M.M.E.A. and Ahmed, D. (2011) Prevalence and Predictors of 6-Month Exclusive Breastfeeding in a Rural Area in Egypt. BreastfeedingMedicine, 6, 191-196. https://doi.org/10.1089/bfm.2011.0035
[55]
Amin, T., Hablas, H. and Al Qader, A.A. (2011) Determinants of Initiation and Exclusivity of Breastfeeding in Al Hassa, Saudi Arabia. BreastfeedingMedicine, 6, 59-68. https://doi.org/10.1089/bfm.2010.0018
[56]
Sangho, H., Sidibé Keïta, A., Mariko, O., Dembélé Keïta, H. and Traoré Guindo, M. (2017) Perception et pratique de l’allaitement maternel exclusif par les 74 femmes de Sogoniko en commune VI du district de Bamako. Revuemaliennedescienceetdetechnologie, 3, 255-256.
[57]
Ramiro González, M.D., Ortiz Marrón, H., Arana Cañedo-Argüelles, C., Esparza Olcina, M.J., Cortés Rico, O., Terol Claramonte, M., etal. (2018) Prevalencia de la lactancia materna y factores asociados con el inicio y la duración de la lactancia materna exclusiva en la Comunidad de Madrid entre los participantes en el estudio ELOIN. Anales de Pediatría, 89, 32-43. https://doi.org/10.1016/j.anpedi.2017.09.002
[58]
Noirhomme-Renard, F. and Noirhomme, Q. (2009) Les facteurs associés à un allaitement maternel prolongé au-delà de trois mois: Une revue de la littérature. Journal de Pédiatrie et de Puériculture, 22, 112-120. https://doi.org/10.1016/j.jpp.2009.03.006
[59]
Bonet, M., L’hélias, L.F. and Blondel, B. (2008) Allaitement maternel exclusif et allaitement partiel en maternité: La situation en France en 2003. Archives de Pédiatrie, 15, 1407-1415. https://doi.org/10.1016/j.arcped.2008.06.014
[60]
Hassani, A., Barkat, A., Souilmi, F., Lyaghfouri, A., Kabiri, M., Karboubi, L., et al. (2005) La conduite de l’allaitement maternel. Étude prospective de 211 cas à la maternité Souissi de Rabat. Journal de Pédiatrie et de Puériculture, 18, 343-348. https://doi.org/10.1016/j.jpp.2005.04.014
[61]
Turck, D. (2005) Allaitement maternel: Les bénéfices pour la santé de l’enfant et de sa mère. Archives de Pédiatrie, 12, S145-S165. https://doi.org/10.1016/j.arcped.2005.10.006
[62]
Bellati-Saadi, F., Sall, M., Martin, S.L., et al. (1996) Situation actuelle de l’allaitement maternel dans la région d’Agadir au Maroc à propos d’une enquête chez 220 mères. Médecined’AfriqueNoire, 43, 194-196.
[63]
Crost, M. and Kaminski, M. (1998) L’allaitement maternel à la maternité en France en 1995. Enquête nationale périnatale. Archives de Pédiatrie, 5, 1316-1326. https://doi.org/10.1016/s0929-693x(99)80049-9
