Breastfeeding and complementary feeding practices of mothers exposed to the Baby-Friendly Hospital Initiative in Limpopo Province

Background. Appropriate infant feeding is crucial for growth and development of children in the first 5 years of their life. Despite the implementation of the Baby-Friendly Hospital Initiative (BFHI), now known as Mother-Baby Friendly Hospital Initiative, exclusive breastfeeding and complementary feeding practices remain barriers to optimal breastfeeding practices in South Africa.Objectives. To explore the impact of the BFHI on breastfeeding and complementary feeding practices of mothers for second or subsequent pregnancies.Methods. The study design was a cross-sectional survey and included 169 mother-baby pairs conveniently selected from clinics in Limpopo Province. Data were collected using a validated questionnaire and analysed for 157 complete data sets using the Statistical Package for Social Sciences version 26.0. Both univariable and multivariable logistic regression analyses were used to examine the impact of baby-friendly hospitals on breastfeeding practices of mothers. Results. Few mothers in both groups practised exclusive breastfeeding for the recommended time (BFHI 22.2%; non-BFHI 30.6%). The main reasons for introducing early complementary foods were that the child was hungry, crying or was not satisfied with breastmilk. Mothers in the BFHI group were three times (odds ratio (OR) 3.53; 95% confidence interval (CI) 1.13 -10.98) more likely to breastfeed their infants, and two times (OR 2.22; 95% CI 1.08 -4.58) more likely to initiate their infants on water with added glucose or salt before the age of 6 months than mothers in the non-BFHI group.Conclusion. Mothers from the non-baby-friendly group had better breastfeeding practices. Evidence showed that for second or subsequent pregnancies, exposure to a baby-friendly facility during first pregnancy did not sustain appropriate breastfeeding and complementary feeding practices. Whether mothers were exposed or not, practices were similar. Strengthening and continual evaluation of breastfeeding interventions might improve impact on child survival outcomes in the study area.