Breastfeeding Up to Two Years of Age and Its' Associated Factors Based on Behaviors, Attitudes, Subjective Norms, and Enabling Factors (BASNEF) Model

Abstract

Introduction: Breastfeeding after birth and during the first two years of life highly affects a baby's development and growth. Various factors can affect mothers' breastfeeding behaviors. Objective: This study aimed to evaluate the breastfeeding status of up to 2 years of age babies and its associated factors based on Behaviors, Attitudes, Subjective Norms, Enabling Factors (BASNEF) model. Materials and Methods: This was an analytical and cross-sectional study. It was conducted on 270 mothers with babies aged 6-24 months, referring to the comprehensive health centers in Rasht, Iran. The samples were selected using a cluster sampling technique. A 6-part questionnaire was used for collecting data assessing the BASNEF model constructs of behaviors, attitudes, subjective norms, and enabling factors, as well as the demographic information of study participants. Chi-squared test, Fisher's Exact test, and multivariate logistic regression analysis (backward method) were used for data analysis. Results: The prevalence rate of breastfeeding was 56.3%, and 61.5% of infants had exclusive breastfeeding. In terms of breastfeeding knowledge, 25.6%, 50%, and 24.4% were at good, moderate, and poor levels, respectively. Regarding attitude towards breastfeeding, 61.9% and 38.1% had undesirable and desirable attitudes, respectively. Furthermore, 50.7% of the infants had favorable breastfeeding and 49.3% had unfavorable breastfeeding. The rate of favorable breastfeeding was significant in terms of infant age (P=0.03) and the pregnancy care location (P<0.05). Regression model suggested that infant's age (OR=1.582, 95%CI= 1.133-2.207, P=0.007), family income (OR=0.65, 95% CI=0.489-0.865, P=0.003), and breastfeeding knowledge (OR=1.3, 95%CI= 1.101-1.428, P=0.001) contributed to breastfeeding status. Conclusion: Raising the mothers' knowledge of breastfeeding by considering the role of husbands, health workers, and grandmothers could help in choosing breast milk for feeding infants aged under 2 years old.