Maternal influences on breastfeeding and weaning practices in Malta

Abstract

While exclusive breastfeeding is recommended for the first 6 months of life, with the introduction of complementary foods at around 6 months (WHO, 2021), literature shows that adherence to these guidelines is low, leading to suboptimal weaning practices. Epidemiological studies have reported an association between socioeconomic status and breastfeeding practices. This study aimed to assess breastfeeding and weaning practices in Malta and to evaluate the maternal influence on these. The study adopted a cross-sectional design, conducting one-time questionnaires with 250 mothers of 8-month-old infants who consented to participate. These were administered at well-baby clinics within the primary health care centres of the Maltese Islands. The questionnaire covered socio-economic and demographic data, breastfeeding initiation and duration, weaning practices, and a brief assessment of the infant's diet at 8 months. Findings indicate increasing health inequalities. Mothers were more likely to exclusively breastfeed if they were younger (p=0.012) and better educated (p=0.003). Suboptimal breastfeeding duration was also more frequently reported in mothers with a lower education level. The mean (standard deviation) cessation age was 2.6 (1.88) months in the latter while a mean (standard deviation) cessation age of 4.0 (2.19) months was reported in better-educated mothers. No evidence of an association was found between maternal level of education and weaning initiation age. Weak associations were reported between the type of food offered during weaning and maternal level of education (p=0.095), as well as maternal employment status (p=0.089). Findings highlighted the need of community support and public health interventions that take into account social indicators to promote adherence to WHO infant feeding guidelines.