Breastfeeding Knowledge, Attitudes, Prior Exposure and Intention of a Sample of Undergraduate Students in Honduras
Authors: Rendon Mariana , Lou Zixin , Spence Marsha L , Mejia Maria , Colby Sarah E , Kavanagh Katherine F 
Published: November 2023

Over 95% of Honduran mothers initiate breastfeeding (BF) but less than a third (31.2%) exclusively breastfeed through 6 months. Prior research indicates that understanding the BF knowledge, attitudes, prior exposure, and intent of young adults may provide important clues for the development of future culturally appropriate breastfeeding interventions. The objective was to describe the BF knowledge, attitudes, prior experiences, and future BF intention in a sample of undergraduate students in Honduras, and to compare these by gender, age, class‐standing, and major. An exploratory, cross‐sectional survey was conducted in February 2015 with a convenience sample of 286 undergraduate students from a major public university in Tegucigalpa, Honduras. The instrument was a self‐administered, paper‐based questionnaire covering demographics; BF knowledge and attitudes; and BF exposure, family involvement in decision‐making, and intent. Chi‐square analysis was used to compare responses by gender, age (<19 vs ≥19 years), class standing (freshman vs. non‐freshman) and major (health‐related vs. non‐health‐related). Participants were almost evenly split between females (51.4%) and males (48.6%), were mostly freshmen (70.9%) and from non‐health related majors (77.9%). Participant age ranged from 18 to 24 years, with a mean age of 19.1 (±1.45). BF knowledge was moderate, with a mean score of 8.0 (±1.98) out of a possible 13 points. Over 90% of participants agreed that breast milk should be the first food for babies, but less than half knew that BF should be started within the first hour after birth (48.3%), that BF helps prevent respiratory infections in the baby (47.6%), and only 28.7% knew that women who have breastfed have a lower risk of breast cancer. BF attitudes were neutral, with a mean score of 53.8 (±7.88) out of a possible 80. Though most participants agreed that breast milk is cheaper than formula (83.8%), nearly half believed that formula‐feeding gives more freedom to the mother (49.4%), over a third believed that mothers should wean their babies before returning to work/school (37.3%), and nearly one third reported that seeing a woman breastfeed in public makes them uncomfortable (28.1%). In terms of BF exposure, most participants reported being breastfed as an infant (89.3%); knowing someone who had breastfed (95.3%); and having witnessed someone BF (98.9%). Intention in this population was relatively high, with over three‐fourths of participants (82.0%) expressing the intention to breastfeed, or support a partner to breastfeed, in the future, though females were more likely to report this intention than males (88.8% vs. 74.4%, females vs. males, respectively; p=0.02). The relatively high level of BF intent may be partially explained by the social norm of high BF initiation in the Honduran population, which may reduce the need for targeting knowledge and attitudes specific to this behavior. However, the moderate BF knowledge and neutral attitudes may somewhat explain the low rate of exclusivity and may be important targets for future BF interventions.

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