Maternal breastfeeding beliefs, appraisals, practices, and food insecurity influence quality of breastfeeding interaction in Bangladesh

Maternal cognitions and food insecurity have been linked to caregiving practices, but their influence on maternal‐infant interaction is unknown. This study determined whether maternal breastfeeding beliefs, appraisals, and practices influenced the quality of breastfeeding interaction, and whether these maternal factors differed by food security. A cohort of 180 mother‐infant dyads was selected from the randomized controlled trial, Maternal Infant Nutritional Interventions Matlab, Bangladesh. Maternal‐infant interaction was observed in the home. Maternal beliefs, appraisals, practices, and food insecurity were obtained from questionnaires. Infants were 3.4 – 4.0 mo old. Quality of breastfeeding interaction was better if mothers believed that they should talk with their infants during feeding, appraised that infants were satisfied and/or their breasts were not empty after the breastfeeding session, and used more than one feeding initiation cue. Food‐insecure mothers reported more often that their breasts were empty and their infant was not satisfied at the end of a breastfeeding session than did food‐secure mothers. Efforts to support better breastfeeding interaction should promote positive parenting beliefs, provide information about feeding initiation cues, and assist food‐insecure mothers. American Institute of Bangladesh Studies, Cornell Einaudi Center for International Studies