The Role of Socio-Structural Factors in Influencing Feeding Intentions and Practices Among Mothers with Infants in Mthatha, South Africa

Breastfeeding is universally regarded as the cornerstone of infant feeding, as it is the ideal infant feeding choice for optimal nutrition and development. Socio-structural factors of breastfeeding in child health play an important role in guiding women's decisions on options to feed their babies. A cross-sectional study was conducted among mothers with infants aged 0-6 months in Mthatha, Eastern Cape, with the aim of assessing the role of socio-structural factors in shaping feeding intentions and practices among mothers with infants. Written Informed consent was obtained in accordance with the Declaration of Helsinki from the participants prior to data collection. Data was gathered with a validated designed questionnaire as well as analyzed using Social Sciences (SPSS) version 29. A total of 181 mothers were enrolled. Only 45.9% reported that they exclusively breastfed their babies, of which the highest proportion of exclusive breastfeeding (EBF) was observed among the 21-29 age group at 51.8%, and the lowest among those aged 20 years and below (3.6%). Marital status (<i>p</i> = 0.005) and employment status (<i>p</i> < 0.001) were significantly associated with exclusive breastfeeding, with higher EBF rates observed among married mothers and those who were self-employed. Both the EBF mothers and non-EBF mothers shared a common belief that colostrum was not beneficial for infants (<i>p</i> = 0.854), whereas their views differed significantly on the amount of water given to infants before they reached six months (<i>p</i> = 0.001). There was no significant relationship between EBF status and having a family member who had breastfed in the past six months (<i>p</i> = 0.815); also, a weak association was noted for having a friend who had breastfed recently (<i>p</i> = 0.057). The difference in EBF practice between those receiving antenatal care (ANC) breastfeeding education and those not receiving it was not statistically significant (<i>p</i> = 0.591). A statistically significant association was found between the support level and exclusive breastfeeding status (<i>p</i> < 0.001). This study highlights that the successful practice of exclusive breastfeeding (EBF) is strongly associated with high levels of social support. Interventions are needed to engage active partners, family members, and community members in creating a supportive environment for breastfeeding mothers.