Exploring Relationships Between Food Security Status, Infant Feeding Attitude and Breastfeeding Intention in Pregnant Women Attending a Health Care Facility in Cape Town, South Africa

Background: Breastmilk provides optimal infant nutrition and contributes to successful growth and development. Interlinked determinants influence breastfeeding attitude, intention, and duration. Research Aims: This study aimed to investigate relationships between socioeconomic indicators, food security status, infant feeding attitude and breastfeeding intentions of pregnant women in Cape Town, South Africa. Methods: This cross-sectional descriptive study recruited 218 adult women (third trimester; singleton pregnancy; without gestational diabetes or pre-eclampsia). A study-specific questionnaire, including validated infant feeding attitude and food security status questionnaires, was used. Descriptive statistics were expressed as percentages and medians (interquartile ranges), while associations were explored with non-parametric tests and regression modeling. Results: Participants’ median age was 27 years (23–32). The majority had monthly household incomes between 0-308 USD (R0–R5000) (61.1%), did not receive social grants (60.4%), were employed (53.7%), and were married or living with partners (53.0%). Exclusive breastfeeding intention after birth was 84.4% but 32.9% on returning to the workplace. Infant feeding attitudes predominantly reflected neutral towards breastfeeding (96.8%), with a median score of 61.0 (58.0–64.0). Households with children ( n = 127) indicated 18.1% food insecure and 52.8% at risk for hunger. Overall household level food insecurity was 60.7% and individual level food insecurity 37.6%. Food security status amongst all levels showed no significant association with infant feeding attitude or breastfeeding intention. Food secure participants were four times more likely to expect to receive breastfeeding support. Conclusion: Food security status was not associated with infant feeding attitude, breastfeeding intention after birth, or on returning to the workplace.