Awareness of How to Reduce the Risk of Breastmilk Insufficiency

Output

% of women of reproductive age (15–49 years) who can name at least four promoted ways to reduce the risk of breast milk insufficiency

Concerns about real or perceived breast milk insufficiency are a common reason for introducing other foods or liquids before six months or stopping breastfeeding earlier than intended. Giving other foods or liquids before six months may increase infants’ exposure to infection, particularly when substitutes are nutritionally inadequate or prepared or stored unsafely. The indicator therefore measures the proportion of women who can name at least four promoted ways to reduce the risk of breast milk insufficiency.

Collect the following data by conducting individual interviews with a representative sample of women of reproductive age:

 

RECOMMENDED SURVEY QUESTIONS (Q) AND POSSIBLE ANSWERS (A)

Q1: Can you please tell me all the different things a woman can do to help reduce the risk of having too little breast milk for her baby?

 

A1:

1) eat and drink to satisfy hunger and thirst

2) start breastfeeding within one hour of birth

3) give only breast milk for the first six months

4) breastfeed frequently, according to the baby’s cues, day and night

5) ensure good positioning and attachment

6) let the baby finish the first breast, then offer the second

7) avoid unnecessary bottles and pacifiers

8) express milk when separated from the baby

9) keep the baby close or in skin-to-skin contact

10) seek skilled help when breastfeeding difficulties arise

11) other - specify: ......................................

12) does not know

13) no response / refused

 

NOTE: Instruct data collectors not to read the answer options to the respondent. If the initial response is limited, they should use only neutral probes, such as ‘What else can she do?’. Accept responses that have the same meaning as the pre-defined options. Adapt the options before data collection to reflect the evidence-based practices promoted by the project, and keep them unchanged across survey rounds.

 

To calculate the indicator's value, divide the number of respondents who could name at least four promoted ways to reduce the risk of breast milk insufficiency by the total number of respondents interviewed. Multiply the result by 100 to convert it to a percentage.

This data can be disaggregated by the number of children a woman has, whether she breastfeeds, and exposure to breastfeeding promotion or counselling. If relevant and feasible, also by the woman's age, the age of her youngest child, and location.

1) Report the percentage of respondents naming each individual practice, in addition to the headline percentage naming at least four. This will show which promoted messages are least recalled and is often more useful for programme decisions than the combined threshold alone.

2) This is a programme-specific knowledge indicator. It measures spontaneous recall of promoted practices, not actual breast milk production, breastfeeding behaviour or whether an individual infant is receiving enough milk. The threshold of four is not a globally standard cut-off. Pilot the revised answer list before use and keep the question, answer options, probing and coding unchanged across survey rounds.

Also consider using the following indicators:

• Perceived Access to Skilled Breastfeeding Counselling (measures access to support needed to apply the promoted knowledge)

• Addressing Breastfeeding Difficulties (measures closely related knowledge about responding to breastfeeding problems)

• Exclusive Breastfeeding Under Six Months (measures the principal breastfeeding practice linked to the indicator’s purpose)