Clinical Research
Knowledge, Attitudes, Exposure, and Future Intentions of Hong Kong University Students Toward Infant Feeding

https://doi.org/10.1111/j.1552-6909.2007.00144.xGet rights and content

Objective

To explore relationships between university students’ infant feeding knowledge, attitudes, breastfeeding exposures, and future infant feeding intentions.

Design

Descriptive cross‐sectional survey.

Setting

This study was conducted at a large publicly funded university in Hong Kong. Student enrollment in the university is approximately 15,000.

Participants

Four hundred three male and female Chinese university students. Participants were young (94.4% less than 25 years of age), undergraduate students (92.2%), unmarried (99.2%), and without children (100%).

Results

Sixty‐three percent of participants wanted their future child to be breastfed. Infant feeding knowledge scores ranged from 28.6% to 100%, with a mean of 71.1% (SD= 13.3), indicating overall high knowledge levels. Participants who intended to breastfeed were more likely to have positive attitudes, to have been breastfed themselves, or to know someone who had breastfed.

Conclusions

The results provide information to health care providers on the planning of effective breastfeeding promotion programs. Findings from this study suggest that promoting breastfeeding solely to childbearing couples is unlikely to result in significant improvements in either breastfeeding initiation or duration. Future infant feeding campaigns should be directed at the societal level to change negative attitudes and to increase acceptance of breastfeeding as a normal and natural feeding method.

Section snippets

Background

Although the literature specifically examining infant feeding perceptions of nonpregnant young adults is limited, some research has been conducted with adolescents and the general public. Public opinion surveys have found that breastfeeding is considered inappropriate outside of the home, in public, or in front of men (Li et al., 2002, Li et al., 2004, McIntyre et al., 2001a, McIntyre et al., 2001b). Furthermore, there is a general perception that breastfeeding restricts the mother’s freedom

Method

This study was conducted on the main campus of a large publicly funded university in Hong Kong. Student enrollment in the university is approximately 15,000. Ten faculties and two schools offer programs leading to undergraduate, graduate, and doctoral degrees as well as advanced professional qualifications. Although the medium of instruction is English, for the majority of students the native language is Chinese (Cantonese). A separate medical campus is located geographically separate from the

Characteristics of participants

The demographic characteristics of the study participants are presented in Table 1. Participants were almost evenly split between males (46.9%) and females (53.1%), with most being unmarried and less than 25 years of age. Participants were predominantly undergraduate students (92.2%) from engineering (24.6%), science (18.0%), arts (16.0%), business (13.1%), and social science (12.6%) faculties. Less than one third of participants (30.3%) reported that they were breastfed as children, almost two

Discussion

Evidence from this study suggests that even in a group of young adults not imminently considering pregnancy and childbearing, infant feeding knowledge levels are already high. While research with adolescents has demonstrated high levels of infant feeding knowledge (Goulet et al., 2003), findings from this study do conflict with research in other countries that found low infant feeding knowledge among college and university students (Kang et al., 2005, Tjiang and Binns, 2001). The Kang et al.

Acknowledgments

The authors thank Dr. Christine A. Pollock for the use of her survey instrument and Ms. Cheung Tung Yuen for assistance with the study.

References (51)

  • R.W. Brislin

    The wording and translation of research instruments

  • Census and Statistics Departmen

    Women and men in Hong Kong: Key statistics

    (2001)
  • D.W. Chapman et al.

    Translation procedures for the cross‐cultural use of measurement

    Educational Evaluation and Policy Analysis

    (1979)
  • C. Connolly et al.

    Attitudes of young men and women to breastfeeding

    Irish Medical Journal

    (1998)
  • R.M. Cusson

    Attitudes toward breast‐feeding among female high‐school students

    Pediatric Nursing

    (1985)
  • Department of Health and Human Services (U.S.)

    HHS blueprint for action on breastfeeding

    (2000)
  • A. DiGirolamo et al.

    Intention or experience? Predictors of continued breastfeeding

    Health Education & Behavior

    (2005)
  • J.E. Dodgson et al.

    Theory of planned behavior‐based models for breastfeeding duration among Hong Kong mothers

    Nursing Research

    (2003)
  • J.E. Dodgson et al.

    Breastfeeding patterns of primiparous mothers in Hong Kong

    Birth

    (2003)
  • J.E. Dodgson et al.

    An analysis of infant feeding messages in the Hong Kong print media

    (2005, November)
  • I.T. Forrester et al.

    Assessment of students’ attitudes toward breastfeeding

    Journal of Human Lactation

    (1997)
  • J.K. Friel et al.

    The effect of a promotion campaign on attitudes of adolescent females towards breastfeeding

    Canadian Journal of Public Health

    (1989)
  • C. Goulet et al.

    Attitudes and subjective norms of male and female adolescents toward breastfeeding

    Journal of Human Lactation

    (2003)
  • J. Greene et al.

    Feeding preferences and attitudes to breastfeeding and its promotion among teenagers in Northern Ireland

    Journal of Human Lactation

    (2003)
  • A. Hannan et al.

    Regional variation in public opinion about breastfeeding in the United States

    Journal of Human Lactation

    (2005)

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