Knowledge levels and practices of mothers with 6-12 months old babies regarding breastfeeding and complementary nutrition in Denizli city center

Aims: "This study aimed to examine the knowledge, attitudes, and practices of mothers with 6–12-month-old infants living in the city center of Denizli regarding breastfeeding and complementary feeding, to identify the factors influencing these practices, and to investigate the effects of infant feeding practices on the Infant and Child Feeding Index (ICFI) score." Methods: This is a cross-sectional study conducted with mothers of infants aged 6–12 months who were registered in three family health centers (FHCs) in Denizli. Data were collected via telephone interviews with the mothers. A semi-structured "Participant Questionnaire Form," developed by the researchers in accordance with the literature and consisting of 60 questions, was used as the data collection tool. The questionnaire comprises four sections: descriptive characteristics of the mothers, descriptive characteristics of the infants, mothers' knowledge regarding breastfeeding, and mothers' knowledge and practices regarding complementary feeding. The final section of the questionnaire includes the Infant and Child Feeding Index (ICFI). ICFI scores were classified as "low" (≤7 points), "medium" (8–9 points), and "high" (≥10 points). Anthropometric measurements of the infants were conducted by midwives and nurses working in the FHCs. Data were analyzed using the SPSS software. Results: The study included 217 infants, of whom 113 (52.1%) were male, and 51.2% of the mothers were university graduates. The vast majority of participating mothers (99.08%) reported breastfeeding their babies. Regarding the breastfeeding process, 83.87% of mothers stated that they began breastfeeding within the first 30 minutes to 1 hour after birth. However, 15.67% reported giving some form of food or water before initiating breastfeeding. It was found that mothers exclusively breastfed their babies for an average of 3.38 months, and one in five mothers (approximately 20%) exclusively breastfed for the full 6 months. The average age at which complementary feeding was introduced was 5.39 months (SD = 0.86), while the transition to solid and textured foods occurred at an average of 7.18 months (SD = 1.13). The study found that bottle use had a negative effect on exclusive breastfeeding during the first six months (p=0,029). Maternal education level (p=0,020) and family type (p=0,019) were significantly associated with breastfeeding status. The continuation rate of breastfeeding was higher among university graduate mothers. Among mothers who had stopped breastfeeding, the use of formula milk, bottles, and pacifiers was found to be higher. A statistically significant difference was observed between complementary feeding initiation time and household income; mothers with lower income levels started complementary feeding later compared to those with medium income levels. In our study, the mean Infant and Child Feeding Index (ICFI) score was found to be 9.49 ± 1.7, with 13.4% of infants having a low score, 28.6% a medium score, and 58.1% a high score. The mother's marital status, exclusive breastfeeding during the first six months, and the use of pacifiers, bottles, and formula were found to influence the ICFI score. Receiving information about complementary feeding was also found to have a positive effect on the ICFI. Conclusion: This study examined the knowledge, attitudes, and practices related to breastfeeding and complementary feeding among mothers with infants aged 6 to 12 months in Denizli, revealing the influence of healthcare policies on the breastfeeding process. It was found that the rate of exclusive breastfeeding during the first six months is low, highlighting the need for education and support programs. While bottle use negatively affected breastfeeding, mothers with higher education levels had higher rates of continued breastfeeding. Income level and access to information influenced the timing of complementary feeding and feeding habits. The study concluded that extending the duration of breastfeeding and timely initiation of complementary feeding positively impact nutritional quality. Based on these findings, it is recommended to promote breastfeeding, expand targeted education and support programs for disadvantaged groups, and provide comprehensive guidance by healthcare professionals.