Infant Feeding Behaviors Proximate Determinants #aternal choices Opportunities to act on choices

Intermediate Determinants

Infant feeding information and physical and social support during pregnancy, childbirth and post-partum: Access to antenatal care and quality of care Quality of assistance during delivery and in the first few days Access to postnatal maternal and child health care, and quality of care Type and quality of professional support to lactation management Access to peer counseling and Mother to Mother support

Familial, medical, and cultural attitudes and norms; Demographic and economic conditions /nderlying Determinants
Age, parity, physical and psychological health of the mother !reastfeeding experience of the mother herself, and with previous children "ducation, employment, social class, ethnicity, area of residence #nowledge, attitudes, confidence in the a$ility to $reastfeed Marital status, family si%e, support from father&partner and family 'ifestyles (smo)ing, alcohol, drugs, diet, physical exercise* !irth weight, gestational age, $irth interventions, mode of delivery, health of the new$orn Access to role models who have had positive $reastfeeding experiences

Commercial pressures

Prevalence and aggressiveness of direct and indirect mar)eting of infant formulas, $ottles, and artificial nipples&pacifiers, and early weaning supplements

Public health policies 'evel of priority and financial support given to $reastfeeding +fficial policies, recommendations and plans Monitoring and surveillance systems Quality of pre and in service training of health wor)ers ,inancial support for voluntary Mother to Mother support activities Information, "ducation, and -ommunications a$out infant feeding and use of different media for $reastfeeding advocacy Social policies and culture 'egislation on and enforcement of formula mar)eting (the International -ode* 'egislation on maternity protection and its enforcement .epresentation and portrayal of infant feeding and mothering in all forms of media +$stacles and $arriers to $reastfeeding in pu$lic Prevalence and level of activity of community $ased Mother to Mother support groups 'evel of community awareness and )nowledge

ocal, !tate, and "ational policies and norms