Background: The exclusive breastfeeding rate in China remains significantly low. Numerous studies have identified the impact of maternal characteristics on exclusive breastfeeding; however, the correlation between primary family caregivers’ characteristics, such as health and nutrition knowledge, and exclusive breastfeeding still lacks clarity. The aim of this study is to investigate the association between the health and nutrition knowledge of primary family caregivers and exclusive breastfeeding in rural China. Methods: In 2019, a cross-sectional study was conducted in two prefectures within the Qinba Mountains area, located in the southern region of Shaanxi province. Data on knowledge of health and nutrition, breastfeeding practices, breastfeeding family support, breastfeeding self-efficacy, and conflict frequency were collected via structured questionnaires from 372 caregiver-infant pairs. Infant feeding practices were assessed based on the caregivers’ recall of the previous day (within the 24 h before the interview). The mother was interviewed first, followed by a brief questionnaire for the primary family caregiver, both conducted individually to minimize disruptions from other family members. Univariate and multivariate regression analyses were conducted to explore the correlation between knowledge of mothers and primary family caregivers and exclusive breastfeeding. Results: The exclusive breastfeeding rate for six-month-old infants in the sample was 15.7%. On average, mothers scored 4.6 (SD 1.4) for health and nutrition knowledge, while primary family caregivers scored 3.6 (SD 1.4). Both maternal (OR 1.48; 95% CI 1.16, 1.88) and primary family caregiver’s (OR 1.34; 95% CI 1.05, 1.70) health and nutrition knowledge were significantly associated with exclusive breastfeeding. A positive correlation (OR 1.98; 95% CI 1.40, 2.80) existed between the average health and nutrition knowledge of the mother and primary family caregiver and exclusive breastfeeding. The primary family caregiver’s health and nutrition knowledge was positively correlated with the practical family support perceived by the mother (OR 1.23; 95% CI 1.02, 1.49) and breastfeeding self-efficacy of the mother (β = 1.40; 95% CI 0.29, 2.50). Conclusions: The characteristics of the primary family caregiver play a large role in exclusive breastfeeding. To promote exclusive breastfeeding, interventions should address the needs of the whole family instead of just mothers.

This study explored how maternal and infant illness correlated with the risk of postpartum depression in the Chinese Qinba Mountains region. In total, 131 villages comprising 435 families with infants (≤6 months old) were randomly sampled. We collected data on maternal and infant illnesses and maternal health knowledge level. The Depression, Anxiety, and Stress Scale-21 was used to measure the risk of postpartum depression. We used descriptive statistics and multivariate logistic regression for the analysis. Infant overall health status was a risk factor for postpartum depression (odds ratio (OR) = 1.90, 95% Confidence Interval (95% CI) = 1.10~3.28), whereas maternal overall health status was not correlated with postpartum depression (OR = 1.36, 95% CI = 0.55~3.39). For specific illnesses, infants experiencing over two common illnesses in the past two weeks (OR = 1.98, 95% CI = 1.13~3.45) and mothers experiencing over two common pains within two weeks after delivery (OR = 1.77, 95% CI = 1.02~3.08) were risk factors for postpartum depression, whereas infants with mild and severe stunted growth, maternal C-section, and postpartum body mass index (normal or overweight) were not correlated with it (all p > 0.050). Maternal health knowledge was an important moderator of maternal and infant illnesses on the risk of postpartum depression. In conclusion, maternal and infant illness were essential factors for the risk of postpartum depression in a poor rural region in western China, which may be mainly affected by the feeling of uncertainty of illness. Improved maternal and infant health and enhanced maternal health knowledge might alleviate the risk of postpartum depression.

Background The exclusive breastfeeding rate in China remains quite low. Numerous studies have identified the impact of maternal characteristics on exclusive breastfeeding. However, how the family members’ characteristics, for example primary family caregivers’ health and nutrition knowledge, correlated with exclusive breastfeeding is still unclear. Methods A cross-sectional study was conducted in two prefecture-level cities from the Qinba Mountains area. Data on exclusive breastfeeding, knowledge of health and nutrition, breastfeeding practices, breastfeeding family support, breastfeeding self-efficacy, and conflict frequency were collected via structured questionnaires from 372 caregivers-infant pairs. The mother was interviewed first, and then the primary family caregiver was given a brief questionnaire. Each interview was conducted alone to avoid interruptions from other family members. Univariate and multivariate regressions were conducted to explore the correlation between knowledge of mothers and primary family caregivers and exclusive breastfeeding. Results The exclusive breastfeeding rate among infants aged 6 months in this sample was 15.7%. The average score for the mothers’ health and nutrition knowledge was 4.6 (SD = 1.4), while the average score for the primary family caregivers was 3.6 (SD = 1.4). The health and nutrition knowledge of both the mother (OR = 1.48, P = 0.002) and the primary family caregiver (OR = 1.34, P = 0.017) remained significantly positively associated with exclusive breastfeeding, and the odds ratios were relatively close. There was a significant positively correlation (OR = 1.98, P < 0.001) between the average health and nutrition knowledge of the mother and the primary family caregiver and exclusive breastfeeding. The primary family caregiver’s knowledge of health and nutrition showed a significant positive correlation with the family practical support perceived by the mother (OR = 1.23, P = 0.027), and it also had a significant positive correlation with the breastfeeding self-efficacy of the mother (β = 1.40, P = 0.013). Conclusions The characters of family primary caregiver play much role on exclusive breastfeeding. To promote exclusive breastfeeding, interventions should address the needs of the whole family instead of just mothers.