Does the Grandmother Matter? Knowledge and Attitudes in Intergenerational Transmission of Breastfeeding: A Cross-Sectional Study

Background: Grandmothers are vital holders of breastfeeding knowledge and play a crucial role in breastfeeding practices. However, their role in supporting exclusive breastfeeding is frequently overlooked. Research aim: To investigate grandmothers’ breastfeeding knowledge and attitudes, explore mothers’ perceptions of grandmothers’ breastfeeding support, and analyze factors among mothers and grandmothers associated with breastfeeding practices. Methods: A cross-sectional study with a six-week postpartum breastfeeding mode assessment was conducted at a baby-friendly tertiary Maternity and Children’s Hospital in China between March and June 2021. The validated Breastfeeding Knowledge Questionnaire, Iowa Infant Feeding Attitude Scale, and Mothers’ Perceptions of Grandmothers’ Breastfeeding Support Scale were used. Using multivariable logistic regression, the association between study variables and exclusive breastfeeding within 6 weeks postpartum was explored. Results: In total, 310 mother-grandmother dyads completed structured questionnaires, and 292 mothers were followed at 6 weeks postpartum. The mean score for grandmothers’ breastfeeding knowledge was 9.32 (SD = 2.33) out of 14 points. One hundred and seventy-nine (57.7%) of the grandmothers exhibited positive attitudes towards breastfeeding. Mothers perceived that grandmothers provided positive family support ( M = 27.77, SD = 3.40). Mothers’ breastfeeding plans and perceived breastfeeding support, grandmothers’ education levels, and breastfeeding attitudes were independent factors associated with exclusive breastfeeding within 6 weeks postpartum. Conclusion: Grandmothers’ involvement in breastfeeding remains influential; however, they lack sufficient breastfeeding knowledge and put pressure on mothers concerning formula milk use. The study provides a basic framework for future prospective and interventional research to exert grandmothers’ roles effectively and promote exclusive breastfeeding rates.