Adolescents’ interest in breastfeeding practices: using school-based education to promote future DOHaD-related parenting in Africa

Breastfeeding is a critical component of infant nutrition, and breastfed infants are less likely to become stunted or obese reducing the risk of non-communicable diseases in adult life. Optimal breastfeeding practices remain a challenge worldwide; as adolescents are the mothers and fathers of tomorrow, integrating DOHaD-informed knowledge into school curricula is called for. However, research indicates adolescents have low awareness of the importance of the first 1000 days of life, only see specific elements as relevant to them, and gender-related differences exist in their comprehension. This study evaluated the impact on adolescents of an in-class presentation on parenting and the benefits of breastfeeding in high schools in 5 African countries. Pre- and post-intervention questionnaires were completed by 345 pupils (182 girls, 163 boys, mean age 17.9 years). Analysis indicated the education session impacted pupils' perceptions of parenting and changed which aspects of breastfeeding they viewed as most and least interesting. A statistically significant difference was evident between genders on the importance of cost-benefits; more boys saw relevance for fathers that no cost is incurred for formula. Boys also ranked the potential to reduce diabetes healthcare costs in adult life higher than girls. Girls preferentially ranked breastfed babies crying less, being easier to feed at night, and diaper changing being less gross as benefits for fathers. School-based education can engage adolescents and impact knowledge and attitudes about breastfeeding. Awareness of differences in girls' and boys' perceptions of relevance will enable educational content to be targeted to attract and inform both genders.