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Al Naseeb NM, Badr H, Alghamdi S. A correlational study of breastfeeding duration among Saudi mothers: The role of self-efficacy, intention, and social support. BELITUNG NURSING JOURNAL 2023; 9:132-138. [PMID: 37469583 PMCID: PMC10353599 DOI: 10.33546/bnj.2510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/14/2023] [Accepted: 03/20/2023] [Indexed: 07/21/2023] Open
Abstract
Background Breastfeeding is an essential source of nutrition for infants and offers numerous benefits for both the mother and child. Despite the consensus on its advantages, limited research in Saudi Arabia has explored the factors influencing breastfeeding duration. Objective This study aimed to examine the relationships between breastfeeding self-efficacy, intention, social support, and breastfeeding duration. Methods The study employed a correlational research design, and data were collected from three armed forces hospitals in Taif, Saudi Arabia, from December 2020 to February 2021. The samples comprised 356 conveniently selected breastfeeding mothers, assessed using the Breastfeeding Personal Efficacy Beliefs Inventory, Modified Infant Feeding Intention Scale, and Exclusive Breastfeeding Social Support Scale. Simple linear regressions were conducted for data analysis. Results Breastfeeding duration was divided into two groups. Group 1 consisted of mothers still breastfeeding at the time of data collection, while Group 2 comprised those who had discontinued breastfeeding. Of the total samples, 51.6% (n = 184) of mothers were classified under Group 1, while the remaining 48.4% (n = 172) were allocated to Group 2. Specifically, 78.3% of mothers had stopped breastfeeding by the time their infants were six months old, and 93.3% intended to introduce formula feeding at three months. In Group 1, the results revealed that self-efficacy (β = 0.625, p <0.001), intention (β = 0.643, p <0.001), and social support (β = 0.612, p <0.001) were positively associated with breastfeeding duration. Similarly, in Group 2, a strong positive correlation was observed between self-efficacy (β = 0.72, p <0.001), intention (β = 0.73, p <0.001), social support (β = 0.699, p <0.001), and breastfeeding duration. These three factors jointly explained 40% of the variance in breastfeeding duration in Group 1 (adjusted R2 = 0.4) and 50% in Group 2 (adjusted R2 = 0.5). Conclusion Breastfeeding intention was found to have a more significant impact on breastfeeding duration than self-efficacy and social support. These results can inform nurses and midwives in supporting breastfeeding mothers by providing them with the necessary information and increasing their awareness of breastfeeding-related factors.
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Affiliation(s)
- Nourah. M Al Naseeb
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
- Armed Forces Hospital in Al-Hada, Saudi Arabia
| | - Hanan Badr
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salmah Alghamdi
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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Alruwaily S, Masud N, Alshaibani H, Sheikho M, Alshoaibi M, Awadalla A. Knowledge, perception and acceptability of breastfeeding and bottle feeding among Saudi population. Sudan J Paediatr 2023; 23:177-186. [PMID: 38380408 PMCID: PMC10876268 DOI: 10.24911/sjp.106-1665846928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 07/20/2023] [Indexed: 02/22/2024]
Abstract
Despite the enormous benefits of breastfeeding (BF), its prevalence is suboptimal, with exclusive BF ranging between 7.3 % and 51% in the Saudi community. The aim of this study was to assess the Saudi community's knowledge regarding BF, exposure to BF promotional messages and formula milk advertisements and acceptability of BF in public places. It was a cross-sectional study that included Saudis aged 20-55 years old between December 2019 and June 2020. It utilised a self-administered questionnaire, which asked about background information, knowledge of BF, exposure to BF-promoting messages and exposure to formula milk advertisements and acceptability of BF versus bottle feeding in public. Data were analysed using the Statistical Package for the Social Sciences (SPSS v. 22). For the analysis, a p-value <0.05 was considered significant. The sample included for analysis was 914. The mean age of participants was 33.8 ± 9 years. The majority of participants were female 823 (90%); males 87 (10%). The vast majority (94%) agreed that breast milk is more beneficial than formula milk. Nearly two-thirds (61%) were continuously exposed to messages advertising formula feeding, compared to only 35% who were exposed to messages promoting BF. The study found that 67.2% accept BF in public places. Among male participants, only 49% accepted BF in public places compared to 79% of female participants who accepted it; p-value <0.001. Acceptability of BF in public places was significantly higher among participants who had family members who breastfed (68%), compared to those who did not (50%), (p-value 0.01).
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Affiliation(s)
- Sarah Alruwaily
- Department of Pediatrics, King Abdullah Children Specialist Children Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nazish Masud
- Research Unit, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Haya Alshaibani
- Department of Pediatrics, King Abdullah Children Specialist Children Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Maha Sheikho
- Department of Pediatrics, King Abdullah Children Specialist Children Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Meshael Alshoaibi
- Department of Pediatrics, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Asma Awadalla
- Department of Pediatrics, King Abdullah Children Specialist Children Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Research Unit, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Farrag NS, Hashad RE, El-Gilany AH. The Practice of Breastfeeding in Public and its Associated Factors Among Egyptian Mothers. Breastfeed Med 2023; 18:66-73. [PMID: 36579924 DOI: 10.1089/bfm.2022.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: The practice of breastfeeding in public (BFP) is associated with the perceived social norms. No sufficient knowledge is available regarding this practice, the attitudes related, and the significant associated factors in Egypt. Aim: To assess the prevalence of BFP, attitudes, barriers, and enabling factors. Methods: A cross-sectional study was conducted in Dakahlia Governorate, Egypt, including breastfeeding mothers whose babies were ≤12 months of age. A predesigned validated interviewer-administered questionnaire was used to collect data. Results: The study included 400 participants, 72.8% of them had practiced breastfeeding in public at least once. Regression analysis showed that being urban, high socioeconomic standard, having babies who were of normal birthweight and not the first in order were significant predictors of higher prevalence of BFP. Also, positive mother's attitude and having a family member who also practiced BFP were independent significant predictors. Finally, mothers who practiced breastfeeding in public are less likely to have supportive families' attitude. The most common causes of not practicing BFP is men's presence (94%), followed by husband disagreement (78.5%), absence of breast cover (69.3%), or feeling embarrassed (63.2%). Conclusion: Breastfeeding in public is a frequent practice among the studied mothers. Underlying factors associated with BFP can help guide tailored health education message to nursing mothers. Privacy was the keyword behind not practicing BFP.
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Affiliation(s)
- Nesrine Saad Farrag
- Public Health, Community Medicine Department, Faculty of Medicine, Port-Said University, Port-Said, Egypt
| | | | - Abdel-Hady El-Gilany
- Public Health, Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Taha Z, Al Dhaheri AI, Wikkeling-Scott L, Ali Hassan A, Papandreou D. Determinants of Delayed Initiation of Breastfeeding: A Cross-Sectional Multicenter Study in Abu Dhabi, the United Arab Emirates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159048. [PMID: 35897420 PMCID: PMC9331463 DOI: 10.3390/ijerph19159048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 01/25/2023]
Abstract
One of the best practices to reduce the risk of infant morbidity and mortality is the early initiation of breastfeeding, specifically within the first hour of birth, as the World Health Organization (WHO) recommends. Limited data exist on breastfeeding initiation and its related factors in the United Arab Emirates (U.A.E.). Therefore, the purpose of this research study was to evaluate and analyze the determinant factors associated with delayed initiation of breastfeeding among mothers with children aged <2 years old in a cross-sectional multicenter setting in Abu Dhabi, U.A.E. Seven governmental community and healthcare centers participated in the study from diverse geographic areas of Abu Dhabi. A trained female research assistant collected information from mothers with young children attending the centers. All participants were informed in detail about the purpose of the study and signed a written consent form. A total of 1610 mother−child pairs were included in the study. The mean (standard deviation) of maternal age and children’s age was 30.1 (5.1) years and 8.1 (5.9) months, respectively. Six hundred and four (604) (37.5%) reported delayed initiation of breastfeeding. Factors associated with delayed breastfeeding initiation were being of non-Arab nationality (adjusted odds ratio (A.O.R.) 1.30, 95% confidence interval (CI) 1.03, 1.63), caesarean section (AOR 2.85, 95% CI 2.26, 3.58), non-rooming-in (AOR 2.82, 95% CI 1.53, 5.21), first birth order (AOR 1.34, 95% CI 1.07, 1.69), and mothers with low-birth-weight children (AOR 3.30, 95% CI 2.18, 4.99) as was analyzed by multivariate logistic regression analysis. In conclusion, approximately four out of ten mothers delayed initiation of breastfeeding for more than one hour after delivery. The results of this study call for urgent policy changes to improve the early initiation rates of breastfeeding mothers in the U.A.E.
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Affiliation(s)
- Zainab Taha
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates;
- Correspondence: ; Tel.: +971-2-5993111
| | - Aysha Ibrahim Al Dhaheri
- Abu Dhabi Public Health Centre, Abu Dhabi P.O. Box 144534, United Arab Emirates; (A.I.A.D.); (A.A.H.)
| | - Ludmilla Wikkeling-Scott
- School of Community Health and Policy, Portage Campus, Morgan State University, 1700 E. Cold Spring Lane, Baltimore, MD 21251, USA;
| | - Ahmed Ali Hassan
- Abu Dhabi Public Health Centre, Abu Dhabi P.O. Box 144534, United Arab Emirates; (A.I.A.D.); (A.A.H.)
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3NX, UK
| | - Dimitrios Papandreou
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates;
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Al Sabbah H, Assaf EA, Taha Z, Qasrawi R, Radwan H. Determinants of Exclusive Breastfeeding and Mixed Feeding Among Mothers of Infants in Dubai and Sharjah, United Arab Emirates. Front Nutr 2022; 9:872217. [PMID: 35619950 PMCID: PMC9127614 DOI: 10.3389/fnut.2022.872217] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/12/2022] [Indexed: 12/19/2022] Open
Abstract
Background Breastfeeding (BF) is considered the ultimate method of infant feeding for at least the first 6 months of life. Exclusive breastfeeding (EBF) is one of the most effective interventions to improve child survival. The main objective of this study was to assess the prevalence and duration of exclusive breastfeeding and the associated factors among women in Dubai and Sharjah, UAE. Methods A cross-sectional study was conducted in four hospitals and four healthcare centers in Dubai and Sharjah between September 2017 and December 2017. Hospitals and centers are governmental and provide maternal and child health services. A convenience sample of 858 Arab and Emirati mothers with children under the age of 2 years participated in the study. Face-to-face interviews were conducted by using structured questionnaires. The study was approved by the University Ethical Committee and the UAE Ministry of Health before data collection. Descriptive statistics were computed to describe all the questionnaire items. The chi-square test was used to compare the study's categorical variables. A binary logistic regression analysis was used to predict the relationship between BF and its associated factors. Statistical tests with P-values < 0.05 were considered statistically significant. Results The mean age of the participating mothers was 30.6 (SD 5.5) years. Results showed that the prevalence of exclusive breastfeeding among the study participants was 24.4% (31.1% in Sharjah and 22% in Dubai; P = 0.003). The binary logistic regression reported that mother's and father's education, skin-to-skin period, number of children, mothers' health, and place of living were significantly associated with exclusive breastfeeding (P < 0.05). The results reported a significant association between EB and duration of breastfeeding (OR = 6.9, P = 0.002), husband education (OR = 2.1, P = 0.015), mother education (OR = 1.3, P = 0.027), number of children (OR = 7.9, P = 0.045), having any health problem (OR = 1.2, P = 0.045), and living place (OR = 1.4, P = 0.033), and a non-significant positive effect of family size and family income. Furthermore, the result reported a significant association between mixed breastfeeding and duration of breastfeeding (OR = 0.1, P = 0.000), skin-to-skin period (OR = 0.3, P = 0.002), underweight (OR = 4.7, P = 0.034), last infant's sex (OR = 1.6, P = 0.010), having maid at home (OR = 2.1, P = 0.000), number of children (OR = 0.2, P = 0.013), and living place (OR =1.1, P = 0.014), and a non-significant association with family size and family income. Conclusions Therefore, a health promotion program for exclusive breastfeeding during antenatal health visits, together with initiating health policies in maternal hospitals to encourage the initiation of breastfeeding during the first hour of birth and the introduction of skin-to-skin contact during the first 5 min of birth are highly recommended.
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Affiliation(s)
- Haleama Al Sabbah
- Department of Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Enas A Assaf
- Department of Community Nursing, Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Zainab Taha
- Department of Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Radwan Qasrawi
- Department of Computer Science, Al-Quds University, Jerusalem, Palestine.,Department of Computer Engineering, Istinye University, Istanbul, Turkey
| | - Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Taha Z, Wikkeling-Scott L. Review of Kangaroo Mother Care in the Middle East. Nutrients 2022; 14:nu14112266. [PMID: 35684066 PMCID: PMC9182704 DOI: 10.3390/nu14112266] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
Mothers and newborns have a natural physiological requirement to be together immediately after birth. A newborn has a keen sense of smell and will instinctively seek out the mother’s nipple and begin breastfeeding if placed skin-to-skin with her. This practice is known as Kangaroo Mother Care (KMC). It was first suggested in 1978 and has been recommended by the World Health Organization (WHO) as a means to ensure successful breastfeeding. It is well documented that KMC is associated with positive breastfeeding outcomes, particularly in cases where breastfeeding is exclusive and, on average, continued for 3 months or longer. Studies of infant nutrition and breastfeeding have shown the importance of immediate, uninterrupted skin-to-skin contact between newborn and mother following vaginal birth. This practice is also recommended for mothers who give birth via cesarean section, once the newborn is stable. The rate of breastfeeding is still suboptimal in Middle Eastern countries, in light of the WHO’s recommendation that mothers should exclusively breastfeed for the first six months and continue breastfeeding for up to two years. To increase the rate of breastfeeding, practices should be promoted that have been shown to improve outcomes, such as KMC. However, little is known about this important practice in the region. The aim of this study was to shed light on KMC-related studies conducted in the Middle East between January 2010 and January 2022. Specifically, this review examines breastfeeding practice rates for the first 6 months of birth, and evidence of KMC practices, by country and type of study design. The research terms used for this review were “skin to skin”, “Skin to skin contact”, and “Kangaroo Mother Care”, focusing on “Middle East”, “Eastern Mediterranean”, “Arabian Gulf”, “Arab”, and “GCC”.
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Affiliation(s)
- Zainab Taha
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
- Correspondence: ; Tel.: +971-2-5993111; Fax: +971-2-4434847
| | - Ludmilla Wikkeling-Scott
- School of Community Health and Policy, Portage Campus, Morgan State University, 1700 E. Cold Spring Lane, Baltimore, MD 21201, USA;
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Heberle ABDS, Cardelli AAM, Higarashi IH, Carvalho MDDB, Nohama P, Pelloso SM. Ergonomics of anatomical bra models for breastfeeding: a contribution of nursing. Rev Bras Enferm 2021; 75:e20210264. [PMID: 34852124 DOI: 10.1590/0034-7167-2021-0264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/14/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the ergonomics of two models of breastfeeding bras. METHODS descriptive study carried out with 152 infants in a Brazilian university hospital. The prototypes were separated into two groups (A and B). To compare the two bra models, the Odds Ratio (OR) was used as a measure of the strength of the association. In subjective perceptions, the Modified Borg Scale, and the chi-square test of independence (χ2) were used. To compare the two prototypes, the Z test and logistic regression analysis were performed. A significance level of 5% was considered. RESULTS the bra in group B was more suitable for ergonomics of physical and psycho-aesthetic comfort than the bra in group A (p < 0.0001), according to the logistic regression tests. CONCLUSIONS modeling B was ergonomically adequate, with usability and evaluation criteria centered on breastfeeding women.
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Affiliation(s)
| | | | | | | | - Percy Nohama
- Pontifícia Universidade Católica do Paraná. Curitiba, Paraná, Brazil
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Possner M, El-Neklaway I, Khater M, Fikry M, Alshahoud AN, Salah M, Said W, Tawfik E. Acceptability of "High sn-2" Infant Formula in Non-Breast Fed Healthy Term Infants Regarding Gastrointestinal Tolerability by Both Parents and Pediatrician: An Open-Label Pilot Study in the Gulf Cooperation Council (GCC) Countries. Pediatr Rep 2021; 13:639-649. [PMID: 34941637 PMCID: PMC8706475 DOI: 10.3390/pediatric13040076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/20/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
Recent studies have highlighted the positive impact of high sn-2 formulas on gastrointestinal (GI) tolerance. We assessed the GI tolerance, acceptability, and safety of high sn-2 infant formula among non-breastfed healthy term infants in the Gulf countries. A multicenter observational study was conducted on 227 healthy-term infants who were prescribed high sn-2 palmitate infant formula and received a minimum of two formula feedings per day for the past two weeks prior to the study's initiation. The number of stools per day decreased significantly from a median of four (interquartile range [IQR] = 4) at baseline to 3.0 (2) stools per day at the end of follow-up (p = 0.015). The percentage of stool amount changed significantly, where 61.2% and 33.7% of the infants had an amount of 25-50% of the diaper and >50% of the diaper, respectively (p < 0.001) at the end of the follow-up. Similarly, the percentage of hard stool decreased significantly from 17.4% at baseline to 0.4% of the population at week 12 (p < 0.00). The prevalence of colic and abdominal distention declined from 21.4% and 39.9% at baseline to 2.9% and 9.4% at week 12, respectively (p < 0.05). The same decline was observed in abdominal distension and regurgitation score (p < 0.05).
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Affiliation(s)
- Mike Possner
- Nestle Nutrition Institute, 60528 Frankfurt am Main, Germany;
| | - Ibrahim El-Neklaway
- Head of Pediatric Department, Almana General Hospital, Khobar 31952, Saudi Arabia;
| | - Mohamed Khater
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria 21548, Egypt;
- Department of Pediatrics, Mouwasat Medical Services, Riyadh 13241, Saudi Arabia
| | - Mohamed Fikry
- Wyeth Nutrition Middle East, Dubai P.O. Box 17327, United Arab Emirates;
| | | | | | - Waleed Said
- Head of Pediatrics Department, Al Garhoud Private Hospital, Dubai P.O. Box 36868, United Arab Emirates;
| | - Eslam Tawfik
- Department of Pediatrics, Faculty of Medicine, Cairo University hospitals, Cairo 12613, Egypt
- Sheikh Khalifa Medical City, Abu Dhabi P.O. Box 51900, United Arab Emirates
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Shahrani ASA, Hushan HM, Binjamaan NK, Binhuwaimel WA, Alotaibi JJ, Alrasheed LA. Factors associated with early cessation of exclusive breast feeding among Saudi mothers: A prospective observational study. J Family Med Prim Care 2021; 10:3657-3663. [PMID: 34934662 PMCID: PMC8653446 DOI: 10.4103/jfmpc.jfmpc_852_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/22/2021] [Accepted: 07/04/2021] [Indexed: 12/01/2022] Open
Abstract
CONTEXT World Health Organization recommending initiation of breastfeeding within hour of birth, exclusive breastfeeding for the first 6 months. In Saudi Arabia, there is a paucity of studies on the factors associated with early cessation of exclusive breastfeeding. AIMS We aimed to assess the exclusive breastfeeding rates and to identify the risk factors for early breastfeeding cessation at maternal and institutional levels. SETTINGS AND DESIGN A prospective observational study carried out at King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia. METHODS AND MATERIALS It included all postpartum women who had given birth to full term, singleton, healthy newborns, and were breastfeeding before discharge. Data were collected before discharge, 2 weeks, and 8 weeks postpartum using an adapted instrument. STATISTICAL ANALYSIS Using JMP14 software with appropriate statistical tests. RESULTS The study included 136 mothers, of whom 37.5% were exclusively breastfeeding in the first 2 weeks; this rate dropped to 19% with a statistically significant difference (P < 0.0001). Early breastfeeding cessation was significantly associated with maternal age, health status, mother's knowledge, and attitude, in addition to other modifiable factors that was encountered during hospital stay such as latching difficulties and introduction of formula feeding. CONCLUSIONS This study reported low exclusive breastfeeding rates in the first 2 months postpartum among Saudi mothers. Multiple factors were associated with breastfeeding, and some are modifiable. Breastfeeding promotion and support for is a critical role required from healthcare workers in all settings, including primary health care. Healthcare professionals play a major role in promoting, protecting, and supporting exclusive breastfeeding.
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Affiliation(s)
- Abeer Salem Al Shahrani
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hessah Mamdouh Hushan
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Noura Khalid Binjamaan
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Wajd Abdulrahman Binhuwaimel
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Jawaher Jazaa Alotaibi
- Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Lama Ali Alrasheed
- Health Sciences Research Center, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Al Maamari S, Al Shammakhi S, Alghamari I, Jabbour J, Al-Jawaldeh A. Young Children Feeding Practices: An Update from the Sultanate of Oman. CHILDREN (BASEL, SWITZERLAND) 2021; 8:818. [PMID: 34572250 PMCID: PMC8465673 DOI: 10.3390/children8090818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/06/2021] [Accepted: 09/14/2021] [Indexed: 11/24/2022]
Abstract
Despite proven benefits, most countries fail to meet international targets for appropriate complementary and Breast Feeding (BF) practices. This study assessed feeding practices of children under two years of age and correlated them with family parameters in Oman, a high income country in the Eastern Mediterranean Region. METHODS Data from this study originated from the latest Oman National Nutrition Survey (ONNS). Assessment of children and their mothers' socioeconomic, anthropometric, and nutritional variables was conducted at the household level. Evaluated feeding practices included age appropriate BF, diet diversity, and minimum acceptable diet (MAD). RESULTS Pairs of mothers and infants (n = 1344) were assessed. Early BF, exclusive BF at 6 months, infant formula, and iron rich meals were provided to 81, 29, 44, and 84% of children, respectively. Age appropriate BF and MAD were found in 58% and 35% of children, respectively. Low maternal education, younger age, low household income, and governorate negatively affected diet acceptability. CONCLUSION Omani children successfully received early BF postpartum and consumed iron rich meals. Yet, rates of exclusive BF rates at six months and MAD for children under two were low. Comprehensive strategies should be placed to assess and influence children feeding practices in the Sultanate.
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Affiliation(s)
- Salima Al Maamari
- Nutrition Department, Ministry of Health, Muscat 393, Oman; (S.A.M.); (S.A.S.); (I.A.)
| | - Saleh Al Shammakhi
- Nutrition Department, Ministry of Health, Muscat 393, Oman; (S.A.M.); (S.A.S.); (I.A.)
| | - Ibtisam Alghamari
- Nutrition Department, Ministry of Health, Muscat 393, Oman; (S.A.M.); (S.A.S.); (I.A.)
| | - Jana Jabbour
- Nutrition Department, School of Health Sciences, Modern University of Business and Sciences, Beirut 113-7501, Lebanon
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 11371, Egypt;
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 11371, Egypt;
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11
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Aldalili AYA, El Mahalli AA. Research Title: Factors Associated with Cessation of Exclusive Breastfeeding. J Multidiscip Healthc 2021; 14:239-246. [PMID: 33564240 PMCID: PMC7866906 DOI: 10.2147/jmdh.s277819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The study aimed to determine the prevalence of exclusive breastfeeding (EBF), measure the association between EBF and sociodemographic and obstetric characteristics of lactating mothers, and determine challenges of EBF. Methods The study was cross-sectional and was conducted in four primary health care centres (PHCCs) at Alehsa region in Saudi Arabia (SA). Lactating mothers coming to vaccinate their babies (0–6 months) were recruited. Sample size totalled 372, where 93 were randomly selected from each centre. Sociodemographic and obstetric characteristics of participants, breastfeeding (BF) status, and challenges of EBF were collected. Basic univariate descriptive statistics were conducted to explore the sociodemographic and obstetric characteristics, BF status and challenges of BF. Bivariate analyses were done to explore the association between the dependent and independent variables. Binary logistic regression models were then executed. A 2-tailed p-value < 0.05 was considered significant. Results EBF rate was nearly 60%. Cessation of EBF was associated with younger age, inconvenience/fatigue due to BF, sore breasts or nipples/too painful, perceived low milk quantity, BF skills were not effective, maternal choice, and baby-centred factors. Conclusion and Recommendations EBF was associated with problems/difficulties in BF technique. It is recommended that health care professionals like doctors, nurses, and midwives should train mothers during and after pregnancy regarding BF technique or pumping breast milk in case of BF difficulties, improve mothers’ confidence about the ability to breastfeed and enhance mothers’ knowledge on the normal process of lactation. Secondly, it is the role of policymakers to ensure implementation of Baby-Friendly Hospital Initiative (BFHI) guidelines in hospitals to meet the WHO’s global target of infants being exclusively breastfed until six months of age.
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Affiliation(s)
| | - Azza Ali El Mahalli
- Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Hernández-Cordero S, Lozada-Tequeanes AL, Fernández-Gaxiola AC, Shamah-Levy T, Sachse M, Veliz P, Cosío-Barroso I. Barriers and facilitators to breastfeeding during the immediate and one month postpartum periods, among Mexican women: a mixed methods approach. Int Breastfeed J 2020; 15:87. [PMID: 33059706 PMCID: PMC7559131 DOI: 10.1186/s13006-020-00327-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/24/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Evidence suggests that inadequate hospital practices, as well as sociocultural and community factors have detrimental effects on timely initiation as the first breastfeed within first hour after birth, and exclusive breastfeeding. The purpose of the study was to examine the factors that influence timely initiation of breastfeeding and exclusive breastfeeding at birth and 1 month postpartum in Mexican women delivering in public and private hospitals. METHODS Mixed methods were conducted between May and July 2017, including surveys (n = 543) and semi-structured interviews (n = 60) in the immediate (7 h) and intermediate (30 days) postpartum periods. Participants were women aged 15-49 years, in public and private hospitals, of urban and rural municipalities of Chihuahua and Puebla, Mexico. RESULTS Timely initiation was reported by 49.4% of mothers, and 34.7% reported that their children received infant formula at the hospital. Only 44.8% of women reported exclusive breastfeeding at 1 month postpartum. Timely initiation of breastfeeding was higher in women with vaginal delivery (62.1 vs 35.5%; p < 0.05) and those who received information during pregnancy (OR 1.07; p = 0.018). Exclusive breastfeeding at 1 month postpartum was related to older maternal age (OR 1.05; p < 0.001) and the fact that the mothers had received more information about breastfeeding during pregnancy (OR 1.13; p = 0.0001). Infant formula use was less associated with timely initiation (OR 0.46; p = 0.001). Participants in qualitative data identified the emotional, physical and economic benefits of breastfeeding, however, the perception about insufficient production of human milk, and the belief that infant formula is recommended, persists. CONCLUSIONS Modification of hospital practices, such as decreasing the number of cesarean and the use of infant formula, as well as the support of the initiation and continuation of exclusive breastfeeding by health personnel and family members, could help increase breastfeeding practices in Mexican women.
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Affiliation(s)
| | | | | | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Matthias Sachse
- Fondo de las Naciones Unidas para la Infancia, Ciudad de México, Mexico
| | - Paula Veliz
- Fondo de las Naciones Unidas para la Infancia, Ciudad de México, Mexico
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Charafeddine L, Masri S, Shamsedine L, Ghandour L, Tamim H, El Khoury N, Hachem Z, Nabulsi M. Validation of the Arabic version of the breastfeeding behavior questionnaire among Lebanese women. Int Breastfeed J 2020; 15:54. [PMID: 32517707 PMCID: PMC7282113 DOI: 10.1186/s13006-020-00296-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Breastfeeding Behavior Questionnaire (BBQ) assesses women's perceptions of their breastfeeding behavior. It was adapted to several languages and used in different settings, but has not been validated in Arabic-speaking populations. None of the previous studies that used the BBQ in other cultures examined its ability to predict the actual breastfeeding behaviors of mothers postpartum. This study validated the BBQ in a cohort of Lebanese pregnant women between December 2013 and January 2016, and examined whether it can predict exclusive breastfeeding at one, three and six months. METHODS The internal consistency reliability and construct validity of the Arabic BBQ (BBQ-A) were tested on 354 pregnant women. Its predictive ability was assessed by correlating the women's BBQ-A scores with their breastfeeding outcomes at one, three and six months post-delivery. RESULTS The BBQ-A had a good internal consistency reliability (Cronbach's alpha = 0.78). Exploratory factor analysis revealed that it is unidimensional. Inter-item correlations ranged between - 0.016 and 0.934, with corrected-item total correlations ranging from 0.273 to 0.678. Perceived positive breastfeeding behavior correlated with positive breastfeeding attitudes, good breastfeeding knowledge and stronger breastfeeding intention supporting its external validity. However, in binomial multivariate logistic regression analysis, the BBQ-A did not predict exclusive breastfeeding at one, three or six months. CONCLUSIONS The BBQ-A is a reliable and valid instrument to assess women's perceptions of their breastfeeding behavior in an Arab context. Availability of this instrument is important for investigators conducting breastfeeding research in the Arab world. However, the BBQ-A does not predict exclusive breastfeeding at one, three or six months. Further research on the Breastfeeding Behavior Questionnaire is needed to examine its predictive validity in other cultures.
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Affiliation(s)
- Lama Charafeddine
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Saadieh Masri
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Lama Shamsedine
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Lilian Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Clinical Research Institute, Biostatistics Unit, American University of Beirut, Beirut, Lebanon
| | - Nathalie El Khoury
- Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Zahraa Hachem
- Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Mona Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
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Sumarni, Puspasari I, Mallongi A, Yane E, Sekarani A. Effect of moringa oleifera cookies to improve quality of breastmilk. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.10.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abdel-Rahman ME, El-Heneidy A, Benova L, Oakley L. Early feeding practices and associated factors in Sudan: a cross-sectional analysis from multiple Indicator cluster survey. Int Breastfeed J 2020; 15:41. [PMID: 32410678 PMCID: PMC7227029 DOI: 10.1186/s13006-020-00288-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 05/06/2020] [Indexed: 11/24/2022] Open
Abstract
Background In efforts to reduce neonatal mortality, the World Health Organization (WHO) has included breastfeeding among its recommended packages of interventions. Early initiation of breastfeeding and avoidance of prelacteal feeding are key contributors to optimal feeding practices. This study aims to assess the prevalence and associated factors of early breastfeeding practices in Sudan. Methods This study utilises the cross-sectional nationally-representative Sudan Multiple Indicator Cluster Survey (MICS) conducted in 2014. The sample includes women who had a live birth in the two years before the survey and their self-report on early breastfeeding practices, namely early initiation and prelacteal feeding. Percentages of these early breastfeeding practices indicators were estimated accounting for the complex survey design. Multivariable logistic regression analyses were used to examine the factors associated with these outcomes. Results Of 5622 mothers, 69% initiated breastfeeding within one hour of birth, 72% avoided prelacteal feeding in the first three days after birth, and 51% met the criteria for both (i.e. practised optimal early feeding practice). Optimal early feeding varied across regions of Sudan. Birth by caesarean section (Adjusted Odds Ratio [AOR] 0.34; 95% CI 0.25, 0.47) and at a health facility (AOR 0.75; 95% CI 0.60, 0.94) were negatively associated with optimal early feeding practice. Mothers with secondary education (AOR 1.62; 95% CI 1.30, 2.02), those who desired their pregnancy at the time (AOR 1.31; 95% CI 1.08, 1.60), those who were assisted by a skilled birth attendant at birth (AOR 1.48; 95% CI 1.19, 1.83), and those who gave birth to female infants (AOR 1.16; 95% CI 1.02, 1.33) had higher odds of use optimal early feeding practice. Similarly, the odds of optimal early feeding increased with parity and maternal age. Conclusions Only half of Sudanese mothers practised optimal early feeding practice, with important differences between regions in the country. Early feeding practices in Sudan are associated with various maternal, child and community level factors. The findings suggest the need to develop breastfeeding promotion programs with consideration of regional variations and healthcare system interventions.
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Affiliation(s)
- Manar E Abdel-Rahman
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
| | - Asmaa El-Heneidy
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Laura Oakley
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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Alshammari SA, Alhazmi AM, Alenazi HA, Alshammari HS, Alshahrani AM. Mammography uptake among the female staff of King Saud University. J Family Med Prim Care 2020; 9:221-228. [PMID: 32110594 PMCID: PMC7014892 DOI: 10.4103/jfmpc.jfmpc_706_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/07/2019] [Accepted: 12/05/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Breast cancer is having a major impact on women's health worldwide. Early detection is the best defense against the associated morbidity and mortality of the disease. Objectives: To assess the level of mammography uptake among working Saudi women and identify the obstacles and barriers that negatively affect it. In addition, to identify the most effective sources of breast-cancer-related information and early detection screening. Method: We conducted a cross-sectional study of women employees of King Saud University aged 40 years and above on March–May 2015 using a self-report questionnaire. Results: A total of 229 participants were recruited from the female staff of King Saud University. Of the participants, 34% were aged 41 years or above, approximately 66% were married, 53.3% had a bachelor's degree, and 61.1% worked as administrators; further, 64.6% had a history of breastfeeding. The rate of mammography uptake was 51.5%. Univariate logistic regression indicated that age, education, and being single predict the rate of mammography uptake. However, multivariate logistic regression indicated that earlier age significantly predicts a higher risk of a low rate of mammography uptake. The main obstacle negatively affecting mammography uptake was ineligible criteria (21.8%). The main sources of information regarding breast cancer were awareness campaigns and television and radio (45.4% and 43.7%, respectively). Conclusion: The participants' rate of mammography uptake, awareness of mammograms, the risk factors, and signs of breast cancer were low. To improve breast-cancer mortality rates in Saudi Arabia, earlier detection of breast cancer through increasing awareness of mammograms is of paramount importance.
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Affiliation(s)
- Sulaiman Abdullah Alshammari
- Health Promotion and Health Education Research Chair, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Mohsen Alhazmi
- Health Promotion and Health Education Research Chair, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Zhao Y, Lin Q, Wang J, Bao J. Effects of prenatal individualized mixed management on breastfeeding and maternal health at three days postpartum: A randomized controlled trial. Early Hum Dev 2020; 141:104944. [PMID: 31881459 DOI: 10.1016/j.earlhumdev.2019.104944] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Pregnant women with antenatal depression are more prone to postpartum depression and failure in breastfeeding than women without antenatal depression. The purpose of this study was to evaluate the effectiveness of a prenatal individualized mixed management intervention on breastfeeding and maternal physical and psychological status at three days postpartum. METHODS This randomized single-blind controlled trial was conducted from December 2017 to August 2018 with 182 primiparous women in Shanghai, China. Participants with Edinburgh Postnatal Depression Scale (EPDS) scores ≥9 were randomly allocated to the intervention group (n = 91) or control group (n = 91). The intervention group underwent a 4-session individualized mixed management intervention and the control group received usual care. Feeding patterns, Breastfeeding Self-Efficacy Scale (BSES), Infant Breastfeeding Assessment Scale (IBAS), and EPDS were used to measure the main outcomes. Two-tailed p-values of p < .05 were considered statistically significant. RESULTS The intervention group had significantly more effective breastfeeding behavior, better breastfeeding self-efficacy, more successful breastfeeding initiation, lower EPDS scores, more sleep time, and better appetite than the control group. CONCLUSION The prenatal individualized mixed management intervention demonstrated significant short-term improvement in breastfeeding and maternal physical and psychological health at three days postpartum. TRIAL REGISTRATION ChiCTR-IOR-17013761; December 7, 2017.
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Affiliation(s)
- Ying Zhao
- School of Nursing, Fudan University, Shanghai, PR China
| | - Qiping Lin
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China
| | - Jing Wang
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, PR China.
| | - Jiangbo Bao
- School of Nursing, Fudan University, Shanghai, PR China.
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Diwakar V, Malcolm M, Naufal G. Violent conflict and breastfeeding: the case of Iraq. Confl Health 2019; 13:61. [PMID: 31892940 PMCID: PMC6937642 DOI: 10.1186/s13031-019-0244-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 12/04/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND This study explores the relationship between armed conflict and breastfeeding practices of Iraqi mothers. To date, the relationship between violent conflict and breastfeeding is surprisingly understudied. Especially in the Middle East, which is conflict-prone and has a young population, research on war and household behavior is critical for promoting recovery and sustainable development. METHODS This study employs a unique pairing of the Iraq Body Count Database and the 2006 and 2011 Multiple Indicator Cluster Surveys for Iraq. We use probit models to explore the association between armed conflict and several breastfeeding outcomes - whether a child was ever breastfed, whether a child was breastfed within 1 h after birth, whether a child is currently breastfed, and whether an infant under 6 months of age is exclusively breastfed. Our proxies for conflict intensity are the average rate of conflict-related casualties across the 3 years prior to survey administration and the rate of casualties averaged across the 2 years prior to the birth of the child, in the governorate in which the family resides. We employ a number of other independent variables important for breastfeeding status, including health controls and characteristics of the household, child and mother. We also use a Cox proportional hazards model to study the association between conflict and breastfeeding duration. We complement this analysis with various robustness checks, including disaggregation by year, controls for household wealth and an analysis of breastmilk substitutes and their potential for an interaction with household wealth. RESULTS We find in our main results that increases in conflict-related casualties are associated with a significant decline in the probability that a child was ever breastfed and a decline in the probability that a child is currently breastfeeding. There is no significant association with exclusive breastfeeding or with initiation of breastfeeding within 1 h after birth. This result is robust to alternative measures of conflict, although some coefficients from estimation based on the 2006 subsample are positive and not significant, and reverse causation is a potential source of bias in interpreting cross-sectional feeding patterns. Results on breastfeeding duration are mixed. Our results also suggest an increase in the use of breastfeeding substitutes like formula concurrent to higher levels of conflict among wealthier households. CONCLUSION The results are informative in the context of designing policy aimed at stabilizing the long-term health and productivity of populations in conflict areas. Infant formula provided with the objective of offering temporary relief creates risks, including reducing the probability and duration of breastfeeding. Attention to the supply of health care and to support systems for women, especially skilled breastfeeding support and targeted support to infants dependent on formula, are matters of the utmost urgency during and after conflict periods.
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Affiliation(s)
- Vidya Diwakar
- Overseas Development Institute, 203 Blackfriars Road, London, SE1 8NJ UK
| | - Michael Malcolm
- West Chester University, 700 S High Street, West Chester, PA 19382 USA
| | - George Naufal
- Public Policy Research Institute, 4476 Texas A&M University, College Station, TX 77843-4476 USA
- Institute of Labor Economics (IZA), Bonn, Germany
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Vandenplas Y, Al-Hussaini B, Al-Mannaei K, Al-Sunaid A, Helmi Ayesh W, El-Degeir M, El-Kabbany N, Haddad J, Hashmi A, Kreishan F, Tawfik E. Prevention of Allergic Sensitization and Treatment of Cow's Milk Protein Allergy in Early Life: The Middle-East Step-Down Consensus. Nutrients 2019; 11:nu11071444. [PMID: 31248015 PMCID: PMC6683055 DOI: 10.3390/nu11071444] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/20/2019] [Indexed: 12/23/2022] Open
Abstract
Allergy risk has become a significant public health issue with increasing prevalence. Exclusive breastfeeding is recommended for the first six months of life, but this recommendation is poorly adhered to in many parts of the world, including the Middle-East region, putting infants at risk of developing allergic sensitization and disorders. When breastfeeding is not possible or not adequate, a partially hydrolyzed whey formula (pHF-W) has shown proven benefits of preventing allergy, mainly atopic eczema, in children with a genetic risk. Therefore, besides stimulating breastfeeding, early identification of infants at risk for developing atopic disease and replacing commonly used formula based on intact cow milk protein (CMP) with a clinically proven pHF-W formula is of paramount importance for allergy prevention. If the child is affected by cow’s milk protein allergy (CMPA), expert guidelines recommend extensively hydrolyzed formula (eHF), or an amino acid formula (AAF) in case of severe symptoms. The Middle-East region has a unique practice of utilizing pHF-W as a step-down between eHF or AAF and intact CMP, which could be of benefit. The region is very heterogeneous with different levels of clinical practice, and as allergic disorders may be seen by healthcare professionals of different specialties with different levels of expertise, there is a great variability in preventive and treatment approaches within the region itself. During a consensus meeting, a new approach was discussed and unanimously approved by all participants, introducing the use of pHF-W in the therapeutic management of CMPA. This novel approach could be of worldwide benefit.
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Affiliation(s)
- Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrijne Unversiteit Brussel, 1090 Brussels, Belgium.
| | - Bakr Al-Hussaini
- Department of Paediatrics, King Abdulaziz University Hospital, Jeddah 22252, Saudi Arabia.
| | - Khaled Al-Mannaei
- Department of Paediatrics, Al Salam International Hospital, Dasma 35151, Kuwait.
| | - Areej Al-Sunaid
- Department of Paediatric Gastroenterology, King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia.
| | - Wafaa Helmi Ayesh
- Clinical Nutrition Department, Dubai Health Authority, PO Box 4545 Dubai, UAE.
| | - Manal El-Degeir
- Department of Paediatrics, National Guard Hospital, Dammam 31412, Saudi Arabia.
| | - Nevine El-Kabbany
- Department of Paediatrics, Mediclinic Welcare Hospital, PO Box 31500 Dubai, UAE.
| | - Joseph Haddad
- Department of Paediatrics, Saint George Hospital University Medical Center, Balamand University, PO Box 166378 Beirut, Lebanon.
| | - Aziza Hashmi
- Department of Clinical Nutrition Services, King Abdulaziz Medical City-Jeddah, Ministry of National Guard Health Affairs, Jeddah 21423, Saudi Arabia.
| | - Furat Kreishan
- Department of Paediatrics, Alhakeem Furat Clinic, Amman 11942, Jordan.
| | - Eslam Tawfik
- Department of Paediatrics, Sheikh Khalifa Medical City, PO Box 51900 Abu Dhabi, UAE.
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Cetthakrikul N, Topothai C, Suphanchaimat R, Tisayaticom K, Limwattananon S, Tangcharoensathien V. Childhood stunting in Thailand: when prolonged breastfeeding interacts with household poverty. BMC Pediatr 2018; 18:395. [PMID: 30591029 PMCID: PMC6309093 DOI: 10.1186/s12887-018-1375-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 12/18/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Childhood stunting, defined as the height-for-age standardized score lower than minus two, is one of the key indicators for assessing well-being and health of a child; and can be used for monitoring child health inequalities. Thailand has been successful in improving health and providing financial protection for its population. A better understanding of the determinants of stunting will help fill both knowledge and policy gaps which promote children's health and well-being. This study assesses the factors contributing to stunting among Thai children aged less than five years. METHODS This study obtained data from the Multiple Indicator Cluster Survey Round 4 (MICS4), conducted in Thailand in 2012. Data analysis consisted of three steps. First, descriptive statistics provided an overview of data. Second, a Chi-square test determined the association between each covariate and stunting. Finally, multivariable logistic regression assessed the likelihood of stunting from all independent variables. Interaction effects between breastfeeding and household economy were added in the multivariable logistic regression. RESULTS In the analysis without interaction effects, while the perceived size of children at birth as 'small' were positively associated with stunting, children in the well-off households were less likely to experience stunting. The analysis of the interactions between 'duration of breastfeeding' and 'household's economic level' found that the odds of stunting in children who were breastfed longer than 12 months in the poorest household quintile were 1.8 fold (95% Confidence interval: 1.3-2.6) higher than the odds found in mothers from the same poorest quintiles, but without prolonged breastfeeding. However prolonged breastfeeding in most well-off households (those between the second quintile and the fifth wealth quintile) did not show a tendency towards stunting. CONCLUSIONS Childhood stunting was significantly associated with several factors. Prolonged breastfeeding beyond 12 months when interacting with poor economic status of a household potentiated stunting. Children living in the least well-off households were more prone to stunting than others. We recommend that the MICS survey questionnaire be amended to capture details on quantity, quality and practices of supplementary feeding. Multi-sectoral nutrition policies targeting poor households are required to address stunting challenges.
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Affiliation(s)
- Nisachol Cetthakrikul
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
- Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Kanjana Tisayaticom
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Supon Limwattananon
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
- Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
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Alnasser Y, Almasoud N, Aljohni D, Almisned R, Alsuwaine B, Alohali R, Almutairi O, Alhezayen R. Impact of attitude and knowledge on intention to breastfeed: Can mHealth based education influence decision to breastfeed exclusively? Ann Med Surg (Lond) 2018; 35:6-12. [PMID: 30258626 PMCID: PMC6153120 DOI: 10.1016/j.amsu.2018.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/06/2018] [Accepted: 09/12/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding has been endorsed as the healthiest feeding choice for newborns. This study aims to assess impact of expecting mothers' knowledge and attitude toward intention to breastfeed exclusively. Utilizing mobile health (mHealth) as educational tool can offer a widely distributed and affordable platform to promote exclusive breastfeeding. RESEARCH AIMS AND QUESTIONS This study aims to assess impact of expecting mothers' knowledge, attitude and beliefs on decision to breastfeed exclusively. Furthermore, it purposes mobile health (mHealth) as educational tool offering a widely distributed, affordable and accessible platform to promote exclusive breastfeeding. METHODS The study was conducted in prenatal clinics' waiting areas to interview expecting mothers utilizing a translated version of Infant Feeding Practices Survey II (IFPS II, CDC). After completing the survey, an educational video was shown utilizing a tablet and the question was re-asked about intention toward breastfeeding exclusively. RESULTS Most expecting mothers indicated having some awareness about breastfeeding (67%) but only 46.1% intended to initiate exclusive breastfeeding early in life prior to the intervention. Moreover, only 53.7% believed breastfeeding is the best nutritional choice. Actually, 39.5% of participants considered breastfeeding equal to formula. Most working mothers complained of lack of workplace support to breastfeed. Also, they were not comfortable breastfeeding in front of others except spouse. Additionally, most participants found nurses and media as poor information resources. Resources utilizing social media and Internet were found useful. After watching the educational video, the majority expressed positive intention to breastfeed exclusively (80.8%). Positive intentions were associated with advance maternal age, prior breastfeeding knowledge and willingness to hear experts' opinions. CONCLUSION Saudi women have limited knowledge about exclusive breastfeeding and early initiation. They feel unprepared, unsupported, lack resources and socially challenged. An educational material utilizing mHealth can alter intentions to breastfeed exclusively.
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Affiliation(s)
- Yossef Alnasser
- Pediatric Department, King Saud University, Saudi Arabia
- British Columbia Children Hospital, University of British Columbia, Canada
| | - Nouf Almasoud
- School of Medicine, King Saud University, Saudi Arabia
| | | | | | | | - Rawa Alohali
- School of Medicine, King Saud University, Saudi Arabia
| | - Ohoud Almutairi
- School of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Reem Alhezayen
- Pediatric Department, King Saud University, Saudi Arabia
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Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region. CHILDREN-BASEL 2018. [PMID: 29534482 PMCID: PMC5867500 DOI: 10.3390/children5030041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity (p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.
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