Initiation and continuation of breastfeeding among Jordanian first-time mothers: a prospective cohort study

Maternal awareness of breastfeeding policies in baby-friendly hospitals in Jordan

AIM

This study aims to investigate the maternal perception and awareness of Baby-Friendly Hospital Initiative (BFHI) policies.

METHOD

A descriptive, cross-sectional research design was employed. A total of 205 mothers who gave birth in two hospitals in Jordan comprised the sample for this study. A self-administered questionnaire developed from the review of literature and from an audit tool of one of the research settings was used to assess maternal perception of BFHI policies and maternal awareness of breastfeeding. Ethical approval was sought before data collection.

FINDINGS

Mothers had moderate levels of awareness of breastfeeding importance; further, most of them mentioned the provision of a policy that addresses all the steps to successful breastfeeding as a major facilitator to breastfeeding. In terms of the BFHI, mothers had a moderate level of awareness of breastfeeding initiatives and showed positive perceptions of BFHI policies.

CONCLUSION AND IMPLICATION

Improving maternal perception of BFHI policies and maternal awareness of breastfeeding has the potential to affect breastfeeding uptake and management. Future research is recommended in the areas of (1) identification of barriers to breastfeeding among Jordan mothers, (2) determination of the impact of translating maternal awareness to breastfeeding uptake, and (3) effect of infant gender and antenatal care in breastfeeding initiation and maintenance.

Understanding factors affecting breastfeeding practices in one city in the Kingdom of Saudi Arabia: an interpretative phenomenological study

Background

Breastfeeding duration has declined in the Kingdom of Saudi Arabia (KSA) in recent decades, although accurate national data about different breastfeeding indicators by infant age are lacking. This qualitative study, the first in KSA, aimed to understand the factors affecting mothers’ decisions and experiences regarding any breastfeeding practices.

Methods

A qualitative phenomenological approach was used to investigate mothers’ experiences of breastfeeding. Non-probability convenience sampling and snowballing strategies were designed to recruit participants. Semi-structured interviews were conducted with 16 mothers, from two hospitals and three primary health clinics in Al-Madinah city, from December 2017 to March 2018. Interpretative phenomenological analysis was the analysis framework.

Results

Three themes were identified: 1) ‘Up against the system’: policies, staff and systems were the main barriers to exclusive breastfeeding; 2) ‘Social support and negativity’: family support in the first 40 postpartum days protected breastfeeding continuation and was highly appreciated, but negative comments limited breastfeeding practices thereafter; and 3) ‘Managing tensions’: mothers’ religious beliefs about breastfeeding boosted their decisions; however, the challenge of managing tensions influenced mothers to stop breastfeeding earlier than they wished. The study revealed that mothers had no doubts about wanting to breastfeed their babies; but continuation was adversely affected by unhelpful hospital policies and staff actions, the lack of ongoing social support, and by others people’s negativity, rather than by the mothers’ own views. Stopping breastfeeding earlier than planned was a complex decision for most mothers. However, mothers said that they intended to breastfeed their next baby successfully.

Conclusions

Healthcare professionals (maternity staff, paediatricians and pharmacists) need education and training to support exclusive breastfeeding effectively. Increasing the number of hospitals with Baby Friendly Hospital Initiative accreditation, which includes staff practice changes, is needed to protect and support exclusive breastfeeding. Ongoing professional and peer support, and improving conditions at workplaces and universities, are needed to help mothers to continue breastfeeding successfully. Effective, coordinated national policies can support mothers’ decisions in relation to breastfeeding. Such changes will reduce the tensions experienced by women and help them to achieve their breastfeeding goals and to breastfeed for longer.

Correlation between Candidate Single Nucleotide Variants and Several Clinicopathological Risk Factors Related to Breast Cancer in Jordanian Women: A Genotype-Phenotype Study

This study aim to investigate the association of breast cancer risk and prognostic factors with single nucleotide variants of the BRCA1, BRCA2, DAPK1, MMP9, TOX3, and TP53 genes in Jordanian women. Blood samples were collected from 230 Jordanian breast cancer patients for use in DNA extraction followed by genotyping and subsequent statistical analysis. We found that two single nucleotide variants (SNVs) of the BRCA2 gene, namely rs1799944 and rs766173, were significantly associated with breastfeeding status. Likewise, the rs11141901 and rs1041326 SNVs of the DAPK1 gene were linked with co-morbidity (p-value = 0.002) and family history of BC (p-value = 0.015), while the rs1045042 SNV of the same gene was associated with both allergy (p-value = 0.001) and family history of BC (p-value = 0.02). Tumor differentiation was correlated with the DAPK1 SNVs rs11141901 (p-value = 0.041) and rs1041326 (p-value = 0.005). Additionally, the rs2250889 SNV of the MMP9 gene was significantly associated with HER2 status, whereas the TP53 SNVs rs12951053 and rs1042522 were associated with age at menarche (p-value = 0.043) and breastfeeding status (p-value = 0.013), respectively. In contrast, the TP53 SNV rs2287497 was significantly linked to age at first pregnancy (p-value = 0.001), smoking (p-value = 0.041), and axillary lymph node status (p-value = 6e^-4). No such association was found for the BRCA1 and TOX3 SNVs. The current findings suggest significant associations between certain SNVs and breast cancer risk and prognosis in Jordanian women.

Barriers to exclusive breastfeeding in rural community of central Gujarat, India

Context:

Exclusive breastfeeding (EBF) in first the 6 months of life is the most effective way to satisfy nutritional and psychological needs of a baby. However, EBF rate for India remained low at 54.9% during 2015–2016. It is therefore essential to understand the reasons for such a low EBF rate in the country so that appropriate interventions can be developed and implemented.

Objectives:

(1) To estimate the prevalence of EBF in rural community of central Gujarat and (2) to identify barriers to EBF in this community.

Materials and Methods:

A community-based cross sectional study was conducted among mothers of 330 infants of age 6 months to 1 year using pretested questionnaire. Two-stage cluster sampling technique was used to select the sample. χ² test, t-test, and logistic regression were applied to assess the significance of associations.

Results:

EBF rate in the studied population was detected to be 49.7%. Early marriage of parents, less educated parents, male child, Christian religion, working mother, less number of antenatal visits, operative delivery, late initiation of breastfeeding, not feeding colostrum, lack of knowledge about EBF, and poor counseling of mother regarding EBF were identified as barriers to EBF.

Conclusion:

Prevalence of EBF was found to be lower than the national average in the rural community of central Gujarat. Effective strategies at local, state, and national levels should aim at addressing the barriers to EBF that are identified in this study.