| BMC Public Health | |
| Determinants of exclusive breastfeeding in an urban population of primiparas in Lebanon: a cross-sectional study | |
| Hibah Osman3  Rawan Chaaban3  Matilda Saliba3  Monique Chaaya2  Haya Hamade1  | |
| [1] Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon;Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon;Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon | |
| 关键词: Lebanon; Postpartum support; Breastfeeding; | |
| Others : 1161980 DOI : 10.1186/1471-2458-13-702 |
|
| received in 2012-07-09, accepted in 2013-07-11, 发布年份 2013 | |
PDF
|
|
【 摘 要 】
Background
The proportion of mothers who exclusively breastfeed their babies up to 6 months remains low. Determinants of breastfeeding practices have been largely documented in high-income countries. Little evidence exists on possible predictors of breastfeeding behaviors in the Middle East. Our aim was to assess the prevalence of breastfeeding in Beirut and determine the factors that impact breastfeeding behavior in this population.
Methods
Data for this longitudinal study is nested within a randomized controlled trial (RCT) assessing the impact of a 24-hour hotline and postpartum support film on postpartum stress. Healthy first-time mothers delivering in the capital Beirut between March and July 2009, were interviewed at 1–3 days and 8–12 weeks post delivery. A multiple logistic regression analysis was used to determine the factors associated with exclusive breastfeeding at 8–12 weeks postpartum.
Results
The overall breastfeeding rate at 8–12 weeks postpartum was 67%. The exclusive breastfeeding rate was 27.4%. Factors associated with exclusive breastfeeding included maternal work (OR=3.92; p-value<0.001), planned pregnancy (OR=2.42, p-value=0.010), intention to breastfeed (OR=3.28; p-value=0.043), source of maternal emotional support (OR = 1.87, p-value=0.039) and the use the postpartum support video, the hotline service or both (OR=2.55, p-value=0.044; OR=3.87, p-value=0.004 and OR=4.13, p-value=0.003).
Conclusions
The proportion of healthy first-time mothers who exclusively breastfeed in Beirut is extremely low. Factors associated with breastfeeding behavior are diverse. Future research and interventions should target different levels of the maternal-child pair’s ecosystem.
Trial registration
ClinicalTrials.gov, NCT00857051
【 授权许可】
2013 Hamade et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150413050016754.pdf | 205KB |
【 参考文献 】
- [1]James DC, Lessen R: Position of the American Dietetic Association: promoting and supporting breastfeeding. J Am Diet Assoc 2009, 109:1926-1942.
- [2]Ball O: Breastmilk is a human right. Breastfeed Rev 2010, 18:9-19.
- [3]Weimer J: The economic benefits of breastfeeding: A review and analysis. ERS Food Assistance and Nutrition Research Report No. 13. Washington, DC: USDA Economic Research Service; 2001.
- [4]Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, Eidelman AI: Breastfeeding and the use of human milk. Pediatrics 2005, 115:496-506.
- [5]World Health Organization: The optimal duration of exclusive breastfeeding. Geneva; 2002.
- [6]Imdad A, Yakoob MY, Bhutta ZA: Effect of breastfeeding promotion interventions on breastfeeding rates, with special focus on developing countries. BMC Public Health 2011, 11(Suppl 3):24-32.
- [7]Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HS: Maternal and Child Undernutrition Study G: Maternal and child undernutrition: consequences for adult health and human capital. Lancet 2008, 371:340-357.
- [8]Newton ER: The epidemiology of breastfeeding. Clin Obstet Gynecol 2004, 47:613-623.
- [9]Jacknowitz A: Increasing breastfeeding rates: do changing demographics explain them? Womens Health Issues 2007, 17:84-92.
- [10]Yngve A, Sjostrom M: Breastfeeding determinants and a suggested framework for action in Europe. Public Health Nutr 2001, 4:729-739.
- [11]Amin RM, Said ZM, Sutan R, Shah SA, Darus A, Shamsuddin K: Work related determinants of breastfeeding discontinuation among employed mothers in Malaysia. Int Breastfeed J 2011, 6:4-10.
- [12]Thulier D, Mercer J: Variables associated with breastfeeding duration. J Obstet Gynecol Neonatal Nurs 2009, 38:259-268.
- [13]Dewey KG: Maternal and fetal stress are associated with impaired lactogenesis in humans. J Nutr 2001, 131:3012S-3015S.
- [14]Forster DA, McLachlan HL, Lumley J: Factors associated with breastfeeding at six months postpartum in a group of Australian women. International Breastfeeding Journal 2006, 1:18-29.
- [15]Pan Arab Project for Family Health: Lebanon Family Health Survey Principal Report. Beirut; 2004.
- [16]Al-Sahab B, Tamim H, Mumtaz G, Khawaja M, Khogali M, Afifi R, Nassif Y, Yunis KA, National Collaborative Perinatal Neonatal Network (NCPNN): Predictors of breast-feeding in a developing country: results of a prospective cohort study. Public Health Nutr 2008, 11:1350-1356.
- [17]Batal M, Bosulghourijian C, Abdallah A, Afifi R: Breastfeeding and feeding practices of infants in a developing country: a national survey in Lebanon. Public Health Nutr 2006, 13:1-8.
- [18]Khayat R, Campbell O: Hospital practices in maternity wards in Lebanon. Health Policy Plan 2000, 15:270-278.
- [19]Batal M, Boulghourjian C, Akik C: Complementary feeding practices in a developing country: a cross-sectional study across Lebanon. East Mediterr Health J 2010, 16:181-186.
- [20]Osman H, El Zein L, Wick L: Cultural beliefs that may discourage breastfeeding among Lebanese women: a qualitative analysis. International Breastfeeding Journal 2009, 4:12-17.
- [21]Central Intelligence Agency Library. https://www.cia.gov/library/publications/the-world-factbook/geos/le.html webcite
- [22]Central Administration of Statistics: Living conditions of Households. Beirut; 2004.
- [23]Chaaya M, Osman H, Naassan G, Mahfoud Z: Validation of the Arabic version of the Cohen Perceived Stress Scale (PSS-10) among pregnant and postpartum women. BMC Psychiatry 2010, 10:111.
- [24]Ghubash R, Abou-Saleh MT, Daradkeh TK: The validity of the Arabic Edinburgh postnatal depression scale. Soc Psychiatry Psychiatr Epidemiol 1997, 32:474-476.
- [25]Ahmed M, Abdel-Khalek AM: The development and validation of an Arabic form of the STAI: Egyptian results. Personality and Individual Differences 1989, 10:277-285.
- [26]Lauer J, Betran A, Victora C, de Onis M, Barros A: Breastfeeding patterns and exposure to suboptimal breastfeeding among children in developing countries: review and analysis of nationally representative surveys. BMC Med 2004, 2:1-29.
- [27]Kimani-Murage EW, Madise NJ, Fotso J, Kyobutungi C, Mutua MK, Gitau TM, Yatich N: Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi, Kenya. BMC Public Health 2011, 11:396-406.
- [28]Al-Akour NA, Khassawneh MY, Khader YS, Ababneh AA, Haddad AM: Factors affecting intention to breastfeed among Syrian and Jordanian mothers: a comparative cross-sectional study. International Breastfeeding Journal 2010, 5:6-13.
- [29]Dodgson JE, Henly SJ, Duckett L, Tarrant M: Theory of planned behavior-based models for breastfeeding duration among Hong Kong mothers. Nurs Res 2003, 52:148-158.
- [30]Semenic S, Loiselle C, Gottlieb L: Predictors of the duration of breastfeeding among first-time mothers. Res Nurs Health 2008, 31:428-441.
- [31]Tamim H, El-Chemaly SY, Nassar AH, Aaraj AM, Campbell OM, Kaddour AA, Yunis KA, National Collaborative Perinatal Neonatal Network (NCPNN): Cesarean delivery among nulliparous women in Beirut: assessing predictors in nine hospitals. Birth 2007, 34:14-20.
- [32]Carayol M, Zein A, Ghosn N, Du Mazaubrun C, Breart G: Determinants of caesarean section in Lebanon: geographical differences. Paediatr Perinat Epidemiol 2008, 22:136-144.
- [33]Kassak KM, Mohammad Ali A, Abdallah AM: Opting for a cesarian section: what determines the decision? Public Administration & Management 2005, 13:100-122.
- [34]Prior E, Santhakumaran S, Gale C, Philipps LH, Modi N, Hyde MJ: Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. Am J Clin Nutr 2012, 95:1113-1135.
- [35]Kabakian-Khasholian T, Kaddour A, Dejong J, Shayboub R, Nassar A: The policy environment encouraging C-sections in Lebanon. Health Policy 2007, 83:37-49.
- [36]Khalaf M: The Lebanese woman and the labor market. Al-Raida 1993, 10:14-17.
- [37]Ryan AS, Zhou W, Arensberg MB: The effect of employment status on breastfeeding in the United States. Womens Health Issues 2006, 16:243-251.
- [38]Saadé N, Barbour B, Salameh P: Maternity leave and experience of working mothers in Lebanon. East Mediterr Health J 2010, 16:994-1002.
- [39]Olang B, Farivar K, Heidarzadeh A, Strandvik B, Yngve A: Breastfeeding in Iran: prevalence, duration and current Recommendations. International breastfeeding journal 2009, 4:8-17.
- [40]Johnelle Sparks P: Rural–urban differences in breastfeeding initiation in the United States. J Hum Lact 2010, 26:118-129.
PDF