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Breast-feeding and feeding practices of infants in a developing country: a national survey in Lebanon

Published online by Cambridge University Press:  02 January 2007

Malek Batal*
Affiliation:
Department of Nutrition and Food Sciences, American University of Beirut, PO Box 11-0236, Beirut, Lebanon
Choghik Boulghourjian
Affiliation:
Department of Nutrition and Food Sciences, American University of Beirut, PO Box 11-0236, Beirut, Lebanon
Ahmad Abdallah
Affiliation:
Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Beirut, Lebanon
Rima Afifi
Affiliation:
Faculty of Health Sciences, American University of Beirut, PO Box 11-0236, Beirut, Lebanon
*
*Corresponding author: Email [email protected]
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Abstract

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Objective

Breast-feeding (BF) provides the ideal food for the healthy growth and development of infants. The prevalence of BF in Lebanon shows mixed results. The present study was the first large-scale, extensive survey on BF parameters in Lebanon that aimed to explore demographic, socio-economic and other fundamental issues associated with the initiation and duration of BF by Lebanese mothers.

Design

The survey was cross-sectional in design and administered over 10 months.

Setting

Information on all variables was collected from mothers at health centres.

Subjects

Two-stage sampling was conducted to select participants. A total of 1000 participants were randomly selected. A consent form was provided to each participant. Data were collected from 830 of these.

Results

Almost all mothers were Lebanese, married and had given birth in a hospital. About a third stated that breast milk was the first food introduced after birth. Although 55.9% started breast-feeding their newborns within a few hours after birth, and 18.3% within half an hour, 21.2% replied that they initiated BF a few days after birth. Only 4.6% of the mothers replied that they never breast-fed their infant. Timing of initiation of BF was associated with the type of delivery (vaginal/Caesarean section) and hospital-related factors (rooming-in, night feedings and frequency of mother–infant interaction). Of the mothers who breast-fed exclusively beyond 6 months, 86.7% had initiated BF a few hours following delivery, while only 13.3% had initiated BF a few days later. Compared with the exceptionally high proportion of BF initiation, exclusivity of BF was low, dropping to 52.4% at 1 month. Exclusivity of BF was also associated with place of residence (urban/rural) and negatively associated with educational level of the mother. Duration of BF was inversely associated with the use of pain killers during delivery and maternal education. Rural mothers and those who practised exclusive BF maintained BF for a longer duration.

Conclusion

Initiation rates of BF are very high in Lebanon but rates of exclusive BF are low and duration of BF is short. Future research targeting the factors associated with BF, with particular emphasis on exclusivity, is needed. For the 95.4% of mothers who initiated BF, an ecological perspective on intervention aimed at women and their social support system is required to improve duration and exclusivity.

Type
Research Article
Copyright
Copyright © The Authors 2006

References

1Raisler, J, Alexander, C, O'Campo, P. Breast-feeding and infant illness: a dose–response relationship? American Journal of Public Health 1999; 89(1): 2530.CrossRefGoogle ScholarPubMed
2Sizer, F, Whitney, E. Life cycle nutrition: mother and infant. In: Nutrition Concepts and Controversies. Minneapolis/St Paul, MN: West/Wadsworth, 1997.Google Scholar
3Sizer, F, Whitney, E. Nutrition: Concepts and Controversies, 8th ed; St Paul, MN: Wadsworth/Thomson Learning, 2000.Google Scholar
4Akre, J. Infant feeding. The physiological basis. Bulletin of the World Health Organization 1989; 67(Suppl. 1): 1108.Google ScholarPubMed
5Boyle, AM, Morris, DH. Community Nutrition in Action: An Entrepreneurial Approach. St Paul, MN: West Publishing Company, 1994.Google Scholar
6Cushing, AH, Samet, JM, Lambert, WE, Skipper, BJ, Hunt, WC, Young, SA, et al. Breastfeeding reduces risk of respiratory illness in infants. American Journal of Epidemiology 1998; 147(9): 863–70.Google Scholar
7Scariati, PD, Grummer-Strawn, LM, Fein, SB. A longitudinal analysis of infant morbidity and the extent of breastfeeding in the United States. Pediatrics 1997; 99(6): E5.CrossRefGoogle ScholarPubMed
8Musaiger, AO. Breastfeeding patterns and promotion of infant formula in the Republic of Yemen. Journal of Tropical Pediatrics 1992; 39(1): 5964.CrossRefGoogle Scholar
9Black, RE, Brown, KH, Becker, S, Yunis, M. Longitudinal studies of infectious diseases and physical growth of children in rural Bangladesh. Journal of Epidemiology 1982; 115(3): 305–14.CrossRefGoogle ScholarPubMed
10Central Intelligence Agency. The World Factbook, 2002. Washington, DC: US Department of State, 2002.Google Scholar
11Deeb, M. Beirut: A Health Profile 1984– 1994. Beirut: American University Press, 1997.Google Scholar
12El Zein, A. Situation Analysis and Surveys on Child Health in Lebanon. Beirut: United Nations Children's Fund, 1993.Google Scholar
13Yunis, K, Khogali, M, Tamim, H. The first year of life (Aug. 01–Feb. 02 to Aug. 02–Feb. 03). In: A Study on Morbidity and Mortality among Newborn Babies, Infants, and Under Five Year Old Children in Greater Beirut – Lebanon. Monographs of the National Collaborative Perinatal Neonatal Network. Beirut: National Collaborative Perinatal Neonatal Network, 2004.Google Scholar
14Yngve, A, Sjostrom, M. Breastfeeding determinants and a suggested framework for action in Europe. Public Health Nutrition 2001; 4(2B): 729–39.CrossRefGoogle Scholar
15Foster, K, Lader, D, Cheesbrought, S. Infant Feeding 1995. Social Survey Divisions of the Office for National Statistics. London: The Stationery Office, 1997.Google Scholar
16Alexy, U, Kersting, M, Sichert-Hellert, W, Manz, F, Schöch, G. Energy intake and growth of 3- to 36-month old German infants and children: results of the DONALD Study. Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Annals of Nutrition & Metabolism 1998; 42(1): 6874.Google Scholar
17Waterson, T. Inequity in child health as a global issue. Pediatrics 2005; 112(3): 739–41.CrossRefGoogle Scholar
18World Health Organization (WHO). Global Strategy for Infant and Young Child Feeding. The Optimal Duration of Exclusive Breastfeeding. A54/INF.DOC./4 Geneva: WHO, 05 2001.Google Scholar
19World Health Organization (WHO). Global Databank on Breastfeeding and Complementary Feeding 2003. Geneva: WHO, 2003.Google Scholar
20Leung, TF, Tam, WH, Hung, EC, Fok, TF, Wong, GW. Sociodemographic and atopic factors affecting breastfeeding intention in Chinese mothers. Journal of Clinical Psychiatry 2003; 64(8): 966–8.Google Scholar
21Dubois, L, Girard, M. Social determinants of initiation, duration, and exclusivity of breastfeeding at the population level: the results of the Longitudinal Study of Child Development in Quebec (ELDEQ 1998–2002). Canadian Journal of Public Health 2003; 94(4): 300–5.CrossRefGoogle ScholarPubMed
22Azaiza, F, Palti, H. Determinants of breastfeeding among rural Moslem women in Israel. Families, Systems & Health 1997; 15(2): 203–11.Google Scholar
23Abdulrahman, OM. Food habits in Bahrain: infants' feeding habits. Journal of Tropical Pediatrics 1983; 29: 248–51.Google Scholar
24Hanson, MB, Hellerstedt, WL, Desvarieux, M, Duval, SJ. Correlates of breastfeeding in a rural population. American Journal of Health Behavior 2003; 27(4): 432–44.CrossRefGoogle Scholar
25Fida, NM, Al-Aama, JY. Pattern of infant feeding at a university hospital in western Saudi Arabia. Saudi Medical Journal 2003; 24(7): 725–9.Google Scholar
26Dodgson, JE, Tarrant, M, Fong, DY, Peng, XH, Hui, WH. Breastfeeding patterns of primiparous mothers in Hong Kong. Birth 2003; 30(3): 195202.CrossRefGoogle ScholarPubMed
27Bulk-Bunschoten, AM, van Bodegom, S, Reerink, JD, Pasker-de Jong, PC, de Groot, CJ. Reluctance to continue breastfeeding in the Netherlands. Acta Paediatrica 2001; 90(9): 1047–53.Google Scholar
28Lande, B, Andersen, LF, Bærug, A, Trygg, KU, Lund-Larsen, K, Veierød, MB, et al. Infant feeding practices and associated factors in the first six months of life. Acta Paediatrica 2003; 92(2): 152–61.CrossRefGoogle ScholarPubMed
29Kersting, M, Alexy, U, Sichert-Hellert, W, Manz, F, Schöch, G. Measured consumption of commercial infant food products in German infants: results from the DONALD study. Journal of Pediatric Gastroenterology and Nutrition 1998; 27(5): 547–52.Google ScholarPubMed
30Hediger, ML, Overpeck, MD, Ruan, WJ, Troendle, JF. Early infant feeding and growth status of US-born infants and children aged 4–71 mo: analysis from the Third National Health and Nutrition Examination Survey, 1988–1994. American Journal of Clinical Nutrition 2000; 72(1): 159–67.Google Scholar
31Abdulla, SM. Food habits in Iraq. Master's thesis submitted to the High Institute of Public Health, University of Alexandria, Eygpt, 1979; 100–7.Google Scholar
32Wahiba, SA, Galal, O, Kamil, LM, Morsi, KS, El Wakeil, FA. Improved feeding patterns in the prevention of childhood malnutrition. Gazette of the Egyptian Pediatric Association 1975; 23(2): 97109.Google Scholar
33Churchill, CW, Kanawati, A. Cultural factors in nutrition in Lebanon. In: Proceedings of the 6th Symposium on Nutrition and Health in the Near East, American University of Beirut 1971; 282–8.Google Scholar
34McLeroy, KR, Bibeau, D, Steckler, A, Glanz, K. An ecological perspective on health promotion programs. Health Education Quarterly 1988; 15(4): 351–77.CrossRefGoogle ScholarPubMed
35Batal, M, Boulghourgian, C. Breastfeeding initiation and duration in Lebanon: are the hospitals ‘mother friendly’? Journal of Pediatric Nursing 2005; 20(1): 53–9.Google Scholar
36Adriano, C, Roberto, B. Effect on rates of breast feeding of training for the baby friendly hospital initiative. British Medical Journal 2001; 323(7325): 1358–62.Google Scholar