Abstract
Background
There is much concern about declining rates of exclusive breastfeeding (EBF) all over the world including Saudi Arabia which deprives infants from many immunological, nutritional, and psychosocial benefits. This study was performed to determine EBF prevalence and factors influencing EBF in relation to knowledge, attitude and practice (KAP) of breastfeeding mothers (BFM) in Rabigh, Western Saudi Arabia.
Methods
Data about factors that could be associated with EBF and KAP of BFM were collected by cross-sectional questionnaire-based study from 420 BFM.
Results
Prevalence of EBF for 6 months was 27.6% which is far below World Health Organization recommendations. Demographic, socioeconomic, biomedical as well as most studied variables of KAP of 50% to over 90% of participating mothers were adequate to account for low EBF rate. Proper knowledge about benefits of colostrum and continuation of breastfeeding for 2 years was given by only 86.2% and 36.7% of BFM, respectively. The most significant independent factors associated with EBF were perception of sufficient human milk [adjusted odds ratio (AOR) 2.89; 95% confidence interval (CI) 1.72–4.89], absence of nipple pain (AOR 2.77; 95% CI 1.72–4.45) and mothers without university education (AOR 1.86; 95% CI 1.15–3.01). Early introduction of formula in hospital after birth was the main inappropriate feeding practice in 76.2% of infants of BFM.
Conclusion
Findings of this study should be utilized by Rabigh community and other national or worldwide communities with similar characters to promote EBF by targeted educational programs after identification of significant factors influencing EBF and gaps in KAP of BFM.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Parks EP, Shaikhkhalil A, Groleau V, Wendel D, Stallings VA (2016) Feeding of infants, children and adolescents. In: Kliegman RM, Stanton BF, St.-Geme JW, Schor NF, Behrman RE, editors. Nelson Text Book of Pediatrics, 20th ed, Elsevier, Philadelphia, p. 286–295.
Dennis CL. Breastfeeding initiation and duration: a 1990–2000 literature review. J Obstet Gynecol Neonatal Nurs. 2002;31:12–32.
World Health Organization. Nutrition, 2018. https://www.who.int/nutrition/topics/exclusive_breastfeeding/en/. Accessed 22 Aug 2018.
Centers for Disease Control and Prevention. Breastfeeding among US children born 2009–2015, CDC National Immunization Survey. Rates of any and exclusive breastfeeding by age among children born in 2015. https://www.cdc.gov/breastfeeding/data/nis_data/results.html/. Accessed 15 Jan 2018.
Cai X, Wardlaw T, Brown DW. Global trends in exclusive breastfeeding. Int Breastfeed J. 2012;7:12.
Nnebe-Agumadu UH, Racine EF, Laditka SB, Coffman MJ. Association between perceived value of breastfeeding among pregnant women in the United States and exclusive breastfeeding to three and six months postpartum: a prospective study. Int Breastfeed J. 2016;11:8.
Al-Madani M, Vydelingum V, Lawrence J. Saudi mothers’ expected intentions and attitudes toward breast-feeding. Infant Child Adolesc Nutr. 2010;2:187–98.
Al-Hreashy FA, Tamim HM, Al-Baz N, Al-Kharji NH, Al-Amer A, Al-Ajmi H, et al. Patterns of breastfeeding practice during the first 6 months of life in Saudi Arabia. Saudi Med J. 2008;29:427–31.
Al Juaid AM, Binns CW, Giglia RC. Breastfeeding in Saudi Arabia: a review. Int Breastfeed J. 2014;9:1.
Ogbeide DO, Siddiqui S, Al-Khalifa IM, Karim A. Breastfeeding in Saudi Arabian community: profile of parents and influencing factors. Saudi Med J. 2004;25:580–4.
Al-Jassir MS, El-Bashir BM, Moizuddin SK, Abu-Nayan AA. Infant feeding in Saudi Arabia: mothers' attitudes and practices. East Mediterr Health J. 2006;12:6–13.
Thulier D, Mercer J. Variables associated with breastfeeding duration. J Obstet Gynecol Neonatal Nurs. 2009;38:259–68.
Al-Binali AM. Breastfeeding knowledge, attitude and practice among school teachers in Abha female educational district, southwestern Saudi Arabia. Int Breastfeed J. 2012;7:10.
Tan KL. Factors associated with exclusive breastfeeding among infants under six months of age in peninsular Malaysia. Int Breastfeed J. 2011;6:2.
Liben ML, Gemechu YB, Adugnew M, Asrade A, Adamie B, Gebremedin E, et al. Factors associated with exclusive breastfeeding practices among mothers in dubti town, afar regional state, northeast Ethiopia: a community based cross-sectional study. Int Breastfeed J. 2016;11:4.
Al-Jassir MS, El-Bashir BM, Moizuddin SK. Surveillance of infant feeding practices in Riyadh city. Ann Saudi Med. 2004;24:136–40.
El-Gilany A, Shady E, Helal R. Exclusive breastfeeding in Al-Hassa. Saudi Arabia. Breastfeed Med. 2011;6:209–13.
Amin T, Hablas H, Al-Qader AA. Determinants of initiation and exclusivity of breastfeeding in Al Hassa. Saudi Arabia. Breastfeed Med. 2011;6:59–68.
Odom EC, Li R, Scanlon KS, Perrine CG, Grummer-Strawn L. Reasons for earlier than desired cessation of breastfeeding. Pediatrics. 2013;131:e726–32.
Dennis CL, Jackson K, Watson J. Interventions for treating painful nipples among breastfeeding women. Cochrane Database Syst Rev. 2014;12:CD007366.
Kent JC, Ashton E, Hardwick CM, Rowan MK, Chia ES, Fairclough KA, et al. Nipple pain in breastfeeding mothers: incidence, causes and treatments. Int J Environ Res Public Health. 2015;12:12247–63.
Parry JE, Ip DK, Chau PY, Wu KM, Tarrant M. Predictors and consequences of in-hospital formula supplementation for healthy breastfeeding newborns. J Hum Lact. 2013;29:527–36.
Forster DA, Johns HM, McLachlan HL, Moorhead AM, McEgan KM, Amir LH. Feeding infants directly at the breast during the postpartum hospital stay is associated with increased breastfeeding at 6 months postpartum: a prospective cohort study. BMJ Open. 2015;5:e007512.
El Mouzan MI, Al Omar AA, Al Salloum AA, Al Herbish AS, Qurachi MM. Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations. Ann Saudi Med. 2009;29:20–3.
Al-Ayed IH, Qureshi MI. Breastfeeding practices in urban Riyadh. J Trop Pediatr. 1998;44:113–7.
Shommo SAM, Al-Shubrumi HAS. Breastfeeding knowledge, attitude and practice among mothers in Hail district, northwestern Saudi Arabia. J Nurs Health Sci. 2014;3:49–56.
Acknowledgements
Authors would like to acknowledge all mothers who participated in this research study, Dalal Ayedh Alharbi, intern at Btterjee Medical College, and 6th year students of FMR (Fuad Ayyadah Almurashi and Mohammed Suliman Alaslani) who contributed to this research as data collectors.
Funding
No financial support was provided for this study.
Author information
Authors and Affiliations
Contributions
HM was responsible for the concept and design of the study, analysis and interpretation of the data and drafting of the article. MA, MA, AA, LAH, and SA contributed to the design of the study, acquisition and analysis of data, and drafting the article. All authors contributed to the critical revision and final approval of the manuscript to be published.
Corresponding author
Ethics declarations
Ethical approval
This study protocol was approved by Research Ethics Committee of Faculty of Medicine in Rabigh, King Abdulaziz University.
Conflict of interest
No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. All authors report no conflicts of interests and have no relevant disclosures.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Hegazi, M.A., Allebdi, M., Almohammadi, M. et al. Factors associated with exclusive breastfeeding in relation to knowledge, attitude and practice of breastfeeding mothers in Rabigh community, Western Saudi Arabia. World J Pediatr 15, 601–609 (2019). https://doi.org/10.1007/s12519-019-00275-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12519-019-00275-x