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      Determinants of Exclusive Breastfeeding in a Sample of Egyptian Infants

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          Abstract

          BACKGROUND:

          Breastfeeding is an optimum, healthy, and economical mode of feeding an infant. However, many preventable obstacles hinder exclusive breastfeeding in the first six months of life.

          AIM:

          We aimed to assess the social-, maternal- and infant-related factors disturbing exclusive breastfeeding in the first six months of life.

          METHODS:

          It is a retrospective study included 827 dyads of mothers and infants older than 6 months (411 exclusively breastfed, 311 artificially-fed and 105 mixed feds). Mothers were interviewed to obtain sociodemographic information, maternal medical history and perinatal history and a detailed history of infant feeding.

          RSULTS:

          Many factors were found to support the decision for artificial feeding rather than exclusive breastfeeding, including maternal age < 25 years (OR = 2.252), child birth order > 3rd (OR = 2.436), being a primi-para (OR = 1.878), single marital status (OR = 2.762), preterm infant (OR = 3.287) and complicated labor (OR = 1.841). Factors in favor of mixed feeding included cesarean section (OR = 2.004) and admission to the Neonatal Intensive Care Unit (OR = 1.925).

          CONCLUSIONS:

          Although it isn’t a community-based study and its results can’t be generalised, plans to improve health and development of children are preferable to include the following: health education and awareness programs about the importance of exclusive breastfeeding should be directed for young and first-time mothers. Improved antenatal care to reduce perinatal and neonatal problems; and training, monitoring, and supervising community health care workers to recognise labour complications and provide support and knowledge to lactating mothers.

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          Most cited references24

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          Factors influencing breastfeeding exclusivity during the first 6 months of life in developing countries: a quantitative and qualitative systematic review.

          Breastfeeding is the most advantageous feeding option for infants, and epidemiological studies provide evidence for its promotion. The objective of this review was to comprehensively delineate the barriers and facilitators of exclusive breastfeeding of infants aged 0-6 months old by mothers in developing countries. A search of CINAHL, MEDLINE and PsycINFO was carried out to retrieve studies from January 2001 to January 2014. Using our inclusion criteria, we selected studies that described barriers and facilitators of exclusive breastfeeding. Qualitative and quantitative studies were considered. Twenty-five studies involving 11 025 participants from 19 countries were included. Barriers and facilitators of exclusive/full breastfeeding were identified, analysed tabulated and summarised in this review. Maternal employment was the most frequently cited barrier to exclusive breastfeeding. Maternal perceptions of insufficient breast milk supply was pervasive among studies while medical barriers related to illness of mothers and/or infants as well as breast problems, rather than health care providers. Socio-cultural factors such as maternal and significant other's beliefs about infant nutrition also often constitute strong barriers to exclusive breastfeeding. Despite these barriers, mothers in developing countries often possess certain personal characteristics and develop strategic plans to enhance their success at breastfeeding. Health care providers should be informed about the determinants of exclusive breastfeeding and provide practical anticipatory guidance targeted at overcoming these barriers. In so doing, health care providers in developing countries can contribute to improving maternal and child health outcomes.
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            Factors Affecting Exclusive Breastfeeding among Women in Muheza District Tanga Northeastern Tanzania: A Mixed Method Community Based Study

            Objectives Estimates shows exclusive breastfeeding (EBF) has the potential to prevent 11.6 % of all under-five deaths in developing countries. Prevalence of EBF is low globally (35 %), and in sub Saharan Africa ranges between 22 and 33 %. Like other developing countries the prevalence of EBF is 50 % in Tanzania. There is limited information in Tanzania on factors influencing EBF apart from information specific for HIV positive women. This study aimed at examining factors that affect EBF practice among women in Muheza district, Tanga region, northeastern Tanzania. Methods A community based cross-sectional study using both qualitative and quantitative methods was conducted from April to June 2014. To collect relevant information, a total of 316 women with infants aged 6–12 months were interviewed using a questionnaire and 12 key informants using in-depth interview guide. Qualitative data was analyzed using thematic analysis while bivariate and multivariate logistic regression analysis were used assess association between EBF and predictor variables. Results The prevalence of EBF was 24.1 %. The perception that mothers’ breast milk is insufficient for child’s growth, child being thirsty and the need to introduce herbal medicine for cultural purposes were among the important factors for early mixed feeding. In multivariate analysis advanced maternal age (OR 2.6; 95 % CI 1.18–5.59) and knowledge on EBF duration and advantages (OR 2.2; 95 % CI 1.2–3.8) remained significantly associated with EBF practice. Conclusions The prevalence of EBF in our study is low compared with the national prevalence. Strategies to target beliefs that breast milk is insufficient for growth need to be strengthened in the community. Furthermore opportunity to increase EBF training during ante and postnatal visits for women should be enhanced as more than 90 % of women in the district use skilled attendants during pregnancy and delivery.
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              Determinants of exclusive breastfeeding practices among mothers in azezo district, northwest Ethiopia

              Background Exclusive breastfeeding (EBF) is a very important, long lasting and cost effective intervention to help reduce the morbidity and mortality of infants. However, a large proportion of infants are not exclusively breastfed as recommended by the World Health Organization. The study aim was to assess the exclusive breastfeeding practices and identify determinants among mothers in Azezo District, Ethiopia. Methods A community based cross-sectional study was conducted among 346 mothers with infants aged between 0–6 months. Data were collected using a pretested, interviewer administered questionnaire. Descriptive statistics and logistic regression analysis were used to describe the study objectives and identify the determinants of EBF in the previous 24 h. Associations between the study and outcome variables were described using odds ratios and 95 % confidence intervals (CI). Results Any breastfeeding and exclusive breastfeeding in the previous 24 h were 99 and 79 %, respectively. The mean number of exclusive breastfeeds in the 24 h period was 6.5. Exclusive breastfeeding rates were highest among mothers aged ≥ 30 years (Adjusted odds ratio [AOR] 1.75; 95 % CI 1.14, 3.42). Infants whose mothers were unemployed were more likely to be exclusively breastfed than infants whose mothers were employed (AOR 1.62; 95 % CI 1.03, 2.95). Mothers earning ≤ 1000 birr (US $47.62) monthly were 77 % less likely to practice EBF (AOR 0.23; 95 % CI 0.13, 0.44). Mothers who delivered at the healthcare facility practised more exclusive breastfeeding than those who delivered at home (AOR 2.18; 95 % CI 1.22, 4.35). Mothers who received antenatal and postnatal care had better rates of EBF (AOR 2.24; 95 % CI 1.18, 5.76 and AOR 1.62; 95 % CI 1.09, 3.21) and mothers not practicing prelacteal feeding were more likely to exclusively breastfeed compared with mothers practicing prelacteal feeding (AOR 2.16; 95 % CI 1.16, 4.06). Conclusions Any breastfeeding and exclusive breastfeeding rates in the previous 24 h are relatively high in the study area compared with previous studies. Maternal factors (age, education, income, employment, antenatal care, prelacteal feeding), infants’ age, delivery place and information access were independent predictors to EBF in previous 24 h. Improving the mother’s knowledge, income, information access, nutritional counselling, quality of antenatal and postnatal care service, place of delivery and avoiding prelacteal feeding practices are important to improving the exclusive breastfeeding rate in the previous 24 h.
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                Author and article information

                Journal
                Open Access Maced J Med Sci
                Open Access Maced J Med Sci
                Open Access Macedonian Journal of Medical Sciences
                Republic of Macedonia (ID Design 2012/DOOEL Skopje )
                1857-9655
                25 October 2018
                02 October 2018
                : 6
                : 10
                : 1818-1823
                Affiliations
                [1 ]Biological Anthropology Department, Medical Research Division, National Research Centre, Giza, Egypt
                [2 ]Department of Community Medicine Research, Medical Research Division, National Research Centre, Giza, Egypt
                [3 ]Child Health Department, Medical Research Division, National Research Centre, Giza, Egypt
                [4 ]Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
                Author notes
                [* ] Correspondence: Dina Abu Zeid. Child Health Department, Medical Research Division, National Research Centre, Giza, Egypt. E-mail: dinaabuzeid@ 123456yahoo.com
                Article
                OAMJMS-6-1818
                10.3889/oamjms.2018.359
                6236050
                30455755
                87360592-7b29-49b7-b90d-b5c3eed30353
                Copyright: © 2018 Wafaa A. Kandeel, Thanaa M. Rabah, Dina Abu Zeid, Ebtissam M. Salah El-Din, Ammal M. Metwally, Ashraf Shaalan, Lobna A. El Etreby, Sanaa Y. Shaaban.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).

                History
                : 10 June 2018
                : 04 September 2018
                : 09 September 2018
                Categories
                Clinical Science

                infant feeding,exclusive breastfeeding,mixed feeding,egyptian infants,social factors

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