Background
Methods
Study setting and population
Study instrument
-
Knowledge: Good (8–12 points), Fair (4–7 points), Poor (0–3 points)
-
Attitude: Good (5–6 points), Fair (3–4 points), Poor (0–2 points)
-
Practice: Good (4–10 points), Fair (2–3 points), Poor (0–1 point)
-
For how long did you exclusively breastfeed (giving your child only breast milk, no formula milk or food) your last child since birth?
-
If you are still exclusively breastfeeding (giving your child only breast milk, no formula milk or food) your last child, until what age are you planning to continue?
Data collection
Data analysis
Results
Description and characteristics of participants
Mother-related
Variable | Number | (%) |
---|---|---|
Age (in years) | ||
18–24 | 39 | (11.4) |
25–29 | 128 | (37.5) |
30–34 | 107 | (31.4) |
35–39 | 57 | (16.7) |
40–44 | 10 | (3) |
≥ 45 | 0 | (0) |
Marital status | ||
Married | 338 | (99.1) |
Divorced | 2 | (0.6) |
Widowed | 1 | (0.3) |
Educational background | ||
Primary school or lower | 3 | (0.9) |
Secondary school | 65 | (19.1) |
University or higher | 272 | (80) |
Employed | ||
No | 237 | (69.3) |
Yes | 105 | (30.7) |
Self-employed | 0 | (0) |
Employment sector | ||
Private | 68 | (66) |
Public | 35 | (34) |
Entitled to breastfeeding hours by employer | ||
Yes | 83 | (82.2) |
No | 18 | (17.8) |
Living with husband and children only | ||
Yes | 293 | (86.4) |
No (Living with relatives) | 43 | (12.7) |
No (Separated/Divorced/Widowed) | 3 | (0.9) |
Number of housemaids or nannies | ||
0 | 240 | (73.2) |
1 | 70 | (21.3) |
> 1 | 18 | (5.5) |
Monthly family income (in AED) | ||
< 15,000 | 137 | (42) |
15,000–30,000 | 153 | (46.9) |
> 30,000 | 36 | (11.1) |
Number of children | ||
1 | 122 | (35.9) |
2–4 | 206 | (60.6) |
≥ 5 | 12 | (3.5) |
Gender of last child | ||
Male | 169 | (51.4) |
Female | 160 | (48.6) |
Last child’s gestational age at delivery | ||
< 37 weeks | 69 | (20.5) |
≥ 37 weeks | 267 | (79.5) |
Mode of delivery of last child | ||
Vaginal delivery | 196 | (57.6) |
Caesarian section | 144 | (42.4) |
Healthcare provider explained the importance of breastfeeding during antenatal visits for last pregnancy | ||
Yes | 275 | (81.6) |
No | 62 | (18.4) |
Healthcare provider explained the importance of breastfeeding after delivery of last child | ||
Yes | 286 | (84.4) |
No | 53 | (15.6) |
Healthcare provider explained the appropriate practices of breastfeeding for last child | ||
Yes | 268 | (79.8) |
No | 68 | (20.2) |
Variable | Mean (± SDa) | Median (±IQRb) |
---|---|---|
Number of people living inside house (Including housemaids, drivers, etc.) | 4.7 (± 2.9) | 4 (± 2) |
Age of last child (in months) | 8.2 (± 5.7) | 6 (± 8) |
Employer-entitled breastfeeding hours per day (in hours) | 1.1 (± 0.3) | 1 (± 1) |
Employer-entitled breastfeeding hours duration (in months) | 15.3 (± 5.2) | 18 (± 6) |
Breastfeeding duration of previous children (in months) (n = 171) | 16.2 (± 7.3) | 17 (± 12) |
Age of stopping breastfeeding of last child (in months) (n = 66) | 7.1 (± 5.4) | 6 (± 9) |
Family and child -related
Employer-related
Mothers’ breastfeeding knowledge
Variable | Number | (%) |
---|---|---|
Correctly answered breastfeeding knowledge questions by participants (total of 12 scored questions): | ||
Breastfeeding child ≥8 times/day during the first month | 179 | (53.1) |
Breastfeeding duration ≥15 min from each breast during the first month | 116 | (34.6) |
Colostrum is good for child | 289 | (86) |
Breastfeeding is beneficial for both the mother and the child | 315 | (94) |
Children should receive breast milk until ≥24 months of age | 114 | (33.9) |
Complementary food should be introduced at 6 months of age | 290 | (86.1) |
Breast milk is superior to formula milk in fulfilling child’s necessary dietary requirements | 323 | (96.1) |
Breast milk is sufficient for child in the first 6 months of life | 273 | (81.2) |
Breastfeeding decreases the mother’s weight | 193 | (57.3) |
Breast milk does not lose its benefits when it is pumped out or stored | 184 | (55.6) |
Pumped breast milk can be stored at room temperature (60 °F–85 °F/15.5 °C–29.4 °C) for up to 8 hours | 160 | (47.5) |
Pumped breast milk can be stored in the refrigerator (39 °F or colder/3.99 °C or colder) for up to 8 days | 99 | (29.6) |
Participants’ overall knowledge level: | ||
Good | 176 | (51.2) |
Fair | 149 | (43.3) |
Poor | 19 | (5.5) |
Participants’ sources of information about breastfeeding: | ||
Doctors | 197 | (58.5) |
Nurses/midwives | 169 | (50.1) |
Friends | 111 | (32.9) |
Family | 224 | (66.5) |
TV programs | 80 | (23.7) |
Campaigns | 51 | (15.1) |
Magazines | 49 | (14.5) |
Breastfeeding classes | 52 | (15.4) |
Internet | 137 | (40.7) |
Others | 11 | (3.3) |
Factors affecting mothers’ breastfeeding knowledge
Mothers’ breastfeeding attitude
Variable | Number | (%) |
---|---|---|
Response of participants to breastfeeding attitude questions (Total of six scored questions) | ||
Breastfeeding can increase the mother’s weight: | ||
Agree | 69 | (20.6) |
Neutral | 86 | (25.7) |
Disagreea | 180 | (53.7) |
One of the causes of hair loss is breastfeeding: | ||
Agree | 114 | (34) |
Neutral | 74 | (22.1) |
Disagreea | 147 | (43.9) |
Pumping breast milk makes it no longer beneficial for the child: | ||
Agree | 39 | (11.7) |
Neutral | 89 | (26.7) |
Disagreea | 205 | (61.6) |
Mothers should stop breastfeeding if they take any type of medication: | ||
Agree | 138 | (41.8) |
Neutral | 105 | (31.8) |
Disagreea | 87 | (26.4) |
Intention to breastfeed future children: | ||
Agreea | 307 | (92.8) |
Neutral | 15 | (4.5) |
Disagree | 9 | (2.7) |
Plan to attend breastfeeding classes in future pregnancy: | ||
Agreea | 219 | (66.6) |
Neutral | 82 | (24.9) |
Disagree | 28 | (8.5) |
Overall participants’ attitude level: | ||
Good | 72 | (20.9) |
Fair | 182 | (52.9) |
Poor | 90 | (26.2) |
Reasons behind adoption of breastfeeding: | ||
Religious background | 123 | (37) |
Healthcare providers | 92 | (27.7) |
Child health | 298 | (89.8) |
Media | 26 | (7.8) |
Cleanliness and easy preparation | 105 | (31.6) |
Personal determination or experience | 11 | (3.3) |
Encouragement from mother/mother-in-law | 79 | (23.8) |
Encouragement from husband | 81 | (24.4) |
Other | 8 | (2.4) |
I don’t know | 11 | (3.3) |
Factors affecting mothers’ breastfeeding attitude
Mothers’ breastfeeding practice
Variable | Number | (%) | Sample size (n) |
---|---|---|---|
Positively answered breastfeeding practice questions by participants on the basis of their experience with their last child (Total of six scored questions): | |||
Initiation of breastfeeding immediately and within the first hour of life | 193 | (72.6) | 266 |
Currently breastfeeding the last child and intending to continue until the age of ≥24 months | 79 | (28.7) | 275 |
Exclusively breastfed last child for 6 months | 46 | (16.9) | 272 |
Planning to continue exclusively breastfeeding last child until 6 months of age (for children < 6 months of age) | 8 | (2.9) | 273 |
Child was not given ready-made liquid formula in the hospital | 176 | (58.3) | 302 |
Attended breastfeeding classes during pregnancy | 68 | (22.2) | 306 |
Participants’ overall practice level | 338 | ||
Good | 94 | (27.8) | |
Fair | 129 | (38.2) | |
Poor | 115 | (34) | |
Breastfed last child for any duration of time | 266 | (84.4) | 315 |
Had no difficulties in breastfeeding last child | 220 | (82.1) | 268 |
Has past breastfeeding experience from previous children | 185 | (56.9) | 325 |
Has past exclusive breastfeeding experience from previous children | 124 | (39.4) | 315 |
Was advised to start formula milk for last baby by the following persons | 277 | ||
Doctor | 133 | (48) | |
Nurse | 3 | (1. 1) | |
Pharmacist | 8 | (2.9) | |
Family member | 30 | (10.8) | |
Friends | 15 | (5.4) | |
Others | 1 | (0.4) | |
No one | 25 | (9) |
Reasons cited as important | Number | (%) |
---|---|---|
Lactation factors | ||
Breast problem (pain, cracked nipple, etc.) | 8 | (9) |
Psychosocial factors | ||
Breastfeeding was tiring | 9 | (10.1) |
Felt it was time to stop | 5 | (5.6) |
Had too many household duties or other commitments | 4 | (4.5) |
Difficulty finding nursing areas outside the home | 4 | (4.5) |
Breastfeeding was too inconvenient | 3 | (3.4) |
Lack of husband’s support | 2 | (2.2) |
Family recommendation | 1 | (1.1) |
Wanted or needed someone else to feed my baby | 0 | (0) |
Nutritional factors | ||
Decreased milk production | 68 | (76.4) |
Baby hungry/unsatisfied after feeding | 30 | (33.3) |
Baby not gaining sufficient weight | 10 | (11.2) |
Physician’s recommendation | 5 | (5.6) |
Lifestyle factors | ||
Decreased food intake by mother | 6 | (6.7) |
The mother’s hair started falling out | 2 | (2.2) |
Breastfeeding was affecting the mother’s shape/body image | 1 | (1.1) |
Medical factors | ||
Health problems related to the mother (maternal illness/medication use, etc.) | 8 | (9) |
Became pregnant or wanted to become pregnant again | 5 | (5.6) |
Child health problem | 0 | (0) |
Milk-pumping factors | ||
Pumping milk difficult/time consuming, etc. | 4 | (4.5) |
Infant’s self-weaning factors | ||
Refused to feed | 19 | (21.3) |
Began to bite | 5 | (5.6) |
Work related factors | ||
Had to return to work | 14 | (15.7) |
Maternity leave not long enough to develop breastfeeding schedule/habit | 24 | (14.5) |
Insufficient time off during work days for breastfeeding | 20 | (12) |
Home too far from work for breastfeeding | 9 | (5.4) |
Lack of work flexibility for breastfeeding time | 9 | (5.4) |
Lack of nursery at or close to work | 8 | (4.8) |
Could not or did not want to pump or breastfeed at work | 8 | (4.8) |
Problems related to workplace | 4 | (2.4) |
Other reasons | 4 | (2.4) |
Other factors | 3 | (3.4) |
Factors affecting mothers’ breastfeeding practice and exclusive breastfeeding
Variable | No EBF | EBF | p-value |
---|---|---|---|
Number (%) | Number (%) | ||
Age (in years) | 0.362 | ||
18–24 | 13 (72.2) | 5 (27.8) | |
25–29 | 58 (69.9) | 25 (30.1) | |
30–34 | 50 (67.6) | 24 (32.4) | |
35–39 | 32 (78) | 9 (22) | |
40–44 | 7 (100) | 0 (0) | |
≥ 45 | 0 (0) | 0 (0) | |
Education background | 0.814 | ||
Primary school or lower | 1 (100) | 0 (0) | |
Secondary school | 29 (70.7) | 12 (29.3) | |
University or higher | 129 (71.7) | 51 (28.3) | |
Employed | 0.004 | ||
No | 100 (65.8) | 52 (34.2) | |
Yes | 60 (84.5) | 11 (15.5) | |
Self-employed | 0 (0) | 0 (0) | |
Employment sector | 0.052 | ||
Private | 35 (77.8) | 10 (22.2) | |
Public | 23 (95.8) | 1 (4.2) | |
Entitled to breastfeeding hours by employer | 0.112 | ||
Yes | 46 (80.7) | 11 (19.3) | |
No | 11 (100) | 0 (0) | |
Living with husband and children only | 0.048 | ||
Yes | 130 (68.4) | 60 (31.6) | |
No (Living with relatives) | 24 (88.9) | 3 (11.1) | |
No (Separated/ Divorced/Widowed) | 3 (100) | 0 (0) | |
Number of housemaids or nannies | 0.156 | ||
0 | 99 (67.8) | 47 (32.2) | |
1 | 41 (82) | 9 (18) | |
> 1 | 11 (73.3) | 4 (26.7) | |
Monthly family income (in AED) | 0.209 | ||
< 15,000 | 68 (77.3) | 20 (22.7) | |
15,000–30,000 | 71 (65.7) | 37 (34.3) | |
> 30,000 | 15 (71.4) | 6 (28.6) | |
Number of children | 0.151 | ||
1 | 56 (78.9) | 15 (21.1) | |
2–4 | 95 (66.9) | 47 (33.1) | |
≥ 5 | 9 (90) | 1 (10) | |
Gender of last child | 0.010 | ||
Male | 87 (79.1) | 23 (20.9) | |
Female | 67 (63.2) | 39 (36.8) | |
Last child gestational age at delivery | 0.027 | ||
< 37 weeks | 36 (85.7) | 6 (14.3) | |
≥ 37 weeks | 123 (68.7) | 56 (31.3) | |
Mode of delivery of last child | 0.550 | ||
Vaginal delivery | 91 (70.5) | 38 (29.5) | |
Caesarian section | 69 (74.2) | 24 (25.8) | |
Healthcare provider explained the importance of breastfeeding during antenatal visits for last pregnancy | 0.482 | ||
Yes | 124 (70.9) | 51 (29.1) | |
No | 35 (76.1) | 11 (23.9) | |
Healthcare provider explained the importance of breastfeeding after delivery of last child | 0.631 | ||
Yes | 133 (72.3) | 51(27.7) | |
No | 26 (68.4) | 12 (31.6) | |
Healthcare provider explained the appropriate practices of breastfeeding for last child | 0.849 | ||
Yes | 121 (71.2) | 49 (28.8) | |
No | 37 (72.5) | 14 (27.5) | |
Past breastfeeding experience | 0.168 | ||
No other children | 52 (76.5) | 16 (23.5) | |
No | 12 (85.7) | 2 (14.3) | |
Yes | 91 (66.9) | 45 (33.1) | |
Past exclusive breastfeeding experience | 0.000 | ||
No other children | 51 (78.5) | 14(21.5) | |
No | 54 (85.7) | 9 (14.3) | |
Yes | 49 (56.3) | 38 (43.7) | |
Offered readymade formula in hospital | 0.001 | ||
Yes | 72 (84.7) | 13 (15.3) | |
No | 84 (63.2) | 49 (36.8) |
Logistic regression analysis for factors influencing exclusive breastfeeding practices
Variables | Number | Coefficient | Standard Error | Adjusted ORa | (95% CIb) | p-value |
---|---|---|---|---|---|---|
Living with husband and children only | ||||||
Yes | 171 | 1 | ||||
No (Living with relatives) | 25 | -1.58036 | 0.69742 | 0.21 | (0.05 , 0.81) | 0.0235 |
Past exclusive breastfeeding experience | ||||||
No other children | 57 | -1.08063 | 0.44158 | 0.34 | (0.14 , 0.80) | 0.0144 |
No | 57 | -1.46617 | 0.47043 | 0.23 | (0.09 , 0.58) | 0.0018 |
Yes | 82 | 1 | ||||
Given readymade formula in hospital | ||||||
Yes | 77 | -1.12242 | 0.40437 | 0.33 | (0.15 , 0.72) | 0.0055 |
No | 119 | 1 | ||||
Gender of last child | ||||||
Male | 101 | 1 | ||||
Female | 95 | 0.88259 | 0.36800 | 2.42 | (1.18 , 4.97) | 0.0165 |
Breastfeeding knowledge score | 196 | 0.22396 | 0.092921 | 1.25 | (1.04 , 1.50) | 0.0159 |
Employment status | ||||||
No | 135 | 1 | ||||
Yes | 61 | -1.22911 | 0.45997 | 0.29 | (0.12 , 0.72) | 0.0075 |