Exclusive breastfeeding until 6 months postpartum in Lebanon - a systematic review and an online survey

Zablith, Nadine and Reilly, Siobhan and McDermott, Elizabeth (2020) Exclusive breastfeeding until 6 months postpartum in Lebanon - a systematic review and an online survey. PhD thesis, Lancaster University.

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Abstract

Breastfeeding is the ultimate food source for infants and it is highly valuable for both mothers and children’s health. The WHO recommends exclusive breastfeeding (EBF) until six months postpartum. In Lebanon, the EBF rates until six months postpartum are amongst the lowest worldwide, and the factors affecting EBF have been rarely investigated. A systematic review to determine the associations between socio-cultural-demographic factors and EBF at six months postpartum in middle-income countries was conducted. The review has shown that the most frequently reported determinant of EBF was maternal employment, followed by maternal education and maternal age. This study was the first in Lebanon to explore the association between certain demographic, social and cultural factors with EBF for the six months postpartum of mothers residing across Lebanon. The study employed social media to recruit 593 mothers to complete an online questionnaire. Data analysis consisted of bivariate analysis and multivariate logistic regressions. The findings show that EBF until six months postpartum is not associated with the housekeeper presence, positively associated with having a prenatal plan to breastfeed, the mother disagreeing that free formula samples should be distributed to the mothers after delivery at the hospital, having the baby’s crib kept by the mother’s bed side at the hospital, not being offered a free formula sample at the hospital, the mother’s partner perceiving breastfeeding as very important, not having the mother’s father living in the same household besides the partner and children when the child was between zero and six months and being non-Lebanese. It is the first study conducted in low and middle-income countries to explore the maternal attitudes and opinions regarding feeding practices and their association with EBF until six months. This study shows that ensuring appropriate systems, services and support for mothers, while applying the social-ecological model, should be a priority for the stakeholders to improve maternal and child health.