Document Type : original article
Authors
- SYLLA Abdou el Karim 1
- Mouna Lehlim 2
- Aamal Badre 2
- Salima Hajjaji 2
- Soukaina Lyazidi 3
- Sanaa Ameayou 3
- Mounir Chemsi 2
- Abdourahman Habzi, 4
- Said Benomar 2
- Samira Nani 5
- Samira Hassoune 5
1 Laboratory of epidemiology, Hassan II university, Casablanca
2 Neonatal medicine and resuscitation service of Ibn Rochd teaching hospital, Hassan II university of Casablanca, Morocco
3 Laboratory of Epidemiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Morocco
4 Neonatal medicine and resuscitation service, university hospital center Ibn Rochd, Hassan II university Casablanca Morocco
5 Laboratory of Epidemiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Morocco Laboratory of Cellular and Molecular Pathology/ Epidemiology and Histology of Chronic and Cancerous Diseases,
Abstract
Background: In Morocco, the breastfeeding (exclusive) prevalence has decreased from 51% in 1992 to 35% in 2018. This prevalence was lower in neonatal intensive care units with 12.4% in 2014. This study aimed to estimate the prevalence and identify the associated factors of breastfeeding (BF) practice in the NICU of Casablanca Ibn Rochd teaching hospital.
Method: A cross-sectional study was performed between 04 January and 26 June 2021 in NICU. Moroccan mother/newborn couples were consecutively recruited after meeting the study inclusion criteria. We used face-to-face interviews using a pretested questionnaire. Our income variable was the proportion of mothers who exclusively or partially breastfed at least one time after admission, categorized by yes and no. Multiple binary logistic regression was used to test the association of income variable with predictors.
Results: We included 170 mother/newborn couples. Around 74% of mothers practiced partial breastfeeding. The mother factors associated with BF practice were educational level (OR=0,10; 95% CI : 0,01-0,87 ;p=0,037781), family monthly income (OR=4,3 ; 95% CI: 1,12-16 , 56 ; p=0,033606), and marital status (OR=14,3 ; 95%CI:1,37-148,43 ; p=0,025853). The newborns' factors associated to BF practice were hospital stay length (OR= 1, 12 95%CI: 1, 00-1, 25; p=0.047726), and hospitalization motif (OR=0.27; 95% CI: 0,076-0.95; p=0.042085). And healthcare facility factors associated to BF practice included healthcare staff support (OR=6, 7; 95% CI: 2, 2-20, 54; p=0.000891).
Conclusion: The newborns hospitalized for respiratory distress from single mothers with lower educational levels and social standards who did not have enough (or any) support from healthcare staff were the ones who received less breast milk in the NICU of Casablanca Ibn Rochd teaching hospital.
Keywords
- World Health Organization. Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. Geneva: World Health Organization; 2017.
- Pineda rg. Breastfeeding practices in the neonatal intensive care unit before and after an intervention plan. . The University of Florida, 2006. Https://ufdcimages.uflib.ufl.edu /uf/e0/01/56/59/00001/pineda_r.pdf
- Kirchner L, Jeitler V, Waldhör T, Pollak A, Wald M. Long hospitalization is the most important risk factor for early weaning from breast milk in premature babies. Acta Paediatr 2009; 98:9814.
- Hamze L, Mao J, Reifsnider E. Knowledge and attitudes towards breastfeeding practices: A cross-sectional survey of postnatal mothers in China. Midwifery 2019; 74:68–75.
- Yang Y, Lu H. Breastfeeding in hospitalised preterm infants: A survey from 18 tertiary neonatal intensive care units across mainland China. J Paediatr Child Health 2020; 56:1432–7.
- Maastrup R, Hansen BM, Kronborg H, Bojesen SN, Hallum K, Frandsen A, et al. Factors associated with exclusive breastfeeding of preterm infants. Results from a prospective national cohort study. PLoS One 2014; 9:e89077.
- Jasny E, Amor H, Baali A. Mothers’ knowledge and intentions of breastfeeding in Marrakech, Morocco. Arch Pediatr 2019; 26:285–9.
- El Mossaoui M, Benkirane H, Aguenaou H, Barkat A. Breastfeeding, What About in Morocco ?: A Systematic Review and Meta-Analysis. IJISRT 2021; Volume 6:520–37.
- Berrani H, Mdaghri Alaoui A, Kasouati J, Alaoui K, Thimou Izgua A. Allaitement maternel chez le nouveau-né prématuré à l’âge de six mois au Maroc : prévalence et facteurs associés. Arch Pediatr 2015; 22:141–5.
- Fautsch Macías Y, Glasauer P. Guidelines for assessing nutrition-related knowledge, attitudes and practices: KAP manual. Rome: FAO; 2014. http://www. fao.org/3/i3545e/ i3545e.pdf
- Baby-friendly hospital initiative: revised, updated and expanded for integrated care. Geneva: world health organization; 2009. 4.2, guidelines and tools for monitoring baby-friendly hospitals. Available from: https://www. ncbi.nlm.nih.gov/books/nbk153494
- Ikonen R, Aho AL, Kaunonen M. Validity and Reliability of Breastfeeding Advice and Coping with Breastfeeding Instruments. NN 2014; 33:322–8.
- Ahmed AH. Breastfeeding preterm infants: an educational program to support mothers of preterm infants in Cairo, Egypt. Pediatr Nurs 2008; 34:125–30, 138
- Estalella I, San Millán J, Trincado MJ, Maquibar A, Martínez-Indart L, San Sebastián M. Evaluation of an intervention supporting breastfeeding among late-preterm infants during in-hospital stay. Women Birth 2020; 33:e33–8.
- Merewood A, Chamberlain LB, Cook JT, Philipp BL, Malone K, Bauchner H. The effect of peer counselors on breastfeeding rates in the neonatal intensive care unit: results of a randomized controlled trial. Arch Pediatr Adolesc Med 2006; 160:681–5.
- Rayfield S, Oakley L, Quigley MA. Association between breastfeeding support and breastfeeding rates in the UK: a comparison of late preterm and term infants. BMJ Open 2015; 5:e009144–e009144.
- Ikonen R, Paavilainen E, Helminen M, Kaunonen M. Preterm infants’ mothers’ initiation and frequency of breast milk expression and exclusive use of mother’s breast milk in neonatal intensive care units. J Clin Nurs 2018; 27.
- Zachariassen G, Faerk J, Grytter C, Esberg B, Juvonen P, Halken S. Factors associated with successful establishment of breastfeeding in very preterm infants: Breastfeeding very preterm infants. Acta Paediatr 2010; 99:1000–4.
- Pineda RG. Predictors of breastfeeding and breastmilk feeding among very low birth weight infants. Breastfeed Med 2011; 6:15–9.
- Niela-Vilén H, Melender H-L, Axelin A, Löyttyniemi E, Salanterä S. Predictors of Breastfeeding Initiation and Frequency for Preterm Infants in the NICU. J Obstet Gynecol Neonatal Nurs 2016; 45:346–58.
- Degaga GT, Sendo EG, Tesfaye T. Prevalence of Exclusive Breast Milk Feeding at Discharge and Associated Factors Among Preterm Neonates Admitted to a Neonatal Intensive Care Unit in Public Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study. Pediatric Health Med Ther 2020; 11:21–8.
- Kirchner L, Jeitler V, Waldhör T, Pollak A, Wald M. Long hospitalization is the most important risk factor for early weaning from breast milk in premature babies. Acta Paediatr 2009; 98:9814.
- Wang Y, Briere C-E, Xu W, Cong X. Factors Affecting Breastfeeding Outcomes at Six Months in Preterm Infants. J Hum Lact 2019; 35:80–9.
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