Predictors of Exclusive Breastfeeding in the First Six Months: A Cross-sectional Study in Ardabil, Northwest of Iran

Document Type : original article

Authors

1 School of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

2 Department of Health Information Management, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

3 Department of Public Health, School of Health, Ardabil University of Medical Science, Ardabil, Iran.

4 Department of Community and Preventive Medicine, School of Medicine, Ardabil University of Medical Science, Ardabil, Iran.

Abstract

Background: Breast milk provides essential and irreplaceable nutrients for an infant’s growth and development. Consequently, exclusive breastfeeding for the first 6 months of an infant’s life is important for their health and survival.  This study aimed to determine predictors of exclusive breastfeeding in the first 6 months among infants in Iran.
Methods: A cross-sectional study was conducted on 379 lactating women with infants >6 months. Participants attended health care centers in Ardabil city, Iran during 2020. Information about mothers and infants was collected via a questionnaire. Differences in characteristics of women that engaged in exclusive breastfeeding for the first 6 months (EBF-6) compared to no exclusive breastfeeding for the first 6 months (NEBF-6) was analyzed via T-tests. Predictors of exclusive breastfeeding among the infants were examined via logistic regression analyses.
Results: There were 196 respondents (51.7%) categorized into EBF-6 compared to 183 respondents (48.3%) categorized into NEBF-6. A greater number of women in EBF-6 compared to NEBF-6 were housewives (p=0.034). Additionally, the time of the first breastfeeding after birth was earlier for EBF-6 compared to NEBF-6 (p<0.001). Among the variables related to exclusive breastfeeding, only the predictive power of breastfeeding in the first half hour after birth was confirmed (p=0.002). This finding suggested that breastfeeding soon after birth led to an increase of almost 6 times in the probability of engaging in exclusive breastfeeding for 6 months.
Conclusions: Breastfeeding soon after birth appears to strongly influence the likelihood of exclusive breastfeeding for 6 months. Considering the important role of this practice in maintaining and ensuring maternal and child health, early initiation of breastfeeding after birth should be prioritized.

Keywords

References

  1. Ranjbaran M, Jafari Manesh H, Panahi M, Baderan M, Shamsi M, Nakhaei M, et al. The survey of exclusive breast feeding and some socio-economical determinants in Shazand-Arak in 2014. Community Health Journal. 2017 May 9;8(2):10-8.
  2. North K, Gao M, Allen G, Lee AC. Breastfeeding in a global context: epidemiology, impact, and future directions. Clinical Therapeutics. 2022 Feb 1;44(2):228-44.
  3. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The lancet. 2016 Jan 30;387(10017):475-90.
  4. Schanler RJ, Krebs NF, Mass SB. Breastfeeding handbook for physicians. 2013.
  5. Bernardo H, Cesar V, World Health Organization. Long-term effects of breastfeeding: a systematic review.
  6. Schwarz EB, Nothnagle M. The maternal health benefits of breastfeeding. American family physician. 2015 May 1;91(9):602-4.
  7. Wallenborn JT, Levine GA, Carreira dos Santos A, Grisi S, Brentani A, Fink G. Breastfeeding, physical growth, and cognitive development. Pediatrics. 2021 May 1;147(5).
  8. Binns CW, Lee MK. Exclusive breastfeeding for six months: the WHO six months recommendation in the Asia Pacific Region. Asia Pacific journal of clinical nutrition. 2014 Sep;23(3):344-50.
  9. Godfrey JR, Lawrence RA. Toward optimal health: the maternal benefits of breastfeeding. Journal of women's health. 2010 Sep 1;19(9):1597-602.
  10. Binns C, Lee M, Low WY. The long-term public health benefits of breastfeeding. Asia Pacific Journal of Public Health. 2016 Jan;28(1):7-14.
  11. Olang B, Farivar K, Heidarzadeh A, Strandvik B, Yngve A. Breastfeeding in Iran: prevalence, duration and current recommendations. International breastfeeding journal. 2009 Dec;4:1-0.
  12. Ranjbaran M, Nakhaei MR, Chizary M, Shamsi M. Prevalence of exclusive breastfeeding in Iran: Systematic review and meta-analysis. Epidemiology and Health System Journal. 2016 Sep 1;3(3):294-301.
  13. Pakpour A, Alijanzadeh M, Pouresmaeil M, Taherkhani F, Mohammadgholiha R, Jozi N. Predictive factors associated with breastfeeding initiation and duration behaviors of 6-months postpartum mothers referred to health centers in the city of Qazvin based on theory of planned behavior. Iranian Journal of Health Education and Health Promotion. 2016 Jun 10;4(1):20-30.
  14. Olang B, Heidarzadeh A, Strandvik B, Yngve A. Reasons given by mothers for discontinuing breastfeeding in Iran. International breastfeeding journal. 2012 May;7:1-7.
  15. Tomori C. Overcoming barriers to breastfeeding. Best Practice & Research Clinical Obstetrics & Gynaecology. 2022 Sep 1;83:60-71.
  16. Sayres S, Visentin L. Breastfeeding: uncovering barriers and offering solutions. Current opinion in pediatrics. 2018 Aug 1;30(4):591-6.
  17. Hendaus MA, Alhammadi AH, Khan S, Osman S, Hamad A. Breastfeeding rates and barriers: a report from the state of Qatar. International journal of women's health. 2018 Aug 22:467-75.
  1. Dashti M, Scott JA, Edwards CA, Al-Sughayer M. Predictors of breastfeeding duration among women in Kuwait: results of a prospective cohort study. Nutrients. 2014 Feb 20;6(2):711-28.
  2. Ghwass MM, Ahmed D. Prevalence and predictors of 6-month exclusive breastfeeding in a rural area in Egypt. Breastfeeding medicine. 2011 Aug 1;6(4):191-6.
  3. Al-Akour NA, Okour A, Aldebes RT. Factors associated with exclusive breastfeeding practices among mothers in Syria: a cross-sectional study.
  4. Al Tajir GK, Sulieman H, Badrinath P. Intragroup differences in risk factors for breastfeeding outcomes in a multicultural community. Journal of Human Lactation. 2006 Feb;22(1):39-47.
  5. Alyousefi NA, Alharbi AA, Almugheerah BA, Alajmi NA, Alaiyashi SM, Alharbi SS, et al. Factors influencing Saudi mothers’ success in exclusive breastfeeding for the first six months of infant life: a cross-sectional observational study. International Journal of Medical Research & Health Sciences. 2017;6(2):68-78.
  6. Inano H, Kameya M, Sasano K, Matsumura K, Tsuchida A, Hamazaki K, et al. Factors influencing exclusive breastfeeding rates until 6 months postpartum: the Japan Environment and Children’s Study. Scientific Reports. 2021 Mar 25;11(1):6841.
  7. Haas DM, Yang Z, Parker CB, Chung J, Parry S, Grobman WA, et al. Factors associated with duration of breastfeeding in women giving birth for the first time. BMC Pregnancy and Childbirth. 2022 Sep 22;22(1):722.
  8. Bürger B, Schindler K, Tripolt T, Griesbacher A, Stüger HP, Wagner KH, et al. Factors Associated with (exclusive) breastfeeding duration—results of the SUKIE-Study. Nutrients. 2022 Apr 20;14(9):1704.
  9. Mashoufi M, Shadman A, Mardi A, Gharajedaghy H. Predictors of exclusive breastfeeding in the first six months: An analytical cross-sectional study in Ardabil health centers, Iran, 2020.
  10. Walters D, Horton S, Siregar AY, Pitriyan P, Hajeebhoy N, Mathisen R, et al. The cost of not breastfeeding in Southeast Asia. Health policy and planning. 2016 Oct 1;31(8):1107-16.
  11. Hasan M, Hassan MN, Khan MS, Tareq MA, Afroj MS. Prevalence, knowledge, attitudes and factors associated with exclusive breastfeeding among mothers in Dhaka, Bangladesh: a cross-sectional study. Population Medicine. 2021 Sep 7;3(September):1-7.
  12. Paca-Palao A, Huayanay-Espinoza CA, Parra DC, Velasquez-Melendez G, Miranda JJ. Association between exclusive breastfeeding and obesity in children: a cross-sectional study of three Latin American countries. Gaceta Sanitaria. 2019 Nov 29;35(2):168-76.
  13. Salcan S, Topal I, Ates I. The frequency and effective factors of exclusive breastfeeding for the first six months in babies born in Erzincan Province in 2016. The Eurasian journal of medicine. 2018 Nov 30;51(2):145.
  14. Cozma-Petruţ A, Filip L, Banc R, Mîrza O, Gavrilaş L, Ciobârcă D, et al. Breastfeeding practices and determinant factors of exclusive breastfeeding among mothers of children aged 0–23 months in northwestern Romania. Nutrients. 2021 Nov 10;13(11):3998.
  15. Karimi Z, Mohebi S, Afshar N, Gharlipour Z. Factors affecting exclusive breastfeeding: theory of planned behavior. Journal of Research and Health. 2019 Apr 10;9(3):275-81.
  16. Khabazkhoob M, Fotouhi A, Majdi MR, Moradi A, Javaherforoshzadeh A, Haeri Kermani Z, et al. Prevalence of exclusive breastfeeding in Health Center Mashhad, 2007. Iranian Journal of Epidemiology. 2008 Feb 10;3(3):45-53.
  17. Hamidi M, Khoshdel A, Khadivi R, Deris F, SALEHI FA, Parvin N, et al. The causes of formula milk consumption in the infants under 1 year old in Charmahalva Bakhtiari provins Iran, 2007.
  18. Mohammad Beygi A, Mohammad Salehy N, Bayati AK. The pattern of exclusive breast feeding in referred neonatal to health centers of Arak. Journal of Guilan university of Medical sciences. 2009 Jul 10;18(70):17-25.
  19. Dalili H, Farsar A, Barakati H, Raji F, Shariat M, Pourmalek F, et al. Frequency of exclusive breastfeeding and its affecting factors in Tehran, 2011. Acta Medica Iranica. 2014:552-6.
  20. Morowatisharifabad M, Hajizadeh H, Akhavan Karbasi S, Fallahzadeh H. Study of the status of 6-12 months children exclusive breast-fed up to six months and its related factors in the urban health care centers of Ardakan city. Tolooebehdasht. 2013 Dec 10;12(3):84-94.
  21. Poorahmad-Garbandi F, Salaezade M, Etehad R. Reasons for termination of breastfeeding among women referred to Bandar-Abbas health centers. Journal of Preventive Medicine. 2014 Oct 10;1(1):16-22.
  22. Mirahmadizadeh A, Zare P, Moradi F, Sayadi M, Hesami E, Moghadami M. Exclusive breast-feeding weaning pattern and its determinant factors in Fars province in 2010. Daneshvar Medicine. 2012 Jun 21;20(2):11-22.
  23. World Health Organization. Global breastfeeding scorecard, 2019: increasing commitment to breastfeeding through funding and improved policies and programmes. World Health Organization; 2019.
  24. Ong G, Yap M, Li FL, Choo TB. Impact of working status on breastfeeding in Singapore: evidence from the National Breastfeeding Survey 2001. The European Journal of Public Health. 2005 Aug 1;15(4):424-30.
  25. Maharlouei N, Pourhaghighi A, Shahraki HR, Zohoori D, Lankarani KB. Factors affecting exclusive breastfeeding, using adaptive LASSO regression. International journal of community based nursing and midwifery. 2018 Jul;6(3):260.
  26. Adugna B, Tadele H, Reta F, Berhan Y. Determinants of exclusive breastfeeding in infants less than six months of age in Hawassa, an urban setting, Ethiopia. International breastfeeding journal. 2017 Dec;12:1-8.
  27. Kasahun AW, Wako WG, Gebere MW, Neima GH. Predictors of exclusive breastfeeding duration among 6–12 month aged children in gurage zone, South Ethiopia: a survival analysis. International breastfeeding journal. 2016 Dec;12:1-9.
  28. Abedzadeh M, Saberi F, Sadat Z. Quality of nutrition & factors related to it in 4/5-year old babies of Kashan. Feyz Medical Sciences Journal. 2005 Oct 10;9(3):59-64.
  29. Hajian KA. Surveying the patterns of breast feeding in Babol.2002;25(4):205-211.
  30. WHO U. Every newborn: an action plan to end preventable deaths. Geneva: World Health Organization. 2014:2017-18.
  31. UNICEF. From the first hour of life: making the case for improved infant and young child feeding everywhere 2016 (cited 2022); Available from: https://www.unicef. org/publications/index_93027.html.
  32. Hosseini SH, Alavinia SM, Rajabzadeh R, Hosseinzadeh MH, Majdi MR, Nabavi SH. Effective factors on duration of breast feeding in mothers in the city of Farooj, North Khorasan, in 2010.
Journal of Pediatric Perspectives
Volume 12, Issue 11
November 2024
Pages 19116-19125

Files

Share

How to cite

Statistics