A Longitudinal Study on Breastfeeding Practice among Women Living in Western Saudi Arabia
DOI:
https://doi.org/10.6000/1929-4247.2019.08.04.4Keywords:
Breastfeeding practice, Baby-Friendly Hospital Initiative (BFHI), self-efficacy, attitude towards infant feeding.Abstract
This paper presents a longitudinal study of breastfeeding at two private hospitals in Jeddah, Saudi Arabia. Soliman Fakeeh (SF) follows the WHO's baby-friendly hospital initiative (BFHI), Saudi Germany Hospital (SGH) does not. Participants were 102 women in both hospitals (52 BFHI, 50 non-BFHI). Two semi-quantitative questionnaires, translated into Arabic, were used at baseline and one month postpartum. Results showed that most women in the study have initiated breastfeeding but turned to mixed feedings after one month. We also found that self-efficacy has the biggest influence on breastfeeding practice at one month, measured by the Breastfeeding Self-Efficacy Scale (BSES) and regardless of other variables. The BFHI made breast milk the first nutritive substance infants received and had a higher percentage of early initiation of breastfeeding than the non-BFHI. The BFHI hospital supported women to breastfeed practically and educationally. Support was provided by books, internet, and educational sessions. Yet, any effects no longer existed at one month postpartum, at which point most women had shifted to mixed feeding. There was no relationship between the BSES and BFHI status. Thus, we recommend developing breastfeeding promotion programs before delivery and at least a six-months follow-up after delivery, in addition to peer counselling approaches.
References
[1] Breastfeeding Handbook for Physicians, 2nd Edition. Schanler RJKNFMSB, editor: Am Acad Pediatr 2013 2013-10-25 00: 00: 00. 337 p.
[2] The Baby-Friendly Initiative 2019 [Available from: https://www.unicef.org.uk/babyfriendly/about/.
[3] Fida NM, Al-Aama JY. Pattern of infant feeding at a University Hospital in Western Saudi Arabia. Saudi Med J 2003; 24(7): 725-9.
[4] Al-Jassir M, El-Bashir B, Moizuddin S, Abu-Nayan A. Infant feeding in Saudi Arabia: mothers' attitudes and practices. East Mediterr Health J 2006; 12(1/2): 6.
[5] Al-Hreashy FA, Tamim HM, Al-Baz N, Al-Kharji NH, Al-Amer A, Al-Ajmi H, et al. Patterns of breastfeeding practice during the first 6 months of life in Saudi Arabia. Saudi Med J 2008; 29(3): 427-31.
[6] F.C. Exclusive breastfeeding for six months best for babies everywhere 2011 [Available from: https://www.who.int/ mediacentre/news/statements/2011/breastfeeding_20110115/en/#.
[7] Al-Shehri SN, Farag MK, Baldo MH, Al-Mazrou YY, Aziz KMS. Overview on Breastfeeding Patterns in Saudi Arabia. J Trop Pediatr 1995; 41(1): 38-44.
https://doi.org/10.1093/tropej/41.Supplement_1.38
[8] Beake S, Pellowe C, Dykes F, Schmied V, Bick D. A systematic review of structured compared with non-structured breastfeeding programmes to support the initiation and duration of exclusive and any breastfeeding in acute and primary health care settings. Matern Child Nutr 2012; 8(2): 141-61.
https://doi.org/10.1111/j.1740-8709.2011.00381.x
[9] Al-Madani M, Vydelingum V, Lawrence J. Saudi Mothers’ Expected Intentions and Attitudes Toward Breast-Feeding. Infant Child Adolesc Nutr 2010; 2(3): 187-98.
https://doi.org/10.1177/1941406410369699
[10] Alwelaie YA, Alsuhaibani EA, Al-Harthy AM, Radwan RH, Al-Mohammady RG, Almutairi AM. Breastfeeding knowledge and attitude among Saudi women in Central Saudi Arabia. Saudi Med J 2010; 31(2): 193-8.
[11] El-Gilany A, Sarraf B, Al-Wehady A. Factors associated with timely initiation of breastfeeding in Al-Hassa province, Saudi Arabia. East Med Health J 2012; 18(3): 250-4.
https://doi.org/10.26719/2012.18.3.250
[12] Walsh SM, Cordes L, McCreary L, Norr KF. Effects of Early Initiation of Breastfeeding on Exclusive Breastfeeding Practices of Mothers in Rural Haiti. J Pediatr Health Care 2019.
https://doi.org/10.1016/j.pedhc.2019.02.010
[13] El Mouzan MI, Al Omar AA, Al Salloum AA, Al Herbish AS, Qurachi MM. Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations. Ann Saudi Med 2009; 29(1): 20.
https://doi.org/10.4103/0256-4947.51812
[14] Al-Othman AM, Saeed AA, Bani IA, Al-Murshed KS. Mothers' practices during pregnancy, lactation and care of their children in Riyadh, Saudi Arabia. Saudi Med J 2002; 23(8): 909-14.
[15] Tappin D, Britten J, Broadfoot M, McInnes R. The effect of health visitors on breastfeeding in Glasgow. Int Breastfeed J 2006; 1(1): 11.
https://doi.org/10.1186/1746-4358-1-11
[16] Wallis AB, Brînzaniuc A, Chereche? R, Oprescu F, ?irlincan E, David I, et al. Reliability and validity of the Romanian version of a scale to measure infant feeding attitudes and knowledge. Acta Paediatr 2008; 97(9): 1194-9.
https://doi.org/10.1111/j.1651-2227.2008.00914.x
[17] Ho Y-J, McGrath JM. A Chinese version of Iowa Infant Feeding Attitude Scale: Reliability and validity assessment. International J Nurs Stud 2011; 48(4): 475-8.
https://doi.org/10.1016/j.ijnurstu.2010.09.001
[18] Mosalli R, Abd EAAA, Qutub M, Zagoot E, Janish M, Paes B. Perceived barriers to the implementation of a baby friendly initiative in Jeddah, Saudi Arabia. Saudi Med J 2012; 33(8): 895.
[19] Dai X, Dennis C-L. Translation and Validation of the Breastfeeding Self-Efficacy Scale Into Chinese. J Midwifery Women's Health 2003; 48(5): 350-6.
https://doi.org/10.1016/S1526-9523(03)00283-6
[20] Otsuka K, Dennis C-L, Tatsuoka H, Jimba M. The Relationship Between Breastfeeding Self-Efficacy and Perceived Insufficient Milk Among Japanese Mothers. J Obstet Gynecol Neonatal Nurs 2008; 37(5): 546-55.
https://doi.org/10.1111/j.1552-6909.2008.00277.x
[21] Molina Torres M, Dávila Torres RR, Parrilla Rodríguez AM, Dennis C-L. Translation and Validation of the Breastfeeding Self-Efficacy Scale Into Spanish: Data From a Puerto Rican Population. J Hum Lact 2003; 19(1): 35-42.
https://doi.org/10.1177/0890334402239732
[22] Alu? Tokat M, Okumu? H, Dennis CL. Translation and psychometric assessment of the Breast-feeding Self-Efficacy Scale-Short Form among pregnant and postnatal women in Turkey. Midwifery 2010; 26(1): 101-8.
https://doi.org/10.1016/j.midw.2008.04.002
[23] Li R, Rock VJ, Grummer-Strawn L. Changes in public attitudes toward breastfeeding in the United States, 1999-2003. J Am Diet Assoc 2007; 107(1): 122-7.
https://doi.org/10.1016/j.jada.2006.10.002
[24] Noel?Weiss J, Bassett V, Cragg B. Developing a prenatal breastfeeding workshop to support maternal breastfeeding self?efficacy. J Obstet Gynecol Neonatal Nurs 2006; 35(3): 349-57.
https://doi.org/10.1111/j.1552-6909.2006.00053.x
[25] Kaps M, Lamberson W. Biostatistics for animal science: An introductory text: CABI 2009.
https://doi.org/10.1079/9781845935405.0000
[26] Weinstein ME, Oleske JM, Bogden JD. A selected review of breast-feeding recommendations. Nutr Res 2006; 26(8): 379-84.
https://doi.org/10.1016/j.nutres.2006.07.002
[27] Ahmed AE, Salih OA. Determinants of the early initiation of breastfeeding in the Kingdom of Saudi Arabia. Int Breastfeed J 2019; 14(1): 13.
https://doi.org/10.1186/s13006-019-0207-z
[28] Al-Jassir M, Khaja Moizuddin S, Al-Bashir B. A Review of some Statistics on Breastfeeding in Saudi Arabia. Nutr Health 2003; 17(2): 123-30.
https://doi.org/10.1177/026010600301700203
[29] Ogbeide DO, Siddiqui S, Al Khalifa IM, Karim A. Breast feeding in a Saudi Arabian community - Profile of parents and influencing factors. Saudi Med J 2004; 25(5): 580-4.
[30] AlMunajjed M. Women's employment in Saudi Arabia: A major challenge. Booz & Company 2010.
[31] Burns E, Schmied V, Fenwick J, Sheehan A. Liquid gold from the milk bar: Constructions of breastmilk and breastfeeding women in the language and practices of midwives. Soc Sci Med 2012; 75(10): 1737-45.
https://doi.org/10.1016/j.socscimed.2012.07.035
[32] Ebert Wallace LJ, Taylor EN. Potential Risks of ""Risk"" Language in Breastfeeding Advocacy. Women Health 2011; 51(4): 299-320.
https://doi.org/10.1080/03630242.2011.569857
[33] Philipp BL, Merewood A, Miller LW, Chawla N, Murphy-Smith MM, Gomes JS, et al. Baby-Friendly Hospital Initiative Improves Breastfeeding Initiation Rates in a US Hospital Setting. J Pediatr 2001; 108(3): 677-81.
https://doi.org/10.1542/peds.108.3.677
[34] Merewood A, Mehta SD, Chamberlain LB, Philipp BL, Bauchner H. Breastfeeding rates in US Baby-Friendly Hospitals: Results of a national survey. J Pediatr 2005; 116(3): 628-34.
https://doi.org/10.1542/peds.2004-1636
[35] Broadfoot M, Britten J, Tappin DM, MacKenzie JM. The Baby Friendly Hospital Initiative and breast feeding rates in Scotland. Arch Dis Child Fetal Neonatal Ed 2005; 90(2): F114-F6.
https://doi.org/10.1136/adc.2003.041558
[36] Venancio SI, Saldiva SRDM, Escuder MML, Justo Giugliani ER. The Baby-Friendly Hospital Initiative shows positive effects on breastfeeding indicators in Brazil. J Epidemiol Community Health 2012; 66(10): 914-8.
https://doi.org/10.1136/jech-2011-200332
[37] Cattaneo A, Buzzetti R. Quality improvement report: Effect on rates of breast feeding of training for the Baby Friendly Hospital Initiative. Br Med J 2001; 323(7325): 1358.
https://doi.org/10.1136/bmj.323.7325.1358
[38] Amin T, Hablas H, Al Qader AAA. Determinants of initiation and exclusivity of breastfeeding in Al Hassa, Saudi Arabia. Breastfeed Med 2011; 6(2): 59-68.
https://doi.org/10.1089/bfm.2010.0018
[39] El-Gilany A-H, Helal R, Shady E. Exclusive breastfeeding in Al-Hassa, Saudi Arabia. Breastfeed Med 2011; 6(4): 209+.
https://doi.org/10.1089/bfm.2010.0085
[40] Baldo M, Khoja T, Al-Mazrou Y, Basuliman M, Aziz K. Integrating maternal and child health with primary health care in Saudi Arabia. East Med Health J 2000; 6(4): 701-11.
[2] The Baby-Friendly Initiative 2019 [Available from: https://www.unicef.org.uk/babyfriendly/about/.
[3] Fida NM, Al-Aama JY. Pattern of infant feeding at a University Hospital in Western Saudi Arabia. Saudi Med J 2003; 24(7): 725-9.
[4] Al-Jassir M, El-Bashir B, Moizuddin S, Abu-Nayan A. Infant feeding in Saudi Arabia: mothers' attitudes and practices. East Mediterr Health J 2006; 12(1/2): 6.
[5] Al-Hreashy FA, Tamim HM, Al-Baz N, Al-Kharji NH, Al-Amer A, Al-Ajmi H, et al. Patterns of breastfeeding practice during the first 6 months of life in Saudi Arabia. Saudi Med J 2008; 29(3): 427-31.
[6] F.C. Exclusive breastfeeding for six months best for babies everywhere 2011 [Available from: https://www.who.int/ mediacentre/news/statements/2011/breastfeeding_20110115/en/#.
[7] Al-Shehri SN, Farag MK, Baldo MH, Al-Mazrou YY, Aziz KMS. Overview on Breastfeeding Patterns in Saudi Arabia. J Trop Pediatr 1995; 41(1): 38-44.
https://doi.org/10.1093/tropej/41.Supplement_1.38
[8] Beake S, Pellowe C, Dykes F, Schmied V, Bick D. A systematic review of structured compared with non-structured breastfeeding programmes to support the initiation and duration of exclusive and any breastfeeding in acute and primary health care settings. Matern Child Nutr 2012; 8(2): 141-61.
https://doi.org/10.1111/j.1740-8709.2011.00381.x
[9] Al-Madani M, Vydelingum V, Lawrence J. Saudi Mothers’ Expected Intentions and Attitudes Toward Breast-Feeding. Infant Child Adolesc Nutr 2010; 2(3): 187-98.
https://doi.org/10.1177/1941406410369699
[10] Alwelaie YA, Alsuhaibani EA, Al-Harthy AM, Radwan RH, Al-Mohammady RG, Almutairi AM. Breastfeeding knowledge and attitude among Saudi women in Central Saudi Arabia. Saudi Med J 2010; 31(2): 193-8.
[11] El-Gilany A, Sarraf B, Al-Wehady A. Factors associated with timely initiation of breastfeeding in Al-Hassa province, Saudi Arabia. East Med Health J 2012; 18(3): 250-4.
https://doi.org/10.26719/2012.18.3.250
[12] Walsh SM, Cordes L, McCreary L, Norr KF. Effects of Early Initiation of Breastfeeding on Exclusive Breastfeeding Practices of Mothers in Rural Haiti. J Pediatr Health Care 2019.
https://doi.org/10.1016/j.pedhc.2019.02.010
[13] El Mouzan MI, Al Omar AA, Al Salloum AA, Al Herbish AS, Qurachi MM. Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations. Ann Saudi Med 2009; 29(1): 20.
https://doi.org/10.4103/0256-4947.51812
[14] Al-Othman AM, Saeed AA, Bani IA, Al-Murshed KS. Mothers' practices during pregnancy, lactation and care of their children in Riyadh, Saudi Arabia. Saudi Med J 2002; 23(8): 909-14.
[15] Tappin D, Britten J, Broadfoot M, McInnes R. The effect of health visitors on breastfeeding in Glasgow. Int Breastfeed J 2006; 1(1): 11.
https://doi.org/10.1186/1746-4358-1-11
[16] Wallis AB, Brînzaniuc A, Chereche? R, Oprescu F, ?irlincan E, David I, et al. Reliability and validity of the Romanian version of a scale to measure infant feeding attitudes and knowledge. Acta Paediatr 2008; 97(9): 1194-9.
https://doi.org/10.1111/j.1651-2227.2008.00914.x
[17] Ho Y-J, McGrath JM. A Chinese version of Iowa Infant Feeding Attitude Scale: Reliability and validity assessment. International J Nurs Stud 2011; 48(4): 475-8.
https://doi.org/10.1016/j.ijnurstu.2010.09.001
[18] Mosalli R, Abd EAAA, Qutub M, Zagoot E, Janish M, Paes B. Perceived barriers to the implementation of a baby friendly initiative in Jeddah, Saudi Arabia. Saudi Med J 2012; 33(8): 895.
[19] Dai X, Dennis C-L. Translation and Validation of the Breastfeeding Self-Efficacy Scale Into Chinese. J Midwifery Women's Health 2003; 48(5): 350-6.
https://doi.org/10.1016/S1526-9523(03)00283-6
[20] Otsuka K, Dennis C-L, Tatsuoka H, Jimba M. The Relationship Between Breastfeeding Self-Efficacy and Perceived Insufficient Milk Among Japanese Mothers. J Obstet Gynecol Neonatal Nurs 2008; 37(5): 546-55.
https://doi.org/10.1111/j.1552-6909.2008.00277.x
[21] Molina Torres M, Dávila Torres RR, Parrilla Rodríguez AM, Dennis C-L. Translation and Validation of the Breastfeeding Self-Efficacy Scale Into Spanish: Data From a Puerto Rican Population. J Hum Lact 2003; 19(1): 35-42.
https://doi.org/10.1177/0890334402239732
[22] Alu? Tokat M, Okumu? H, Dennis CL. Translation and psychometric assessment of the Breast-feeding Self-Efficacy Scale-Short Form among pregnant and postnatal women in Turkey. Midwifery 2010; 26(1): 101-8.
https://doi.org/10.1016/j.midw.2008.04.002
[23] Li R, Rock VJ, Grummer-Strawn L. Changes in public attitudes toward breastfeeding in the United States, 1999-2003. J Am Diet Assoc 2007; 107(1): 122-7.
https://doi.org/10.1016/j.jada.2006.10.002
[24] Noel?Weiss J, Bassett V, Cragg B. Developing a prenatal breastfeeding workshop to support maternal breastfeeding self?efficacy. J Obstet Gynecol Neonatal Nurs 2006; 35(3): 349-57.
https://doi.org/10.1111/j.1552-6909.2006.00053.x
[25] Kaps M, Lamberson W. Biostatistics for animal science: An introductory text: CABI 2009.
https://doi.org/10.1079/9781845935405.0000
[26] Weinstein ME, Oleske JM, Bogden JD. A selected review of breast-feeding recommendations. Nutr Res 2006; 26(8): 379-84.
https://doi.org/10.1016/j.nutres.2006.07.002
[27] Ahmed AE, Salih OA. Determinants of the early initiation of breastfeeding in the Kingdom of Saudi Arabia. Int Breastfeed J 2019; 14(1): 13.
https://doi.org/10.1186/s13006-019-0207-z
[28] Al-Jassir M, Khaja Moizuddin S, Al-Bashir B. A Review of some Statistics on Breastfeeding in Saudi Arabia. Nutr Health 2003; 17(2): 123-30.
https://doi.org/10.1177/026010600301700203
[29] Ogbeide DO, Siddiqui S, Al Khalifa IM, Karim A. Breast feeding in a Saudi Arabian community - Profile of parents and influencing factors. Saudi Med J 2004; 25(5): 580-4.
[30] AlMunajjed M. Women's employment in Saudi Arabia: A major challenge. Booz & Company 2010.
[31] Burns E, Schmied V, Fenwick J, Sheehan A. Liquid gold from the milk bar: Constructions of breastmilk and breastfeeding women in the language and practices of midwives. Soc Sci Med 2012; 75(10): 1737-45.
https://doi.org/10.1016/j.socscimed.2012.07.035
[32] Ebert Wallace LJ, Taylor EN. Potential Risks of ""Risk"" Language in Breastfeeding Advocacy. Women Health 2011; 51(4): 299-320.
https://doi.org/10.1080/03630242.2011.569857
[33] Philipp BL, Merewood A, Miller LW, Chawla N, Murphy-Smith MM, Gomes JS, et al. Baby-Friendly Hospital Initiative Improves Breastfeeding Initiation Rates in a US Hospital Setting. J Pediatr 2001; 108(3): 677-81.
https://doi.org/10.1542/peds.108.3.677
[34] Merewood A, Mehta SD, Chamberlain LB, Philipp BL, Bauchner H. Breastfeeding rates in US Baby-Friendly Hospitals: Results of a national survey. J Pediatr 2005; 116(3): 628-34.
https://doi.org/10.1542/peds.2004-1636
[35] Broadfoot M, Britten J, Tappin DM, MacKenzie JM. The Baby Friendly Hospital Initiative and breast feeding rates in Scotland. Arch Dis Child Fetal Neonatal Ed 2005; 90(2): F114-F6.
https://doi.org/10.1136/adc.2003.041558
[36] Venancio SI, Saldiva SRDM, Escuder MML, Justo Giugliani ER. The Baby-Friendly Hospital Initiative shows positive effects on breastfeeding indicators in Brazil. J Epidemiol Community Health 2012; 66(10): 914-8.
https://doi.org/10.1136/jech-2011-200332
[37] Cattaneo A, Buzzetti R. Quality improvement report: Effect on rates of breast feeding of training for the Baby Friendly Hospital Initiative. Br Med J 2001; 323(7325): 1358.
https://doi.org/10.1136/bmj.323.7325.1358
[38] Amin T, Hablas H, Al Qader AAA. Determinants of initiation and exclusivity of breastfeeding in Al Hassa, Saudi Arabia. Breastfeed Med 2011; 6(2): 59-68.
https://doi.org/10.1089/bfm.2010.0018
[39] El-Gilany A-H, Helal R, Shady E. Exclusive breastfeeding in Al-Hassa, Saudi Arabia. Breastfeed Med 2011; 6(4): 209+.
https://doi.org/10.1089/bfm.2010.0085
[40] Baldo M, Khoja T, Al-Mazrou Y, Basuliman M, Aziz K. Integrating maternal and child health with primary health care in Saudi Arabia. East Med Health J 2000; 6(4): 701-11.
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2019-11-12
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