Factors associated with breastfeeding in Western of Saudi Arabia : a thesis presented in partial fulfilment of the requirements for the degree of Master in Human Nutrition at Massey University Palmerston North, New Zealand
Background information: The recommendation for optimal breastfeeding duration in the Kingdom of Saudi Arabia (KSA) is based firstly on the Quran and then the World Health Organisation (WHO) recommendation. The rate of initiation of breastfeeding in Saudi Arabia is over 90%, with the early introduction of infant formula.
Objective: To investigate breastfeeding practices at birth and one month postpartum and its association with the BFHI status of the hospital where delivery occurred, and with women’s intentions, self-efficacy, knowledge and attitudes, previous experience, support, and discouragement for breastfeeding.
Study design: Longitudinal study with data collection at baseline and follow-up at one month postpartum.
Method: Women were recruited from two private hospitals in Jeddah, one of these hospitals has baby friendly hospital policies (BFHI). A semi-quantitative questionnaire was used for collecting data by face-to-face interviews with women in the hospital after giving birth and by a phone interview at one month postpartum. SPSS was used for statistical analysis.
Results: One hundred and two women completed the baseline survey, and 77 women completed the study at one month (36 from the BFHI and 41 from the non-BFHI). At baseline, 77% women at the BFHI hospital had introduced breast milk as first nutritive substance, while only 7% of women in the non-BFHI
hospital did. However, at one month postpartum, mixed-feeding was the most common feeding method (58%), and there was no difference in feeding method between women in both hospitals. All Egyptian women in the sample (n= 10) were fully breastfeeding at one month, and Saudi women were more likely to use mixed-feeding. Breastfeeding attitudes, self-efficacy, and previous experience were related to breastfeeding practice at one month. Considering all variables, logistic regression found that breastfeeding self-efficacy was the only variable associated with breastfeeding practice at one month, and women with a higher score were more likely to be exclusively, fully, or predominantly breastfeeding at one month (p= 0.001).
Conclusion: The BFHI was found to be effective in making breast milk the first nutritive substance infants received, and in encouraging early breastfeeding initiation. Breastfeeding self-efficacy was the strongest predictor of breastfeeding intention and practice at one month.