A Metanalysis of Trends in Knowledge and Practice of Breastfeeding in Egypt: A Case Study from the Eastern Mediterranean Region

Abstract

Introduction: Considerable global and country efforts have been made in the past three decades to promote breastfeeding through extending exclusive breastfeeding (EBF) to six months and revising the Ten steps of the Baby Friendly Hospitals Initiative (BFHI). Aim: To assess impact of promotion efforts of the World Health Organization (WHO) and UNICEF on the trends in knowledge and practice of Egyptian mothers towards EBF and practices of BFHI. Methods: This is a metanalysis study of pooled data from local research. A search for the current and past research focused on EBF and BFHI practices was performed through Egyptian University Libraries of Higher education, google and PubMed for using keywords of knowledge and practices about early infant feeding practices over the past 15 years in Egypt. Raw data were pooled for metanalysis. Twenty-four studies were identified: 12 studies from 2008 to 2018 and 12 studies from 2018 to 2022 which allowed for pooled data for 9685 mothers. Findings: Trends increased for knowledge and practice towards EBF, importance of colostrum and hazards of supplementation but not for early initiation of breastfeeding (EIBF) which decreased. Donated supplies of milk formula to hospitals increased. Trend in practices for offering supplements, and feeding bottles with breastfeeding decreased with increase in EBF at birth but with increase in pacifier use. EIBF through skin-to-skin (STS) remains abstinent. Illiteracy and incomplete education are still high among housewives who do not get any sustenance from the government. Conclusions: Trends show support of the WHO recommendations of EBF for 6 months. EIBF and STS remain a challenge. The rights of women in breast-feeding support and protection are far from adequate to meet the rising trends in marketing of milk formula. Low literacy, disempowerment and lack of support remain barriers to EBF and continued breastfeeding for two years.