Failed Breast Feeding among Egyptian Women at One Month Postpartum: A Cross-Sectional Community Based Study

Abstract

Background: Breast-milk is the optimum form of nutrition for the first 6 months of life. Breastfeeding and its impact on child survival in developing countries have been well documented. The aim of the present study was to identify causes of failed breastfeeding reported by women who attended their one month postpartum follow up. Methods: The present work is an exploratory survey that included a random sample of 3500 women who consented to share in this questionnaire. It included questions about the demographic data of the patients and Yes/No questions as regards antenatal preparation for breast feeding, problems faced with breastfeeding, factors influencing the decision to continue/stop breastfeeding. The study was conducted over four years during the time between July 2007 and July 2011. Nominal data were expressed as frequency and percentage, while numerical data were expressed as mean, standard deviation and range. Chi square test was used to compare nominal data. P values less than 0.05 were considered significant. Cox proportional hazards regression analysis model was used for determining the predictors for failed breast feeding. Results: At one month postpartum, only 78% [n=2502] of the mothers who had initiated breastfeeding [n=3210] were still breastfeeding their babies. 45% of those continuing to breast feed [n=1126] were exclusively breast feeding. Among those who stopped breastfeeding, the following reasons were given; concerns about baby's weight gain/loss [n=361; 51%], baby not latching to the breast and preferring bottle feeding [n=226; 32%], painful breastfeeding [n=64; 9%] preparing to return back to work [n=40; 5.6%], fear from obesity [n=7; 0.9%] and fear from breast disfigurement [n=3; 0.4%]. Seven women (0.9%) lost their babies. Cox regression analysis identified three risk factors for failed breastfeeding; younger maternal age, p=0.01, higher rate of employment p=0.03 and low birth weight of the baby p=0.04. Nonsignificant differences included; mode of delivery, parity, socioeconomic status, educational level, separation from the baby at the time of delivery and sex of the baby. Conclusions: From the present work we conclude that many of the problems associated with discontinuation of breastfeeding can be avoided by counseling and health education.