Determinants of exclusive breastfeeding in an urban population of primiparas in Lebanon: a cross-sectional study

BACKGROUND The proportion of mothers who exclusively breastfeed their babies up to 6 months remains low. Determinants of breastfeeding practices have been largely documented in high-income countries. Little evidence exists on possible predictors of breastfeeding behaviors in the Middle East. Our aim was to assess the prevalence of breastfeeding in Beirut and determine the factors that impact breastfeeding behavior in this population. METHODS Data for this longitudinal study is nested within a randomized controlled trial (RCT) assessing the impact of a 24-hour hotline and postpartum support film on postpartum stress. Healthy first-time mothers delivering in the capital Beirut between March and July 2009, were interviewed at 1-3 days and 8-12 weeks post delivery. A multiple logistic regression analysis was used to determine the factors associated with exclusive breastfeeding at 8-12 weeks postpartum. RESULTS The overall breastfeeding rate at 8-12 weeks postpartum was 67%. The exclusive breastfeeding rate was 27.4%. Factors associated with exclusive breastfeeding included maternal work (OR=3.92; p-value<0.001), planned pregnancy (OR=2.42, p-value=0.010), intention to breastfeed (OR=3.28; p-value=0.043), source of maternal emotional support (OR=1.87, p-value=0.039) and the use the postpartum support video, the hotline service or both (OR=2.55, p-value=0.044; OR=3.87, p-value=0.004 and OR=4.13, p-value=0.003). CONCLUSIONS The proportion of healthy first-time mothers who exclusively breastfeed in Beirut is extremely low. Factors associated with breastfeeding behavior are diverse. Future research and interventions should target different levels of the maternal-child pair's ecosystem. TRIAL REGISTRATION ClinicalTrials.gov, NCT00857051.