Predictors of breastfeeding in the Middle East

Objective  To examine the relationship between breastfeeding behaviors and social, economic, demographic, and autonomy variables in Egypt and Jordan

Design  Cross-sectional

Participants  The most recent Egypt and Jordan Demographic Health Surveys of women who had infants

Main Outcome Measures  1) Current breastfeeding, 2) whether the participant breastfed her infant at day 0, 3) the use of supplementation during the first 3 days of life

Results  In Jordan the overall breastfeeding initiation rate was 1317/1763 and in Egypt it was 2140/2263. For Jordan in multivariate models that included social, economic, and demographic factors, wealthy women had a lower odds of reporting breastfeeding (odds ratio [OR], 0.52 [95% confidence interval (CI), 0.34-0.80]), and women who reported low autonomy had a greater odds of breastfeeding (OR, 1.34, [1.03-1.73]).  Women who reported currently working had a significantly lower odds of breastfeeding (OR, 0.53, [0.41-0.69]). There were no significant differences in breastfeeding behaviors and residence (urban versus rural), gender of the infant, or maternal educational status. The same patterns were found for all outcome measures.  Similar patterns were found in Egypt except for the following: women in urban areas had a significantly lower odds of breastfeeding and autonomy was not associated with breastfeeding behaviors.

Conclusions  Low socio-economic status was associated with better breastfeeding behaviors in Jordan and Egypt but the association was greater in Jordan.  In the U.S. and Europe the opposite trends are noted; higher maternal education and household income are associated with higher initiation and duration rates.  Further research is needed to understand the associations noted and to identify interventions, such as tailored breastfeeding education, to improve rates.