title: Determinants of exclusive breastfeeding in an urban population of primiparas in Lebanon: a cross-sectional study.
abstract: 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.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT00857051.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon. hh86@aub.edu.lb
authors.forename: Haya
authors.initials: H
authors.lastname: Hamade
authors.forename: Monique
authors.initials: M
authors.lastname: Chaaya
authors.forename: Matilda
authors.initials: M
authors.lastname: Saliba
authors.forename: Rawan
authors.initials: R
authors.lastname: Chaaban
authors.forename: Hibah
authors.initials: H
authors.lastname: Osman
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000523:psychology / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D015277:Hotlines; D006801:Humans; D007407:Interviews as Topic; D007861:Lebanon; D008137:Longitudinal Studies; D010298:Parity; D011181:Postnatal Care; D011247:Pregnancy; D012923:Social Class; D064890:Social Determinants of Health; D014505:Urban Population; D055815:Young Adult
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