Breastfeeding patterns and practice among women in the north of gaza
Sa'eed Mohammad Ibrahim
سعيد محمد ابراهيم
This study was carried out to evaluate the breastfeeding status by identifying its patterns and practice among women in the North of Gaza and the factors that disrupt the practicing of breastfeeding. A total of 205 mothers with their infants of age 4-24 months, distributed over four Primary Health Care Centers belonged to the Ministry Of Health (MOH) and the United Nations (UNRWA) which provide the Maternal and child Health services in the North of Gaza, were selected randomly to represent the study population. The findings indicated that only19.1% of infants were exclusively breastfed for 4-6 months, and prolonged breastfeeding rate of 12.2%, while 66.3% were mixed breastfeeding. Hence the initiation rate was 97.6 %, the pure bottle feeding rate among infants less than 6 months was 2.4%. There were differences in the feeding patterns related to the study variables , but the main differences in breastfeeding patterns were related to the areas of residency, locality ,citizenship and clinic type, which reached statistical significant level p value = 0.00. As for area of residency the mixed feeding was more frequent in areas inhabited by citizens such as Jabalia city, Beit lahia and Beit hanoon cities 79.3%, 75%, 67.91% respectively compared with Jabalia camp 49.3%, while the exclusive breastfeeding was more frequent in areas inhabited by refugees such as Jabalia camp 31% and parts of Beit hanoon25% compared with 2.1%, 15.5% of Beit lahia and Jabalia cities. In the mean time formula and prolonged patterns were 3.6%, 4.2%, 0, 3.4% and 3.5%,18.7%,19.7%, 1.7% for Beit hanoon, Beit lahia, Jabalia camp, and Jabalia city respectively . Differences in breastfeeding related to locality reached also significant level where the mixed pattern was widely practiced in cities 75.8% while in camps was 49.4%, and the exclusive was the highest in camps 30.1% compared with 12.9% in cities .while formula and prolonged feeding patterns were 0, 3.8% and 20.5%, 7.6% in camps and cities respectively. Differences related to citizenship were high and reached significant level where the mixed and exclusive feeding patterns were 56.3%, 78.5% and 27.7%, 8.6% respectively for refugees and citizens in which the mixed were more dominant among citizens and the exclusive was more practiced by refugees, while formula and prolonged patterns 0.9%, 4.3% and 15.2%, 8.6% were practiced by refugees and citizens consequently.Differences related to clinic type also showed statistical significant level, where the exclusive pattern appeared to be more frequent among women served by health centers administrated by UNRWA, than those who received service from centers belonged to MOH with 29.9%, 9.3% respectively, while the mixed one was practiced more wide by women served by MOH than those who receive service from UNRWA with 77.8% and 53.6% respectively. In the mean time formula and prolonged feeding patterns were 3.7%, 9.3% and 1%, 15.5% for MOH and UNRWA served visitors. Differences in breastfeeding patterns related to friendship type reached also statistical significant level with p value = 0.01, where women with worm friendships had exercised the exclusive pattern 20.2% more than those with no or normal friendship 19.4%, 7.1% respectively, while the mixed feeding pattern was practiced nearly similar for no, worm and normal relationships 61.2%, 69.2%, 64.3% respectively , also the formula and prolonged feeding pattern was 0%, 2.4%,14.3% and 19.4%, 8.1%,14.3% consequently for no, worm and normal relationship. The last differences which reached statistical significant level was related to birth weight/age with p value of 0.05 where mixed feeding pattern among infants of weights: small for gestational age, appropriate for gestational age and large for gestational age was more frequent with rates of 81%, 65.5%, 50% in comparison with rates of exclusive feeding pattern 9.5 %,19%, 40% respectively, formula feeding pattern 9.5%, 1.7%, 0% and prolonged feeding pattern 0%, 13.8%,10% respectively. Differences related to house type and family problems did not reach statistical significant level with p values of 0.07, 0.06 respectively which reflect the domination of mixed feeding pattern in both relationships in comparison with the other patterns. In addition the results showed other differences which also did not reach statistical significant level, but reflect indicators which ensure the decrease of the breastfeeding status and the tendency toward formula milk which invaded the Palestinian market. So, in spite of the study results which represent baseline data for follow up and research, the study also highlighted the risks of the formula invasion of breastfeeding field and the contraction of exclusive breastfeeding rate in the Palestinian community, which need a comprehensive strategies to promote breastfeeding and to protect our children from missing such important nutritional value existing in the breast milk.