EC Gynaecology

Background: Exclusive breastfeeding (EBF) for the first six months of life is crucial for infant and maternal health. The World Health Organization (WHO) recommends EBF, but global rates remain low. Challenges include lack of knowledge, social influences, and perceived insufficient milk supply. This study investigated EBF practices and associated factors among rural women in Berber, Sudan.

Objective: To assess breastfeeding practice among rural women in Berber locality in 2024.

Methods: A cross-sectional study was conducted among 286 breastfeeding mothers with children older than six months in Berber. Data on demographics, breastfeeding practices, and reasons for non-EBF were collected through questionnaires. Chi-square tests were used to assess associations between EBF and maternal/infant characteristics.

Results: Most mothers were aged 20-30, primarily housewives with a primary education and an extended family structure. Hospital births were common (84.3%), and most mothers (90.9%) began breastfeeding immediately. While 60.5% practiced EBF, some cited insufficient milk as a barrier. Significant factors for EBF included education level (p = 0.049) and parity (p = 0.026), with higher EBF rates among mothers with primary education and fewer children. Age, occupation, and delivery method showed no significant impact on EBF practices.

Conclusion: This study sheds light on breastfeeding practices among Sudanese mothers, revealing key demographic and behavioral patterns. A substantial proportion of the mothers were young, predominantly housewives, and members of extended families, with most delivering in hospitals and initiating breastfeeding promptly after birth. Exclusive breastfeeding (EBF) rates were moderate, positively associated with the number of previous births, while maternal age, occupation, and delivery method showed no significant links to EBF. Notably, education demonstrated a modest positive influence on EBF.

Recommendations: This study recommends addressing concerns about insufficient breast milk through targeted education and support for breastfeeding mothers. Community education programs should promote EBF awareness among mothers, families, and community leaders, addressing cultural misconceptions.

 Keywords: Knowledge and Practice of Breastfeeding; Rural Women; Berber; River Nile State; Sudan

1. Still R., et al. “Mothers' understanding of the term 'exclusive breastfeeding': a systematic review”. Maternal and Child Nutrition 3 (2017): e12336.
2. “Breastfeeding: A mother’s gift, for every child”. Unicef (2018): 1-13.
3. Gore RP., et al. “The associated factors hampering mothers towards exclusive breastfeeding EBF through knowledge, attitude and practice (KAP) studies at Al-Sabah children hospital/Juba-South Sudan”. Journal of Community Medicine and Public Health 1 (2017): 101.
4. Ayalew T. “Exclusive breastfeeding practice and associated factors among first-time mothers in Bahir Dar city, North West Ethiopia, removed: A community based cross sectional study”. Heliyon 9 (2020): e04732.
5. Dukuzumuremyi JPC., et al. “Knowledge, attitude, and practice of exclusive breastfeeding among mothers in East Africa: a systematic review”. International Breastfeeding Journal 15 (2020): 70.
6. “Early initiation of breastfeeding: the key to survival and beyond”. Pan American Health Organization (2010): 35-56.
7. Chowdhury R., et al. “Breastfeeding and maternal health outcomes: a systematic review and meta-analysis”. Acta Paediatrica 467 (2015): 96-113.
8. Aldalili AYA and El Mahalli AA. “Research Title: Factors associated with cessation of exclusive breastfeeding”. Journal of Multidisciplinary Healthcare 14 (2021): 239-246.
9. Chiabi A., et al. “Breastfeeding practices in infants in the west region of Cameroon”. Iranian Journal of Public Health 2 (2011): 11-17.
10. Fisk CM., et al. “Breastfeeding and reported morbidity during infancy: findings from the Southampton Women's Survey”. Maternal and Child Nutrition 1 (2011): 61-70.
11. Kayode OO., et al. “Factors affecting exclusive breastfeeding practices among working-class women in Osun State, Nigeria”. Journal of Public Health in Africa 6 (2023): 2191.
12. Mohamed S., et al. “Who Conceptual Framework on Ebf” 4.8 (2015): 28-33.
13. World Health Organization. “Infant and young child feeding”. Geneva: WHO (2019).
14. Hassan AA., et al. “Assessment of initiation of breastfeeding practice in Kassala, Eastern Sudan: a community-based study”. International Breastfeeding Journal 13 (2018): 34.
15. Abdel-Rahman ME., et al. “Early feeding practices and associated factors in Sudan”. Maternal and Child Nutrition 4.2 (2015): 766-778.
16. Demetry RJ and Ruati R. “Ministry of Health, UNICEF and partners celebrate World Breastfeeding Week and call for breastfeeding support for all by closing the gaps in South Sudan”. Juba: UNICEF South Sudan (2024).
17. Ibrahim SO., et al. “Early feeding practices and associated factors in Sudan: a cross-sectional analysis from multiple Indicator cluster survey”. International Breastfeeding Journal 15 (2020): 41.
18. Mohammed AI and Khalid M. “Breastfeeding among infants and its association with the nutritional status of children under five years in Khartoum, Sudan”. International Journal of Healthcare Sciences 1 (2015).
19. Asemahagn MA. “Determinants of exclusive breastfeeding practices among mothers in Azezo district, northwest Ethiopia”. International Breastfeeding Journal 11 (2016): 22.
20. Mekebo GG., et al. “Factors influencing exclusive breastfeeding practice among under-six months infants in Ethiopia”. BMC Pregnancy Childbirth1 (2022): 630.
21. Nkrumah J. “Maternal work and exclusive breastfeeding practice: a community based cross-sectional study in Efutu Municipal, Ghana”. International Breastfeeding Journal 12 (2017): 10.
22. Maonga AR., et al. “Factors affecting exclusive breastfeeding among women in Muheza district Tanga Northeastern Tanzania: A mixed method community based study”. Maternal and Child Health Journal 1 (2016): 77-87.
23. Cascone D., et al. “Evaluation of knowledge, attitudes, and practices about exclusive breastfeeding among women in Italy”. International Journal of Environmental Research and Public Health 12 (2019): 2118.