Risk Factors Associated with Initiation of Breastfeeding among Mothers with Low Birth Weight Babies: A Cross-sectional Multicenter Study in Abu Dhabi, United Arab Emirates.

  • Zainab Taha Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
  • Ahmed Ali Hassan Taami for Agricultural and Animal Production, Khartoum, Sudan
  • Ludmilla Wikkeling-Scott Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
  • Dimitrios Papandreou Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi, United Arab Emirates
Keywords: Low birth weight, Initiation of breastfeeding, Caesarean section, United Arab Emirates


BACKGROUND: Early initiation of breastfeeding is important for good lactation outcomes and has long been recommended by the World Health Organization. Recommendations are based on research showing that breastfeeding saves children’s lives, particularly among vulnerable populations such as low birth weight (LBW) neonates. In spite of a consistent rise in LBW deliveries, and in spite of the importance of breastfeeding for the survival of LBW neonates, a dearth of research exists regarding early initiation of breastfeeding for this population.

AIM: The aim of this study was to investigate the prevalence of, and factors associated with the initiation of breastfeeding among mothers with children aged <2 years who were LBW in Abu Dhabi, United Arab Emirates (UAE).

METHODS: The data for this cross-sectional study were extracted from a larger project on the evaluation of breastfeeding practices in Abu Dhabi. The original data were collected from seven health-care centers located in different urban and suburban areas of Abu Dhabi during 2017. A structured questionnaire was used by trained research assistants who collected relevant data from mothers during the interview.

RESULTS: The study included a total of 1822 mothers of children below the age of 2 years; 175 (9.6%) of those children were identified as LBW. The mean standard deviation [SD] ages of the mothers and the children were 30.5 (5.0) years and 6.0 (5.1) months, respectively. The mean birth weight (SD) of the LBW children was 2079.6 (255.0) grams. Forty (29.9%) mothers of LBW children initiated breastfeeding within the 1

st h. Sixty-four (47.8%) were delivered vaginally, and 70 (52.2%) were delivered through cesarean section (CS). In multivariable logistic regression analysis, the only factor associated with delayed initiation of breastfeeding among the LBW children was CS (adjusted odds ratio 2.33; 95% confidence interval 1.07, 5.07).

CONCLUSION: The prevalence of LBW was 9.6%, and it was associated with delayed initiation of breastfeeding as compared to the normal birth weight babies. While early initiation of breastfeeding should be promoted for all newborns, LBW infants are recognized as a vulnerable group and thus require additional support. There should be more emphasis on promoting and facilitating breastfeeding for LBW babies, especially those delivered by CS.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


World Health Organization. UNICEF-WHO Low Birthweight Estimates: Levels and Trends 2000-2015. In.: United Nations Children’s Fund (‎‎UNICEF)‎‎. Gneva: World Health Organization; 2019. https://doi.org/10.2307/j.ctt1t893gd.28

World Health Organization. Breastfeeding of Low-Birth-Weight Infants Available from: https://www.who.int/elena/titles/supplementary_feeding/en.

Smith ER, Hurt L, Chowdhury R, Sinha B, Fawzi W, Edmond KM, et al. Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis. PLoS One. 2017;12(7):e0180722. https://doi.org/10.1371/journal.pone.0180722 PMid:28746353

Fawzi WW. Timing of initiation, patterns of breastfeeding, and infant survival: Prospective analysis of pooled data from three randomised trials. 2016;4(4):e266-75. https://doi.org/10.1016/s2214-109x(16)00040-1

Gardner H, Green K, Gardner AS, Geddes D. Observations on the health of infants at a time of rapid societal change: A longitudinal study from birth to fifteen months in Abu Dhabi. BMC Pediatr. 2018;18(1):32. https://doi.org/10.1186/s12887-018-1016-z PMid:29415674

Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115(2):496-506. PMid:15687461

Callen J, Pinelli J. A review of the literature examining the benefits and challenges, incidence and duration, and barriers to breastfeeding in preterm infants. Adv Neonatal Care. 2005;5(2):72-88. https://doi.org/10.1016/j.adnc.2004.12.003 PMid:15806448

Hossain M, Islam A, Kamarul T, Hossain G. Exclusive breastfeeding practice during first six months of an infant’s life in Bangladesh: A country based cross-sectional study. BMC Pediatr. 2018;18(1):93. https://doi.org/10.1186/s12887-018-1076-0 PMid:29499670

Oktaria V, Lee KJ, Bines JE, Watts E, Satria CD, Atthobari J, et al. Nutritional status, exclusive breastfeeding and management of acute respiratory illness and diarrhea in the first 6 months of life in infants from two regions of Indonesia. BMC Pediatr. 2017;17(1):211. https://doi.org/10.1186/s12887-017-0966-x PMid:29268732

Taha Z. Trends of breastfeeding in the United Arab Emirates (UAE). Arab J Nutr Exerc. 2017;2(3):152-9. https://doi.org/10.18502/ajne.v2i3.1356

Hussein I, Taha Z, Tewfik I, Badawi S, Siddieg H, Adegboye A, et al. Risk factors for maternal Vitamin D deficiency within the United Arab Emirates. J Pregnancy Child Health. 2016;3(5):1000276.

Wolff PH. The serial organization of sucking in the young infant. Pediatrics. 1968;42(6):943-56. PMid:4235770

Gryboski JD. Suck and swallow in the premature infant. Pediatrics. 1969;43(1):96-102. PMid:5764074

Macías ME, Meneses GJ. Physiology of nutritive sucking in newborns and infants. Bol Med Hosp Infant Mex. 2011;68(4):296-303.

Taha Z, Garemo M, Nanda J. Patterns of breastfeeding practices among infants and young children in Abu Dhabi, United Arab Emirates. Int Breastfeed J. 2018;13:48. https://doi.org/10.1186/s13006-018-0192-7 PMid:30479650

United Arab Emirates, Statistics. Available from: https://www.freedomhouse.org/report/freedom-world/2017/united-arab-emirates.

Scott JA, Binns CW, Oddy WH. Predictors of delayed onset of lactation. Matern Child Nutr. 2007;3(3):186-93. PMid:17539887

Alzaheb RA. A review of the factors associated with the timely initiation of breastfeeding and exclusive breastfeeding in the Middle East. Clin Med Insights Pediatr. 2017;11:1179556517748912.https://doi.org/10.1177/1179556517748912 PMid:29317851

Radwan H. Patterns and determinants of breastfeeding and complementary feeding practices of Emirati Mothers in the United Arab Emirates. BMC Public Health. 2013;13:171. https://doi.org/10.1186/1471-2458-13-171 PMid:23442221

Bruno Tongun J, Sebit MB, Mukunya D, Ndeezi G, Nankabirwa V, Tylleskar T, et al. Factors associated with delayed initiation of breastfeeding: A cross-sectional study in South Sudan. Int Breastfeed J. 2018;13:28. https://doi.org/10.1186/s13006-018-0170-0 PMid:30002722

Nations U. Transforming our World: The 2030 Agenda for Sustainable Development. New York: United Nations, Department of Economic and Social Affairs; 2015.

Kleinman RE, Greer FR. Pediatric Nutrition, (Sponsored Member Benefit)., Illinois, United States: American Academy Pediatrics; 2013.

Meier PP, Johnson TJ, Patel AL, Rossman B. Evidence-based methods that promote human milk feeding of preterm infants: An expert review. Clin Perinatol. 2017;44(1):1-22. https://doi.org/10.1016/j.clp.2016.11.005 PMid:28159199

Meier PP, Patel AL, Bigger HR, Rossman B, Engstrom JL. Supporting breastfeeding in the neonatal intensive care unit: Rush Mother’s Milk Club as a case study of evidence-based care. Pediatr Clin North Am. 2013;60(1):209-26. https://doi.org/10.1016/j.pcl.2012.10.007 PMid:23178066

Harding C. An evaluation of the benefits of non-nutritive sucking for premature infants as described in the literature. Arch Dis Child. 2009;94(8):636-40. https://doi.org/10.1136/adc.2008.144204 PMid:19628881

Berkat S, Sutan R. The effect of early initiation of breastfeeding on neonatal mortality among low birth weight in Aceh Province, Indonesia: An unmatched case control study. Adv Epidemiol. 2014;2014:358692. https://doi.org/10.1155/2014/358692

Parker LA, Hoffman J, Darcy-Mahoney A. Facilitating early breast milk expression in mothers of very low birth weight infants. MCN Am J Matern Child Nurs. 2018;43(2):105-10. https://doi.org/10.1097/nmc.0000000000000408 PMid:29470268

Badaya N, Jain S, Kumar N. Time of initiation of breastfeeding in various modes of delivery and to observe the effect of low birth weight and period of gestation on initiation of breastfeeding. J Contemp Pediatr. 2018;5(4):1509-17. https://doi.org/10.18203/2349-3291.ijcp20182555

Hassan AA, Taha Z, Ahmed MA, Ali AA, Adam I. Assessment of initiation of breastfeeding practice in Kassala, Eastern Sudan: A community-based study. Int Breastfeed J. 2018;13:34. https://doi.org/10.1186/s13006-018-0177-6 PMid:30065774

Adhikari M, Khanal V, Karkee R, Gavidia T. Factors associated with early initiation of breastfeeding among Nepalese mothers: Further analysis of Nepal Demographic and Health Survey, 2011. Int Breastfeed J. 2014;9(1):21. https://doi.org/10.1186/s13006-014-0021-6 PMid:25493094

Morhason-Bello IO, Adedokun BO, Ojengbede OA. Social support during childbirth as a catalyst for early breastfeeding initiation for first-time Nigerian mothers. Int Breastfeed J. 2009;4:16. https://doi.org/10.1186/1746-4358-4-16 PMid:20003310

Killion MM. Skin-to-skin care and rooming-in: Safety considerations. MCN Am J Matern Child Nurs. 2017;42(2):115. https://doi.org/10.1097/nmc.0000000000000320 PMid:28234648

Yurtsal ZB, Kocoglu G. The effects of antenatal parental breastfeeding education and counseling on the duration of breastfeeding, and maternal and paternal attachment. Integrative Food. Nutr Metab. 2015;2:222-30. https://doi.org/10.15761/ifnm.1000134

Martínez Galiano JM, Delgado Rodríguez M. Early initiation of breastfeeding is benefited by maternal education program. Rev Assoc Med Bras (1992). 2013;59(3):254-7. https://doi.org/10.1016/s2255-4823(13)70465-x PMid:23688509

Meier PP, Furman LM, Degenhardt M. Increased lactation risk for late preterm infants and mothers: Evidence and management strategies to protect breastfeeding. J Midwifery Womens Health. 2007;52(63):579-87. https://doi.org/10.1016/j.jmwh.2007.08.003 PMid:17983995

Spatz DL. Ten steps for promoting and protecting breastfeeding for vulnerable infants. J Perinat Neonatal Nurs. 2004;18(4):385-96. https://doi.org/10.1097/00005237-200410000-00009 PMid:15646308.

Radwan H, Sapsford R. Maternal perceptions and views about breastfeeding practices among emirati mothers. Food Nutr Bull. 2016;37(1):73-84. https://doi.org/10.1177/0379572115624289 PMid:26793991

How to Cite
Taha Z, Ali Hassan A, Ludmilla Wikkeling-Scott, Dimitrios Papandreou. Risk Factors Associated with Initiation of Breastfeeding among Mothers with Low Birth Weight Babies: A Cross-sectional Multicenter Study in Abu Dhabi, United Arab Emirates. Open Access Maced J Med Sci [Internet]. 2020Feb.5 [cited 2020Oct.29];8(B):38-4. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2019.855