Comparison of prevalence and reasons behind current breastfeeding practices in Malta & Gozo.

Abstract

i. Background In 2004 the World Health Organization (WHO) launched yet another campaign "Breast is Best" but today, three (3) years later in Malta, exclusively breastfeeding our infants for the first (1st) six (6) months of their infants' lives is not so commonly practiced.

ii. Purpose The study attempted to identify if there were any discrepancies in the exclusive breastfeeding initiation and duration rates, between Maltese and Gozitan mothers, over the first (1st) six (6) months of their infants' lives. While at the same time determine which personal, social and behavioral factors affect the initiation and prolongation of breastfeeding. As well as, to identify the main reasons why the majority of mothers chose to cease exclusive breastfeeding prior to the recommended minimum of six ( 6) months (WHO, 2004).

iii. Method and subjects The study was a longitudinal one, which observed the feeding practices chosen by consenting mothers, whose newborns fit the entry criteria, over the first (1st) six ( 6) months of their lives. Entry criteria for the study included all consenting Maltese and Gozitan mothers, who give birth a single baby in either state hospital, in August 2006, weighing at least two two and a half kilos (2.5 kg) and at no time during their post-natal stay required any form of special medical care. Mothers were initially approached post-natally and the first part of the questionnaire, developed by the researcher based on "The Ten Steps to Successful Breastfeeding" (UNICEF/WHO, 1989) was answered. Monthly, follow-up interviews for those mothers who were at least mixed (breast and bottle) feeding, took place over the telephone for the next six ( 6) months or until mothers switched solely to bottle feeding. The questionnaire was divided into four main sections to attain the mothers' personal information, their knowledge regarding breastfeeding, birthing details, discharge and post-natal support given, soother use by the infants and finally if exclusive breastfeeding was stopped prior to six ( 6) months post discharge, the reasons for this action was obtained.

iv. Results and discussion The results of the study showed that Maltese mothers do initiate exclusive breastfeeding at a higher rate than Gozitan mothers; with Malta's rate being fifty-five percent (55%) and Gozo's being forty-six percent (46%) on discharge. A one percent (1 %) higher rate was also still observed among Maltese mothers after the six (6) month period; although rates decreased considerably to sixteen (16%) and fifteen percent (15%) for Malta and Gozo respectively. Finally, the reasons given for why the majority of Maltese and Gozitan mothers do not initiate nor continue to exclusively breastfeed for at least six ( 6) months were strangely opposite on the two (2) islands. Maltese mothers stating that they simply did not wish to initiate or continue to breastfeed, whereas those Gozitan mothers who did not initiate exclusive breastfeeding, were prevented from doing so because the midwives took their infants away and gave them a bottle. While Gozitan mothers who stopped exclusive breastfeeding prior to their infants being six (6) months old, did so because they believed or were led to believe by medical professionals that their infants were not obtaining enough nutrients from breastfeeding alone.

v. Conclusions and recommendations Although the difference between the exclusive breastfeeding rates across the two (2) islands was not that great, the reasons given why less Gozitan mothers were not practicing exclusive breastfeeding for the first (1 51 ) six (6) months of their infants' lives seems to be due to the fault of medical professionals. Therefore, changing the attitudes of medical professionals and society as a whole should attract more mothers to breastfeed. Moreover, Malta ranked in the second (2nd) last position when compared to other European countries; with only a fifty-five percent (55%) exclusive breastfeeding rate (Huotari, 2004). Therefore, a lot of work needs to be done in order to get the maternity wards in the main state hospitals, on both islands running at the standards needed to obtain "Babyfriendly" certification, by following the set guidelines developed by The United Nations' International Children's Emergency Fund (UNICEF) and WHO, in 1998, based on "The Ten Step to Successful Breastfeeding".