Factors Facilitating and Forcing the Breast-Feeding to Tebessa (East City Algerian) ()
1. Introduction
Breastfeeding is recognized as the form of power best suited for infants and young children. Breast milk contains many biologically active substances that can not be included in infant formula and in respect of nutrients, although the artificial milk contain about the same amounts as milk, their quality is not equivalent [1,2]. The benefits of breastfeeding are also not as nutritional and a large number of publications in scientific literature show the benefits of breastfeeding on maternal health and the health, growth and development children [1]. Good start breastfeeding greatly increases the chances of well continue. And this start is dependent on conditions created around the mother, father and child [3]. The current data are sufficiently convergent research so that policies on health recommend exclusive breastfeeding for almost all children during the first six months of life [4-6]. need However, we must better understand the factors involved in the continuation or discontinuation of breastfeeding, to develop effective strategies to promote and support breastfeeding. The practice of breastfeeding has long been recommended by international authorities had virally disappeared from the habits of the countries both industrialized and developing countries, which resulted, for mothers real difficulties in tracing movements and knowledge useful to its success. In Algeria, breastfeeding is increasingly scarce even in rural areas. Of 730,000 births, Algeria recorded 15,000 deaths of infants every year. The finding is tragic when one knows that the main cause of these casualties is the lack of breastfeeding in [7]. It is this decline in breastfeeding that pushed us to do this work whose goal is to have a clear idea about the situation in Tebessa.
2. Methods
2.1. Study Population
Tebessa or Tbessa, city of Algeria, is located 40 km from the Tunisian-Algerian border. Tebessa, north of Jebel Dokan, rises 960 m above sea level, this town in eastern Algeria, lies at the foot of mountains that extend Tebessa in Tunisia. Its estimated population of 190,000 inhabitants is characterized by its extreme youth and high rate of urbanization. Tebessa is the capital of the Wilaya of Tebessa whose population is estimated at nearly 520,000 inhabitants. The Wilaya of Tebessa covers an area of 13,396 sq.km.
We conducted in PMI (Mother and Child Protection) of the city of Tebessa a cross-sectional survey of 200 mothers. Before the actual survey, we conducted a pre investigation that lasted one week to test the questionnaires. The survey was conducted from 1 to May 30, 2009. Data collection was performed the day of vaccinetion of children (Sunday and Wednesday). The inclusion criterion was a mother that she would or she breastfed her child. Children have retained or received exclusive breastfeeding, mixed or artificial. In both PMI, all mothers meeting the selection criteria were set.
2.2. Implementation of the Survey
We conducted surveys during the interviews, using quesonnaires that included variables describing the socioecomic characteristics of the mother and father, the practice of breastfeeding and the reasons for choosing a method, the value of breast milk, the reasons for the practice or stopping breastfeeding, reasons for introducing supplementary feeding to children and the information they had about breastfeeding before delivery Additional questions been introduced such as the health of children and duraon of breastfeeding.
2.3. Anthropometric Measurements
Children were weighed and measured, we also measured head circumference in order to study the correlation of these anthropometric variables with breastfeeding. To measure the weight we used a baby weighs 745 SECA brand with an accuracy of 0.01 kg and increased to 16 kg for infants aged 0 - 9 months and those 18 months of small size. For infants and very agitated those 18 months and large, we used a brand SECA weighing scales with a precision of 1 kg and a range of 120 kg. Measurements were made as recommended by WHO and the UN ICEF [8,9]. The size was measured by a telescopic measuring rod (for lack of means) brand SECA, a span of two mers and precision of 1 mm. To measure the head circumrence, we used a dressmaker’s tape measure 150 cm long and an accuracy of 1 mm. BMI (Body Mass Index was calculated by the formula BMI = P (kg)/T (m2) (p = weight, T = size) Units.
2.4. Stats
The data were processed and analyzed using Epi-Info version 5, Excel and Minitab version 13. The chi-squared test was used to compare two percentages. A difference was significant for the error probability (p) below 0.05.
3. Results
3.1. Identification of Women Surveyed
3.1.1. Distribution of Women by Age
In this study 200 mothers who breastfeed or who breastfed their children were interviewed (the mode of feeding is either breast or mixed or artificial). The average age of mothers was 30.66 ± 5.76 years ranging from 21 to 44 years (Figure 1).
3.1.2. Distribution of Parents by Occupation and Education Level
The majority of women surveyed are unemployed, with a proportion of 83.5% against 17.50% for fathers. Female employees account for 58.50% of our sample among fathers and 11% among mothers. Fathers are more likely to practice a profession that mothers (24% vs. 5.5%) Most parents in our sample have average educational level (57.50% vs. 55.50 for father’s % mothers) (Table 1).
3.1.3. Breastfeeding Patterns
Breastfeeding was exclusive for 50.50% of children, mixed for 28.50% of children and artificial for 21% of children (Table 2). No significant difference was found between the mode of feeding and age of the mother.
Figure 1. Distribution of mothers according to age.
Table 1. Distribution of mothers and fathers by occupation and education level.
3.2. Facilitating Factors and Binding Breastfeeding Breast
3.2.1. Education Level
Exclusive breastfeeding seems to increase when the level of education of the mother decreases (50.80% vs. 46.15%, p = 0.949). But mixed feeding and formula feeding seems to increase as education levels increased (30.77 % vs. 28.34% and 23.08% vs. 20.86% respectively, p = 0.949).
Considering the father of exclusive breastfeeding and artificial seem to increase when the level of education increases (53.57% vs. 50% and 28.57% vs. 19.77%, p = 0.326.) Conversely mixed feeding increases with education level decreases but the difference is not significant. When considering the educational level of parents, it appears that exclusive breastfeeding and artificial increase with educational level (55.56% and 22.22% vs. 50.26% vs. 20.94% respectively p = 0.912). Conversely mixed feeding seems to increase when the level of education decreased (Table 3).
3.2.2. Parents’ Occupation
The prevalence of exclusive breastfeeding is less common for women employees (63.64% in women who have a function cons liberal 50.90% in women without a profession and 40.91% for employees). However, artificial feeding is more prevalent among female employees (9.09% in women who have a profession vs. 19.76% for women without a profession and 36.36% among employed mothers p = 0.352).
Mixed feeding is very close between the different groups. Taking into account the father’s occupation shows that exclusive breastfeeding is practiced when the father is employed (54.70% vs. 45.83% when the father has a function liberal and 42.86% when the father is unemployed p = 0.09). Mixed feeding is done when the householder has a function Liberal (35.42% vs. 28.21% when the father is employed and 20% when the father has no function p = 0.09). Bottle-feeding is practiced when the father is unemployed (37.14% against 18.75% when the father has a private practice and 17.9% when the father is employed p = 0.09).
When we considered the profession of both parents, we found no significant relationship between mode of feeding and the working mother and father. However, we found that exclusive breastfeeding is more common when one parent works (53.19% vs. 48.28% when both parents have a profession and 40% when both parents do not work p = 0.202). We also found that artificial feeding is done when both parents are not (p = 0.202). Mixed feeding does not vary too depending on profession among different subgroups (Table 4).
Table 3. Influence the level of parental education on the mode of feeding.
Table 4. Influence of parental occupation on the mode of feeding.
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3.2.3. Sources of Knowledge of Mothers on Breastfeeding
Among the factors that facilitate breastfeeding, family (mother, friends, spouse ...) leads with 53.47%, followed by documents with 23.76%, 21.78% the consultant, the midwife with 11.88% and the role of the media with 7.92%. On method of feeding, influenced by the entourage of women, a significant difference was found. 53.47% of women chose exclusive breastfeeding, 38.60% mixed breastfeeding and 33.33% preferred to breastfeed their children through a formula (p = 0.046) (Figure 2).
3.2.4. First Feed Given to the Child in the First Hour after Birth
The first food given to the newborn at birth: breast milk with 66.5%, 16.5% sugar water, tea 12%, 7% simple water and artificial milk last position with 4% (Figure 3).
3.2.5. Causes Stop Breastfeeding
Figure 4 shows that twenty-one percent (21.42%) of