The compliance of mothers to the six items related to their practice of the 10 steps of successful breastfeeding (Immediate breastfeeding initiation, rooming in, breast-feeding on demand, avoiding prelacteal feeding, avoiding use of pacifier, and avoiding use of bottles) are of great importance to achieve better breastfeeding outcomes. The objectives of the study were to estimate the extent of compliance of mothers to these items and to identify some factors associated with this compliance. The study was fulfilled through a cross-sectional approach. It was conducted at the MCH and FH centers in Alexandria Governorate. The study included 390 mothers accompanying their breast-fed infants aged 0-12 months to well baby clinics at those health centers. A pre-designed structured interview questionnaire was constructed to collect the data required from mothers. Only 29.8% of mothers started breastfeeding within the 1st hour after labour, 57.2% of them practiced rooming in, and 78.7% of them regulated breastfeeding according to their infants needs. Prelacteal feeding was given to 58.2% of the infants. 22.8% of mothers used pacifiers and 41% used bottles for their infants. Scoring of the overall compliance of mothers to the 6 points related to their breastfeeding practice of the WHO/UNICEF joint statement showed that 24.1% of mothers scored satisfactory level, 41.3% average level while 34.6% scored as low level of compliance. The level of mothers compliance was positively affected by their level of knowledge about breastfeeding and the six items (χ 2 =267.582, p<0.01) and by the increase in the child order (FET=15.618, p<0.01). It was adversely affected by their social level (χ 2 =19.853, p<0.01), education (χ 2 =28.289, p<0.01) and working status (χ 2 =17.439, p<0.01). It was adversely associated with the history of neonatal asphyxia (FET=17.909, p<0.01), the delivery in health settings (FET=44.278, p<0.01), and the delivery by caesarian section (χ 2 =40.193, p<0.01).
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