Infant Feeding Practices, Nutrition, and Associated Health Factors during the First Six Months of Life among Syrian Refugees in Greater Beirut, Lebanon: A Mixed Methods Study

Abstract

The objective was to describe infant feeding practices, nutrition and related health aspects of infants under six months among Syrian refugees in Greater Beirut, Lebanon. A cross-sectional study was conducted among Syrian refugee mothers with infants under six months in July–October 2018 (N = 114). Additionally, eleven focus group discussions were conducted to explore supportive factors and barriers associated with early breastfeeding practices. The prevalence of pre-lacteal feeding was high (62.5%), whereas early initiation of breastfeeding was low (31%), and exclusive breastfeeding very low (24.6%). One-fifth of the infants were anemic (20.5%) and 9.6% were wasted. A significantly higher proportion of non-exclusively breastfed infants had a fever and took medicines than those who were exclusively breastfed. Supporting factors of adequate infant feeding practices comprised knowledge on maternal nutrition and exclusive breastfeeding, along with receiving support from healthcare professionals and family members. Identified barriers included preterm delivery, pre-lacteal feeding, an at-risk waist circumference and moderate to severe depression among mothers, bottle feeding, early introduction of food, maternal health reasons, breastmilk substitutes’ distribution, and misinformation offered by mothers-in-law. To address sub-optimal feeding practices documented among Syrian refugees, awareness on proper breastfeeding practices, maternal nutrition, and psychosocial support should be provided to mothers and family members alike.

Pediatric Nutrition in Different Countries

“…A significantly higher proportion of non-exclusively breastfed infants had fevers and infections and were on medications. These data confirm the importance of adequate nutrition in the first months of life, and of breastfeeding and exclusive breastfeeding [3].…”

Anemia among Syrian Refugee Children Aged 6 to 23 Months Living in Greater Beirut, Lebanon, including the Voices of Mothers’ and Local Healthcare Staff: A Mixed-Methods Study

“…Astonishingly, the Lebanese doctors pointed out that some Syrian mothers have the conviction that lentils exacerbate anemia. This highlights the fact that adequate knowledge of a nutritious diet for young children is an important factor in preventing child anemia as demonstrated in other studies globally [ 23 , 112 ]. The key single sources of health and nutrition messages listed by the Syrian mothers were the doctors, their own mothers and social media/internet.…”

Evaluation of breastfeeding and infant feeding attitudes among syrian refugees in Turkey: observations of Syrian healthcare workers

“…Previously, a study conducted in Turkey revealed that the rate of exclusive breastfeeding ≥ 6 months in Syrian babies was 28.1%, the rate of the initiation of breastfeeding within one hour was 61.4%, and all the breastfeeding indicators in Syrian refugees were lower than that for local women in Turkey [ 5 ]. In a study conducted in Lebanon, the percentages of prelacteal feeding, the initiation of breastfeeding within one hour, and the exclusive breastfeeding were 62.5%, 31%, and 24.6% respectively, in Syrian refugees [ 11 ]. It was seen that HCWs in this study perceived breastfeeding rates higher than they were in previous surveys.…”

“…According to a qualitative study conducted in Turkey, Syrian refugees think that breastfeeding negatively affects maternal health and that lactating mothers should be well-fed [ 6 ]. In a mixed-method study conducted with Syrian refugees in Lebanon, maternal health was defined as one of the barriers to breastfeeding [ 11 ]. In a qualitative study conducted in eastern Uganda, women highlighted hunger as a cause of insufficient milk production [ 13 ].…”