What motivates women to breastfeed in Lebanon: An exploratory qualitative analysis

BouDiab, Sarah; Werle, Carolina

doi:10.1016/j.appet.2017.12.002

Cited by 22 publications

(28 citation statements)

References 42 publications

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“…They are often approached informally for medical advice through wide social connections (i.e., friends, family, neighbors, friends of friends). Consistent with previous reports on the influential role physicians have on women’s breastfeeding-related decisions in Lebanon [18,19,21], many of our participants highlighted that ‘buy-in’ from women to initiate and continue breastfeeding may be largely influenced by physicians they trust ( manuscript in preparation ). Therefore, the period during undergraduate and graduate medical education for all areas of specialty may provide a critical window of opportunity to target a broad audience of future physicians for maximized impact on breastfeeding rates in Lebanon.…”

Section: Discussionsupporting

confidence: 84%

“…However, suboptimal uptake of this knowledge by physicians is not uncommon [10,11], and insufficient breastfeeding promotion and support is one contributor to low breastfeeding exclusivity, initiation, and continuation rates [9,12–18]. Physicians may be particularly influential in communities where availability of and access to lactation consultants is limiting or when physicians are culturally considered as the most trusted experts compared with other health professionals [19,20]. …”

Section: Introductionmentioning

confidence: 99%

“…Around the globe, limited knowledge, negative beliefs, and lack of interest in the topic of breastfeeding have been reported [15,18,19,21–23]. It may be possible to overcome these barriers in part through early interventions beginning in undergraduate medical schools and extending to relevant residency programs [10,11].…”

Section: Introductionmentioning

confidence: 99%

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A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

Moukarzel

Mamas

Warstadt

et al. 2018

Medical Education Online

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Background: Limited knowledge, negative beliefs, and lack of sufficient breastfeeding promotion and support by physicians contribute to global suboptimal breastfeeding rates. Formal medical education is well-known to influence future physicians’ knowledge, beliefs, and medical practice. However, less understood is the influence of social networks and processes on the exchange and diffusion of knowledge and practices related to breastfeeding. Objectives: We selected the underserved and under-supported public medical school in Lebanon to examine the social side of medical education. Our objectives were to assess knowledge, beliefs, and self-efficacy related to breastfeeding promotion and support among interns and residents. We also examined the social ecosystem surrounding these students concerning the exchange of breastfeeding knowledge. Design: All data were collected during one study visit per participant. First, an interview-administered structured survey was used to assess beliefs, perceived knowledge, basic breastfeeding knowledge, and self-efficacy related to breastfeeding among n = 70 medical interns and residents. Then, social network data were collected during a semi-structured interview and analyzed using an ego-network approach. All interviews were voice-recorded, transcribed, coded, and thematically analyzed. Descriptive statistics were used to analyze quantitative survey and social network results. Results: Although interns and residents had positive beliefs about breastfeeding benefits, they had limited knowledge and low self-efficacy related to the psychosocial and clinical aspects of breastfeeding promotion and support. They did not seem to have a well-connected professional network around breastfeeding knowledge and practices. Several tended to rely on their informal/non-professional network, such as their mothers, partners, and sisters, for knowledge and practice. Conclusions: Our work using breastfeeding as an exemplary case suggests there is a role for better attending to the beliefs of medical students as well as to the social side of medical education. Future studies can use social network theory to help identify and address influences on medical education outcomes.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

Moukarzel

Mamas

Warstadt

et al. 2018

Medical Education Online

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“…Research with pregnant and lactating Lebanese women has demonstrated the importance of social norms in shaping breastfeeding behaviour (BouDiab & Werle, ; Nabulsi, ; Osman et al, ). Family members, especially women's mothers and husbands, have been reported to discourage women to breastfeed, to spread misconceptions around breastfeeding, and to pressure women to introduce infant formula (BouDiab & Werle, ; Nabulsi, ; Osman et al, ). We add to this body of literature that family influence is a powerful driver of breastfeeding/breastfeeding support intention in Lebanon beginning much earlier on in life, starting at least during adolescence.…”

Section: Discussionmentioning

confidence: 99%

“…The former focuses on developing data‐driven policy recommendations for high‐level decision makers within a country to facilitate scaling up and sustaining national breastfeeding programmes (Pérez‐Escamilla et al, ; Pérez‐Escamilla, Curry, Minhas, Taylor, & Bradley, ; Rollins et al, ). The latter involves identifying and addressing individual‐level and household‐level barriers against breastfeeding within smaller groups of well‐characterized individuals within a community such as insufficient evidence‐informed knowledge, low self‐efficacy, negative attitudes, and lack of social support (Akik, ; Batal, Boulghourjian, Abdallah, & Afifi, ; BouDiab & Werle, ; Nabulsi, ). One of the strategies that holds promise for overcoming these barriers, helping normalize breastfeeding, and thereby increasing breastfeeding initiation, exclusivity, and duration in the long‐term, is school‐based breastfeeding education (SBBE).…”

Section: Introductionmentioning

confidence: 99%

Exploring the latitude of attitude: Intentions to breastfeed among adolescents in Lebanese schools

Moukarzel

Jaoudeh

Farhat

et al. 2019

Maternal & Child Nutrition

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School-based breastfeeding education (SBBE) may help improve breastfeeding rates in the long-term by targeting children and adolescents' knowledge, attitudes, skills, and intentions. Breastfeeding rates in Lebanon are suboptimal. Psychosocial drivers of breastfeeding intention among the youth are unknown. We administered a survey to 658 high school students (448 females; 210 males) at two large Lebanese schools to understand intentions, intention drivers, and views on SBBE as means to guide SBBE programme design on the basis of the theory of planned behaviour. We collected information on demographics, intention to breastfeed/support wife to breastfeed future. Intention was predicted by attitude related to breastfeeding health outcomes and family normative beliefs-χ 2 (25) = 115, P < .001 for males, and χ 2 (39.3) = 186, P < .001 for females. Among females, intention was also positively associated with being breastfed, higher socio-economic status, and being more accepting of public breastfeeding. Seventy-eight per cent of students felt they were not learning enough about breastfeeding in school but were interested in SBBE through didactic teaching methods and interactive experiences. Findings indicate that breastfeeding intention among adolescent students is not merely influenced by the extent of knowledge but by more complicated psychosocial drivers that may differ by gender. Our findings also suggest a misalignment exists between what schools are providing with what students feel they need, thereby opening up a potential space for intervention.

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The Effect of Maternal Self-Regulated Motivation on Breastfeeding Continuation

Lau

Fong

Chan

et al. 2021

Matern Child Health J

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What motivates women to breastfeed in Lebanon: An exploratory qualitative analysis

Cited by 22 publications

References 42 publications

A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

A case study on breastfeeding education in Lebanon’s public medical school: exploring the potential role of social networks in medical education

Exploring the latitude of attitude: Intentions to breastfeed among adolescents in Lebanese schools

The Effect of Maternal Self-Regulated Motivation on Breastfeeding Continuation

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