Factors Associated with Delayed Initiation and Cessation of Breastfeeding Among Working Mothers in Abu Dhabi, the United Arab Emirates

Abstract

Introduction Despite the enormous benefits of breastfeeding, working mothers face more challenges to meet the World Health Organization (WHO) recommendations regarding successful breastfeeding practices. Little research has been done to understand the breastfeeding practices among working mothers in the United Arab Emirates (UAE). Thus, the aim of this study was to investigate the prevalence and factors associated with delayed initiation and cessation of breastfeeding among working mothers with children under the age of two years in Abu Dhabi, the UAE. Methods A cross-sectional multicenter study was conducted from March to September 2017. The study included both Emirati and non-Emirati mothers of children below the age of two years. The data were collected from seven government health care centers in Abu Dhabi as well as from the community. Mothers with young children attending the centers during the study days were approached by trained research assistants, who provided oral and written information about the study. Results Among the 1610 mother–child pairs with complete data who were included in this study, 606 were working mothers giving an employment rate of 37.6%. The mean (standard deviation) of maternal age and children’s age were 30.9 (5.1) years and 8.6 (6.1) months, respectively. Of the 606 mothers, 217 (35.8%) delayed initiation of breastfeeding, and 359 (59.2%) ceased breastfeeding. In multivariable logistic regression analysis, factors associated with delayed breastfeeding initiation among working mothers were older mother age (adjusted odds ratio [AOR] 1.04, 95% confidence interval [CI]1.01, 1.08), being of non-Arab nationality (AOR 2.24, 95% CI 1.53, 3.27), caesarean section (AOR 2.70, 95% CI 1.84, 3.96), non-rooming-in (AOR 3.85, 95% CI 1.56, 9.51) and mothers with low birth weight children (AOR 2.47, 95% CI 1.23, 4.94). The main factors associated with cessation of breastfeeding were being of non-Arab nationality (AOR 1.59, 95% CI 1.09, 2.31) and mother with high-income rating (AOR 2.79, 95% CI 1.36, 5.75). Conclusion The study highlighted the need for urgent actions to improve the working mothers’ conditions in order to promote optimal breastfeeding practices, including both early initiation and continuation of breastfeeding among all mothers in the UAE regardless of employment status. Policies to improve EBF rates among professional working mothers should include maternity leave extension to enable mothers to continue breastfeeding.

Determinants of Exclusive Breastfeeding and Mixed Feeding Among Mothers of Infants in Dubai and Sharjah, United Arab Emirates

“…Our study showed that the main factors associated with women refraining from EBF were being working women and living in Dubai. This was similar to a study conducted in Abu Dhabi, where 60% of the working women stopped breastfeeding ( 22 ). In the UAE, the women's labor force increased dramatically between 1990 and 2019 at the rates of 28.9 and 52.39%, respectively ( 46 ), and further rose to 57.5 in 2020 according to the World Bank ( 47 ), which increased the number of working women in the UAE.…”

“…This might be because of the number of working hours or duration of maternal leave. In addition to the lack of nurseries in the mother's workplace, making it difficult for working women to breastfeed their infants ( 22 ). Previous studies have also reported that maternal employment was negatively associated with exclusive breastfeeding ( 16 , 48 – 50 ).…”

“…Early initiation was also found to be significantly associated with EBF in our study; the earlier it started, the more committed. Many studies support the importance of initiating breastfeeding and the relationship with EBF ( 22 , 55 ). In this study, a high income was also found to be strongly associated with mixed feeding.…”

“…As for the UAE, mixed feeding, complimentary food, and fluid additions have been introduced in the first month of life in the UAE ( 21 ). Several factors negatively affect breastfeeding practices in different Gulf countries, such as maternal age, level of education, mothers' perception of insufficient milk production, problems associated with the breast such as nipple problems, mode of delivery (cesarean section), and hospital practices such as non-rooming-in ( 22 , 23 ). In these studies, a high educational level was more strongly associated with lower BF initiation and exclusive breastfeeding rates.…”

Prevalence and multivariable predictors of breastfeeding outcomes in the United Arab Emirates: a prospective cohort study

“…Similar findings were reported in other studies [ 44 , 45 ] where it was explained that the reason for less EBF despite high initiation rate among their participants was due to many factors such as employment and deficient knowledge and education about exclusive breastfeeding benefits to mother and infant. So, despite this initial supportive breastfeeding environment in UAE hospitals, our results clearly indicated that hospital policies based on national recommendations are not sufficient to maintain EBF to 6 months postpartum.…”