Impact of Using Social Marketing Principles on Promoting Breastfeeding Practices and Physical Growth: an Egyptian Community Based Longitudinal Study

Abstract

Background: Improving breastfeeding practices does not always link to interventions relying only on improving nutritional awareness and education but needs cultural and behavioral insights. Aim: Our study provided educational intervention through the use of the social marketing (SM) approach which was respectable to societal norms allowing more conscious choices by mothers to achieve the maximum potential of physical growth of their infants. This study evaluated the effectiveness of the used approach for improving breastfeeding practices and the physical growth of infants aged up to 2 years. Methods: A quasi-experimental intervention design with posttest-only control design was done along 3 years duration with 24 months of intervention and follow up for motivating mothers’ voluntary behavioral change towards breastfeeding promotion using SM principles: product, price, place, and promotion. The interventions targeted 646 pregnant women in their last trimester and mothers of children up to 2 years in addition to 1454 women in their childbearing period. Results: Most of the mothers showed increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn). Early breastfeeding initiation, exclusive breastfeeding (EBF) under 6 months, frequency of breastfeeding per day, percentage of infants who continued breastfeeding till 2 years, were significantly increased from 30%, 23 %, 56%, and 32% to 62 %, 47.3 %, 69 %, and 43.5 % respectively. With the attention of the nutritional educational sessions three or more times, the majority of indicators had the most significant improvement. The girls who recorded underweight results compared to boys, were significantly improved after the intervention (from 66.7 % to 18.8%). At the same time, girls that were found to be obese before the intervention (15.4 %) became no longer obese. Conclusions: Nutritional interventions that are based on the use SM approach showed improvement for the majority of the key performance indicators. Although they were doubled their value before the intervention yet the majority were still modest (below 50 %). With sustained use of the SM approach, infants will achieve their maximum potential for physical growth through providing economically disadvantaged mothers with breastfeeding support.