What are the determinants of early breastfeeding weaning and prolonged breastfeeding in Arab infants

BACKGROUND: Data on the determinants of breastfeeding in the Israeli Arab population are scarce. AIMS: To examine breastfeeding practices and determinants of early breastfeeding weaning ( 1 year of age) among Arab infants. METHODS: A total of 213 heaLthy fuLL term newborns from 2 villages in northern Israel were followed-up until they reached 18 months of age in 2007-2009. Socio-demographic data and prenatal and neonatal history were obtained by maternal interviews. Mothers were interviewed again regarding their breastfeeding practices when the infants were 2, 4, 6, 8, 12 and 18 months of age. RESULTS: Breastfeeding (any) and exclusive breastfeeding rates at enrollment (age 1 week to 2 months) were 98% and 20%, respectively. The proportions of early breastfeeding weaning and prolonged breastfeeding were 33% and 17%, respectively. In the lower socioeconomic status village, the risk of early breastfeeding weaning increased in girls (OR 2.69, P = 0.03), babies having siblings (OR 0.62, P = 0.03], those who had received herbal tea early (OR 3.33, P = 0.01), and neonates who were treated in intensive care after delivery (OR 8.48, P = 0.01]. It decreased with higher paternal education (OR=0.84, P = 0.01). Higher paternal education was also associated with increased odds of prolonged breastfeeding while early introduction of formula negatively affected these odds. In the higher socioeconomic status village, the risk of early breastfeeding weaning increased in relation to early introduction of formula (OR 3.95, P = 0.01) and decreased in relation to maternal use of folic acid in pregnancy [OR=0.20, P = 0.05). Folic acid use in pregnancy and having additional children increased the odds of prolonged breastfeeding, while early formula introduction decreased the odds. CONCLUSIONS: The rate of exclusive breastfeeding is low and early breastfeeding weaning is common in Arab infants. The predictors of early and prolonged breastfeeding are in part behavioral and modifiable. Breastfeeding practices among IsraeLi Arab infants can be improved by adequate health education. Such interventions should also be oriented to Arab fathers.