DURATION OF BREASTFEEDING AND FACTORS THAT AFFECT IT IN ALMADINAH 2016

Abdulrahman Alsaedi, Abdulelah Almushdak, Ahmad Almohamadi, Abdullatif Aljabri, Muath Alhazmi Saud Alharbi, Samar Albahlol, GhadaKhair and Haifa Alrumeh. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History

In addition, AAP states that while breastfeeding mothers "should avoid the use of alcoholic beverages", an "occasional celebratory single, small alcoholic drink is acceptable, but breastfeeding should be avoided for 2 hours after the drink. {5} Weaning is the process of replacing breast milk with other foods; the infant is fully weaned after the replacement is complete. Psychological factors affect the weaning process for both mother and infant, as issues of closeness and separation are very prominent {6} Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections) and lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria). {7}{8} Infants exclusively breastfed have less chance of developing diabetes mellitus type 1 than those with a shorter duration of breastfeeding.{9} Infants that are otherwise healthy uniformly benefit from breastfeeding. "No known disadvantages" stem from breastfeeding. However, extra precautions should be taken or breastfeeding be avoided in circumstances including certain infectious diseases, or use of certain medications{10}{11} Race, ethnicity and socioeconomic status affect choice and duration in the United States. A 2011 study found that on average, US women who breastfed had higher levels of education, were older and were more likely to be white.
Globally about 38% of babies are just breastfeed during their first six months of life. [2] In the United States as of 2012, 75% of women started breastfeeding, 43% breastfeed for six months though only 13% exclusively breastfed, and 23% breastfeed for twelve months. {12} Breastfeeding rates in the United Kingdom were the lowest in the world in 2015 with only 0.5% of mothers still breastfeeding at a year, while in Germany 23% are doing so, 56% in Brazil and 99% in Senegal.{13} That compares with 23% in Germany, 56% in Brazil and 99% in Senegal.
The researchers said it was a "widespread misconception" that breastfeeding was beneficial only in poor countries.
In the UK, 81% of mothers had tried breastfeeding at some point, but only 34% were breastfeeding at six months and 0.5% at 12 months.
In the US, 79% started, 49% were still going after six months and 27% after a year.
It is the worst record in the world. Breastfeeding is far more common in developing countries, but the UK figures are behind even similar countries in Europe.
Women in the UK are advised to feed their baby exclusively on breast milk for the first six months and then a combination of breast milk and other foods, however, it does not give a recommend end-point.{14} Objectives:- To know the duration of breastfeeding in almadinah 2016.  To study the risk factors that affect the duration of breatfeeding.  To know the percentage of use supplementary milk .

Method and participant:-
Sample of 420 participants was collected in Almadinah City ,In Saudi Arabia. The study included 420 participants a Postal survey was sent to mothers randomly from the general population of Almadinah using a questionnaire based on discussed risk factors . Data were analyzed using SPSS version 16. Univariate analysis was done and cross tabulation was used to summarize the frequency and percentage of the variables. Chi-square was used as an appropriate statistical test and P≤ 0.05 was used as a statistical significant level. Multiple regression was used to control for confounders and assess the risk factors.
50% of mothers who used supplementary milk between the first month to six months, 31% after 6 months 19% after 1 year .
A total of 422 person participated in the survey. The majority of the respondents 91% are Saudi mothers and 9% non-saudi mothers.

%
The Percentage of the mother Nationality

Saudi mother The mother is not Saudi Arabia
The majority of mothers:-87% of mothers who have breastfeed their babies.
The minority of mothers:-13% of mothers did not breastfeed their babies.
The majority of mothers:-50% of mothers who used supplementary milk between the first month to six months. The percentage of mothers who were breastfed and use of supplementary milk 42% of mothers breastfed their children only when they need to breastfeed 30% of mothers breastfed their children 4-6 times a day 28 % of mothers breastfed their children 1-3 times a day 31% of the mothers were breast-feeding period for their newborns from 1 month to 6  The percentage of the duration of breastfeeding 27% of the mothers were breast-feeding period for their newborns from one year and half to two years 22% of the mothers were breast-feeding period for their newborns from one year to one year and a half 21% of the mothers were breast-feeding period for their newborns from 6 months to one year 63% of mothers aged between 20-30 years were using supplemental milk and 37% did not use supplementary milk 68% of mothers aged between 30-40 years were using supplemental milk and 32% did not use supplementary milk 69% of mothers aged more than 40 years were using supplemental milk and 31% did not use supplementary milk 63% of mothers aged less than 20 years were using supplemental milk and 37% did not use supplementary milk Mothers less than 20 years:-34% were breastfeeding period of one month to 6 months 25% were breastfeeding period from one year and a half to two years 22% were breastfeeding period from year to year and a half 19% were breastfeeding period of 6 months to a year Mothers aged 20-30 years:-33% were breastfeeding one month to 6 months 29% were breastfeeding period than a year and a half to two years 18% were breastfeeding period from year to year and a half 20% were breastfeeding for 6 months to a year Mothers aged 30-40 years:-30% were breastfeeding one month to 6 months 26% were breastfeeding period from year to year and a half 24% were breastfeeding period than a year and a half to two years 20% were breastfeeding for 6 months to a year Mothers more than 40 years:-31% were breastfeeding period than a year and a half to two years 26% were breastfeeding period from year to year and a half 23% were breastfeeding period of 6 months to a year 20% were breastfeeding period of one month to 6 months After the hypothesis:-Alternative hypothesis: That there is a relationship between age and duration of breast-feeding More than 40 years After statistical testChi-Square for Independence:with Confidence level 95% turned out there is no relation between age and theduration of breast-feeding These two variables are independent.
Mothers less than 20 years:-94% of mothers less than twenty years breastfed their babies 6% of mothers less than twenty years Not breastfeed their babies  After statistical test Chi-Square for Independence:with Confidence level 95% turned out there is no relation between Child Orderand the people who are using supplemental milk These two variables are independent.
Duration of breast-feeding for the first child:-37% of mothers were breastfeeding a child from one month to six months 21% of mothers were breastfeeding a child period of six months to one year 15% of mothers were breastfeeding a child period from year to year and a half 27% of mothers were breastfeeding a child duration from one year to two years Duration of breast-feeding for the second child:-35% of mothers were breastfeeding a child from one month to six months 16% of mothers were breastfeeding a child period of six months to one year 24% of mothers were breastfeeding a child period from year to year and a half From year to year and a half 25% of mothers were breastfeeding a child duration from one year to two years Duration of breast-feeding for the third child:-27% of mothers were breastfeeding a child from one month to six months 21% of mothers were breastfeeding a child period of six months to one year 25% of mothers were breastfeeding a child period from year to year and a half 27% of mothers were breastfeeding a child duration from one year to two years Duration of breastfeeding for the fourth child:-24% of mothers were breastfeeding a child from one month to six months 21% of mothers were breastfeeding a child period of six months to one year 27% of mothers were breastfeeding a child period from year to year and a half 28% of mothers were breastfeeding a child duration from one year to two years Duration of breastfeeding for children fifth or next:-25% of mothers were breastfeeding a child from one month to six months 25% of mothers were breastfeeding a child period of six months to one year 23% of mothers were breastfeeding a child period from year to year and a half 27% of mothers were breastfeeding a child duration from one year to two years After the hypothesis:-Alternative hypothesis:-That there is a relationship between the Child Order and the duration of breast-feeding The value of Chi-Square Tests =8.170 Degree of freedom=12 And the p-value was = 0.77 The second child for mothers:-83% of mothers breastfed her second child 17% of mothers did not breastfeed her second child The third child of the mother:-90% of mothers breastfed her third child 10% of mothers did not breastfeed her third child The fourth child of the mother:-88% of mothers breastfed her fourth child 12% of mothers did not breastfeed her fourth child The fifth child of the mother or the next:-89% of mothers breastfed her fifth or next 11% of mothers did not breastfeed her baby fifth or next After the hypothesis:-Alternative hypothesis:-That there is a relationship between the Child Order and the breast-feeding That there is a relationship between the mother workand the duration of breast-feeding The value of Chi-Square Tests =2.230 Degree of freedom=3 And the p-value was = 0.53 After statistical test Chi-Square for Independencewith Confidence level 95% turned out there is no relation between mother work and duration of breast-feeding These two variables are independent.
Mothers who work:-90% of mothers breastfed their babies 10% of mothers they did Not breastfeed their babies Mothers do not have work:-84% of mothers breastfed their babies 16% of mothers they did Not breastfeed their babies After the hypothesis:-Alternative hypothesis:-That there is a relationship between the mother workand the breast-feeding The value of Chi-Square Tests =16.457 Degree of freedom=9 And the p-value was = 0.058 After statistical test Chi-Square for Independencewith Confidence level 95% turned out there is no relation betweenfamily incomeandthe duration of breast-feeding These two variables are independent.

Discussion:-
This research is the first one encountered about duration of breastfeeding in Almadinah , KSA .our study goes with that of the ministry of health in KSA as our study revealed that average duration of breastfeeding is 8 months while in their study it is 7.5 {15} . in our study 31% of mothers breasfeed for 6 months while globally 38% {16}. There is good percentage of mothers who started breastfeeding in Almadinaas it is 87% in our study its higher than globally percentage 81% {17} . Breastfeeding rates in the United Kingdom were the lowest in the world in 2015 with only 0.5% of mothers still breastfeeding at a year, while in Germany 23% are doing so, 56% in Brazil and 99% in Senegal {13}. Higher percentage found in Australia 90% in their annual report .There is no association between the age and use of supplementary milk value of Chi-Square Tests =1.066 ,Degree of freedom=3,And the p-value was = 0.785. After statistical test Chi-Square for Independence with Confidence level 95% turned out there is no relation between age and the duration of breast-feeding These two variables are independent. There is no relation between the work and breastfeeding duration and use of supplementary milk as whole mothers taking vacation .

Conclusion:-
The percentage of breastfeeding in Almadina is higher than expected , higher than global percent by 6%.The average duration of breastfeeding in Almadinah is higher than other city in KSA . There is no relation between age and breastfeeding and its duration and supplementary milk use .Also there is no relation between level of education and breastfeeding duration and use of supplementary milk .There is no relation between income and breastfeeding duration and use of supplementary milk .There is no relation between order of the child in the family and breastfeeding duration and use of supplementary milk .
How we analyzed:-The statistical program we use isStatistical Package for the Social Sciences (SPSS) version 22. The statistical test.