Health education role in promoting mothers’ beliefs, knowledge and practice of exclusive breastfeeding among King Fahd Armed Forces Hospital population

Hanin A. Shalaby, Rawan A. Obaid, Ruaa H. Alharthi, Malak M. Barayan, Noura S. Bagabas, Raghdh M. Battarjee, Noura A. Baroom, Mie A. Tallab


Background: Breastfeeding is considered an optimal feeding method, as it fulfills the infants' nutritional needs. Exclusive breastfeeding (EBF), which means to feed an infant solely (with some exceptions) on breast milk, is important for the health and well-being of both infant and mother. However, implementing an effective health education program is essential for promoting EBF and improving health awareness. Therefore, the purpose of this study is to measure mothers’ beliefs, knowledge and practice of exclusive breastfeeding before and after implementing the breastfeeding health education program at King Fahd Armed Forces Hospital (KFAFH).

Methods: This study employs a quantitative research method and uses a cross-sectional study design. All in-patient and out-patient postnatal women who received information about EBF in their third trimester were evaluated post-delivery. In the period from December 2018 to March 2019, the total number of participants is (n=234).

Results: The study indicates a statistically significant positive association between EBF knowledge and practice evaluation scores. Higher levels of breastfeeding (BF) knowledge were found to translate into better BF practice. Knowledge scores also had a significant association with beliefs, with higher knowledge being linked to more positive beliefs in relation to BF.

Conclusions: The conducted study reports the major effect of health education intervention on EBF practice among the KFAFH population. As a result, some managerial, and clinical recommendations were addressed. Other recommendations focused on working mothers, as KFAFH may employ some strategies and polices to maximize the use of EBF.


Exclusive breastfeeding, Health education, Knowledge, Beliefs, Practice

Full Text:



Ugurlu M, Yavan T. The Effectiveness of Breastfeeding Education: An Integrative Review. J Behav Heal. 2016;5(4):182.

Cai X, Wardlaw T, Brown DW. Global trends in exclusive breastfeeding. Int Breastfeed J. 2012;7(1):12.

Campos AM, Chaoul Cde O, Carmona EV, Higa R, do Vale IN. Exclusive breastfeeding practices reported by mothers and the introduction of additional liquids. Rev Lat Am Enfermagem. 2015;23(2):283-90.

World Health Organization (WHO). Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals, Geneva. 2009 Available at https://apps.who. int/iris/bitstream/handle/10665/44117/9789241597494_eng.pdf?ua=1. Accessed on 15 January 2019

McQueen K, Sieswerda L, Montelpare W, Dennis C. Prevalence and Factors Affecting Breastfeeding among Aboriginal Women in Northwestern Ontario. JOGNN. 2015;44:51–68.

Olagunju L. The importance of Exclusive Breastfeeding. 2013. Available at: Accessed on 30 January 2019.

Okyere P, Woodall J, Appiah E. Effectiveness of Health Education in Increasing the Duration of Exclusive Breastfeeding in Low Income Countries: A Systematic Review. J Clin Toxicol. 2014;04(02):1-9.

Tariku A, Alemu K, Gizaw Z, Muchie KF, Derso T, Abebe SM, et al. Mothers’ education and ANC visit improved exclusive breastfeeding in Dabat Health and Demographic Surveillance System Site, northwest Ethiopia. PLoS One. 2017;12(6):e0179056.

Arafat LE, Yousuf SA, Al-Battawi JA. Knowledge and Attitude of Exclusive Breast-Feeding Among Saudi Women in Primary Health Care Centers in Jeddah City, Saudi Arabia. IOSR J Nurs Heal Sci Ver VIII. 2017;6(6):2320-940.

Yi CM, Man HS. The effectiveness of breastfeeding education on maternal breastfeeding self-efficacy and breastfeeding duration: a systematic review. JBI Database Systematic Rev Implementation Reports. 2016;9(64):1-24.

Tampah-Naah AM, Kumi-Kyereme A. Determinants of exclusive breastfeeding among mothers in Ghana: a cross-sectional study. Int Breastfeed J. 2013;8(1):13.

Alyousefi NA, Alharbi AA, Almugheerah BA, Alajmi NA, Alaiyashi SM, Alharbi SS et al. Factors Influencing Saudi Mothers’ Success in Exclusive Breastfeeding for the First Six Months of Infant Life: A Cross-Sectional Observational Study. Int J Med Res Heal Sci. 2017;6(2):68-78.

Al-Jassir M, Moizuddin SK, Al-Bashir B. A review of some statistics on breastfeeding in Saudi Arabia. Nutr Health. 2003;17(2):123-30.

El-Mouzan, MI, Al Omar, AA, Al Salloum, AA, Al Herbish, AS & Qurachi, MM Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations. Ann Saudi Med. 2009;29:20–3.

Elyas L, Mekasha A, Admasie A, Assefa E. Exclusive Breastfeeding Practice and Associated Factors among Mothers Attending Private Pediatric and Child Clinics, Addis Ababa, Ethiopia: A Cross-Sectional Study. Int J Pediatr. 2017;2017:8546192.

Motee A, Jeewon R. Importance of Exclusive Breastfeeding and Complementary Feeding among Infants. Curr Res Nutr Food Sci J. 2014;2(2):56-72.

Shanthakumari K, Tamrakar A, Kotian MS. Effectiveness of Planned Health Education on Ideal Breastfeeding among Primigravidae in a Selected Hospital at Mangalore, South Karnataka. IOSR J Nurs Heal Sci. 2014;3(2):54-8.

Murtagh L, Moulton AD. Strategies to Protect Vulnerable Populations. 2011;101(2):217-23.

Gyampoh S, Otoo GE, Nii R, Aryeetey O. Child feeding knowledge and practices among women participating in growth monitoring and promotion in Accra, Ghana. 2014;14(1):1-7.

Wojcicki JM, Holbrook K, Lustig RH, Caughey AB, Muñoz RF, Heyman MB. Infant formula, tea, and water supplementation of latino infants at 4-6 weeks postpartum. J Hum Lact. 2011;27(2):122–30.

Giugliani ER, do Espírito Santo LC, de Oliveira LD, Aerts D. Intake of water, herbal teas and non-breast milks during the first month of life: associated factors and impact on breastfeeding duration. Early Hum Dev. 2008;84(5):305-10.

Laanterä S, Pölkki T, Ekström A, Pietilä AM. Breastfeeding attitudes of Finnish parents during pregnancy. BMC Pregnancy Childbirth. 2010;10:79.

Thomas J. Barriers to Exclusive Breastfeeding Among Mothers During the First Four Weeks Postpartum. 2016:1-108.

Ratnasari D, Paramashanti BA, Hadi H, Yugistyowati A, Astiti D, Nurhayati E. Family support and exclusive breastfeeding among Yogyakarta mothers in employment. Asia Pac J Clin Nutr. 2017;26:31-5.