665395
research-article2016
WHSXXX10.1177/2165079916665395Workplace health & safetyWorkplace health & safety
Workplace Health & Safety
Research Article
Knowledge, Attitude, and Practice of Breastfeeding
Among Working Mothers in South Jordan
Eyad Altamimi, MD1, Reem Al Nsour, MBBS2, Duaa Al dalaen, MBBS3, and Neyaf Almajali, MBBS4
Abstract: Breast milk is the ideal food for human
infants, with benefits to mothers and babies. However,
working mothers are more likely to choose not to
breastfeed or to interrupt breastfeeding prematurely. This
study assessed breastfeeding knowledge and attitudes
among working mothers in South Jordan. Four hundred
cross-sectional, self-administered Arabic surveys were
distributed to working mothers at their workplaces.
In addition to measuring mothers’ knowledge of and
attitudes toward breastfeeding, barriers that prevented
continuing breastfeeding beyond 6 months were also
explored. Three hundred forty-four (80%) completed
questionnaires were returned. The breastfeeding initiation
rate was 72.4%, but only 20.9% were exclusively
breastfeeding by 6 months. The participants showed
satisfactory knowledge about breastfeeding and had
positive attitudes toward breastfeeding. Most of the
women who initiated breastfeeding reported ending
breastfeeding prematurely. Approximately 30% of the
mothers attributed premature cessation of breastfeeding
to work. The results of this study could be useful for
health care providers and policy makers when planning
effective breastfeeding promotion programs and creating
breastfeeding-friendly workplaces.
Keywords: environmental injustice, occupational hazards,
women’s health, built environment, continuous quality
improvement, primary care
B
reast milk is the ideal food for human infants. Beyond
the nutritional value, breastfeeding reduces infection
susceptibility and neonatal mortality through active
protection against infections (Renfrew et al., 2012). In
addition, breastfeeding establishes a unique bond between
DOI: 10.1177/2165079916665395. From 1Mutah University, Alkarak, Jordan, 2Specialty Hospital, Amman–Jordan, 3Al-Karak Teaching Hospital, Al-Karak–Jordan, and 4Jordan University
Hospital, Amman, Jordan. Address correspondence to: Eyad Altamimi, MD, Associate Professor of Pediatrics, Faculty of Medicine, Mutah University, P.O. Box 7, Al-Karak 61710, Jordan; email:
eyadtamimi@gmail.com.
For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
Copyright © 2016 The Author(s)
210
May 2017
mother and infant, which supports maternal role attainment
(Ball, 2010; Labbok, Smith, & Taylor, 2008; Meyers, 2009).
Women of childbearing age comprise a significant sector of
the worldwide workforce. More than half of American,
Canadian, and Australian mothers of children below the age
of 3 years participate in the workforce (Baxter, 2008; Bureau
of Labor Statistics, U.S. Department of Labor, 2006;
Heymann & Kramer, 2009). In Jordan, women represent
48.5% of the population. Literacy rates are one of the
highest in the region for both men and women, and among
young adults. The higher education among women is
responsible for higher employment rates among women
(Majcher-Teleon & Slimène, 2009). However, because of
non-supportive work environments and early return-to-
work, working mothers around the world are less likely to
breastfeed, or to stop breastfeeding prematurely (Centers for
Disease Control and Prevention [CDC], 2008; Hendricks,
Briefel, Novak, & Ziegler, 2006; Kimbro, 2006; Ryan, Zhou,
& Arensberg, 2006).
Khassawneh, Khader, Amarin, and Alkafajei (2006) found
that Jordanian employed mothers were less likely to fully
breastfeed. Understanding work-related factors that lead to
premature cessation of breastfeeding and then implementing
breastfeeding-friendly policies in the workplace could
significantly influence women’s abilities to successfully sustain
breastfeeding. Supporting working mothers to continue
breastfeeding has the potential to affect the health of mothers
and children, employee retention and productivity, and cost
savings to business and society (Bartick & Reinhold, 2010;
Marinelli, Moren, Taylor, & The Academy of Breastfeeding
Medicine, 2013). This study assessed working mothers’
breastfeeding knowledge and attitudes and explored barriers to
continuing breastfeeding beyond 6 months, offering public
health professionals information needed to promote
breastfeeding in Jordan.
vol. 65  ■  no. 5
Applying Research to Practice
The findings of this study suggest that further strategies
should be implemented to improve rates of breastfeeding
among working mothers. Longer paid maternity leaves
and providing appropriate place for breastfeeding at the
workplace will significantly improve breastfeeding rates.
It is expected this will hugely affect the health of
children, mothers, and communities.
Method
The investigators randomly selected private and government
organizations from all business sectors (e.g., health, banking,
education) throughout the Al-Karak governorate. Facilities with
similar work activities were selected randomly to participate.
The investigators met mothers (those women who were
unmarried or married without children were excluded from the
study) at their workplaces.
An Arabic language questionnaire was developed by the
researchers after reviewing multiple published
questionnaires (Batal, Boulghourjian, Abdallah, & Afifi, 2006;
Chaudhary, Shah, & Raja, 2011; Ekambaram, Vishnu Bhat, &
Mohamed Asif Padiyath Ahamed, 2010; Saka, Musayeva,
Ceylan, & Koeturk, 2005; Tarrant & Dodgson, 2007; Zhou,
Younger, & Kearney, 2010). The first part of the
questionnaire was a 14-item scale that measured
breastfeeding knowledge. The questions were intended to
assess mothers’ fundamental understanding of breastfeeding.
Knowledge scores reflected correct and incorrect responses;
the total number of correct responses was calculated and
converted into a percentage score. The second part of the
questionnaire was a 17-item scale to assess mothers’
attitudes toward breastfeeding. The arithmetic mean of the
Likert-type scale (i.e., 5 = strongly agree, 4 = agree, 3 = I do
not agree, 2 = strongly disagree, 1 = I do not know) was
categorized as follows: ≥3.67 = high, 2.34-3.66 = medium,
and ≤2.33 = low. For the purpose of calculating the
percentage of responses, undetermined responses (i.e., I
don’t know) were negligible (maximum of three responses)
and considered disagree responses.
The Ethical Committee of the Faculty of Medicine at Mutah
University approved the study. The mothers received written
information about research aims and study methodology; those
who agreed to participate in the study were given a
questionnaire. Unlimited time was given to complete the
questionnaire. Participants were allowed to take the
questionnaire home and return it the next day; the research
team was available to answer any questions. Returning
completed questionnaires indicated that mothers consented to
the information being used for study purposes. All research data
were anonymous, encrypted, and saved, with limited access by
the research team only.
Workplace Health & Safety
Data were analyzed using the Statistical Package for Social
Sciences, Version 17 (IBM, Armonk, NY, USA). Data are
presented as the mean ± standard deviation (SD). Descriptive
statistics were used to characterize the demographic data and
knowledge and attitude scores. The descriptive data are
presented as the proportion of respondents or the mean ± SD.
Student’s t-test for independent groups (i.e., two-tailed) were
used to compare the attitude scores of participants by education
and previous breastfeeding experience. Statistical significance
was set at p < .05.
Results
Four hundred questionnaires were distributed, and 344
questionnaires (80%) were completed and returned. Most of the
study participants were 30 years old or younger (73.5%), college
graduates (72.4%), and had three or fewer children (64%). Two
hundred forty-five (71.2%) participants reported that they had
attempted breastfeeding, but only 51 (20.9%) had exclusively
breastfed during the first 6 months. Details of the
sociodemographic characteristics of the participants are shown
in Table 1.
Working Mothers’ Breastfeeding Knowledge
Most of the women in the study were knowledgeable about
breastfeeding. Almost all the mothers (n = 341, 99.3%) knew
that “breastfeeding is the ideal food for a newborn.” However,
only 80 (23%) mothers responded to the statement “Cosmetic
surgery of the breast is a contraindication for breastfeeding”
correctly. College graduates and mothers with breastfeeding
experience demonstrated more knowledge. “Breastfeeding helps
the uterus contract to its normal size” was the only statement
with statistical significance (p = .001 and p = .039, respectively).
Table 2 shows the participants’ knowledge about breastfeeding.
Table 3 compares mothers’ breastfeeding knowledge by
mothers’ education and previous breastfeeding experience.
Working Mothers’ Attitudes Toward Breastfeeding
Working mother respondents demonstrated positive
attitudes toward breastfeeding. The statement, “Health
professionals encourage breastfeeding” had the highest
agreement score (4.58 ± 0.72); the statement, “Workplaces
provide designated areas for breastfeeding” had the lowest
score (2.74 ± 1.06).
Mothers with less education believed that formula feeding
was a symbol of wealth, were more affected by formula
commercials, and even stated that they did not like
breastfeeding. These results were statistically significant.
However, mothers with previous breastfeeding experience
reported that it was not difficult for breastfeeding mothers to
care for their families, and they disagreed with inexperienced
mothers who thought that work environments were not
convenient for breastfeeding (p = .012). Table 4 shows the mean
participant responses toward breastfeeding. Table 5 compares
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Workplace Health & Safety May 2017

average responses by education and previous breastfeeding

Table 1.  Sociodemographic Characteristics of Participants experience.
(n = 344)
Breastfeeding Barriers
Characteristic n (%)
Barriers to breastfeeding were defined in relation to maternal
Current age (years) perception (e.g., forced to end breastfeeding although mother
 <25 32 (9.3) was still willing to breastfeed). Two hundred twenty-eight
mothers reported they had ended breastfeeding prematurely.
 25-30 59 (17.2)
Approximately, one third of these mothers (n = 72, 31.6%)
 30-35 129 (37.5) attributed early breastfeeding cessation to work issues (Figure
 >35 124 (36) 1). Only 64 (18.6%) respondents stated they had a designated
area for breastfeeding at their workplaces (Table 4). In addition,
Educational level 213 (61.9%) respondents believed that maternity leave alone
  High school or less 95 (27.6) was not long enough to establish successful breastfeeding
(Table 4).
 College 249 (72.4)
Occupation
 Professional 249 (72.4) Discussion
 Non-professional 95 (27.6)
This study explored the knowledge of, attitudes toward,
practices in relation to, and barriers to breastfeeding among
Family income working mothers in South Jordan. The study demonstrated that
  <300 JDa 230 (66.9) working mothers have satisfactory knowledge of and positive
attitudes toward breastfeeding. However, only one fifth of
  ≥300 JD 114 (33.1)
breastfeeding working mothers breastfed exclusively for 6
Place of residence months. For 30% of respondents, work-related factors were the
  Al-Karak city 126 (36.6) cause of premature cessation. Mothers with previous
breastfeeding experience were more likely to advise new
  Al-Karak suburbs and villages 208 (66.9) mothers to breastfeed.
  Outside Al-Karak 10 (2.9) However, the study also identified knowledge deficits
specifically related to breastfeeding contraindications. The
Living at home
mothers’ answers to questions about contraindications to
  Parents and kids 300 (87.2) breastfeeding showed that more than 40% of the respondents
  Parents, kids, and grandparents 21 (6.1) believed that mothers should stop breastfeeding when babies
have colds, fevers, or diarrhea. Alternatively, more than 50% of
  Parents, kids, and housemaid 23 (6.7) the respondents thought that smoking and breast surgery were
Number of kids contraindications for breastfeeding. Therefore, accurate
contraindications should be included in counseling about
  ≤3 220 (64)
breastfeeding.
 >3 124 (36) Although almost 80% of the respondents admitted that
Smoking society encourages breastfeeding, approximately 60% of the
respondents would not breastfeed in the presence of others and
 Yes 43 (12.5) 42% would be embarrassed if they were seen breastfeeding.
 No 301 (87.5) Embarrassment could be a cause of early breastfeeding
cessation or to choose not to breastfeed at all. Jordanian culture
Previous breastfeeding experience
discourages breastfeeding in public (Scott, Mostyn, & Greater
 Yes 245 (71.2) Glasgow Breastfeeding Initiative Management Team, 2003;
 No 99 (28.8) Tarrant, Dodgson, & Choi, 2004; Tarrant, Dodgson, & Tsang Fei,
2002). Therefore, providing a clean, private, and safe place for
Exclusive breastfeeding (first 6 months; n = 245) lactation (not a bathroom) with a handwashing facility in
 Yes 52 (21.2) proximity to mothers’ work stations could improve
breastfeeding adherence by encouraging mothers to pump as
 No 193 (78.8)
needed (Kimbro, 2006; Marinelli et al., 2013).
a
1 JD = US$1.40. Working mothers are more likely to end breastfeeding
prematurely compared with non-working mothers (CDC, 2008;

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Table 2.  Participants’ Knowledge About Breastfeeding

Questions Right n (%) Wrong n (%)

Breastfeeding is the ideal food for newborn babies 341 (99.1) 3 (0.9)
Breastfeeding provides the newborn infant with nutritional benefits that formula won’t provide 337 (98) 7 (2)
The nursing mother should consult her doctor before taking any medication 335 (97.4) 9 (2.6)
Breastfeeding reduces the risk of malnutrition and obesity in children 335 (97.4) 9 (2.6)
Breastfeeding protects against breast and ovarian cancers 334 (97.1) 10 (2.9)
Breastfeeding helps the uterus contract to its normal size 331 (96.2) 13 (3.8)
Breastfeeding helps the mother return to her pre-pregnancy weight 323 (93.9) 21 (6.1)
A child who is breastfed is less likely to get sick compared with formula-fed children 290 (84.3) 54 (15.7)
Breastfeeding reduces constipation 295 (85.8) 49 (14.2)
Some foods and beverages such as the ring, anise, and honey increase breast milk production 295 (85.8) 49 (14.2)
Breastfeeding is a method of contraception 226 (65.7) 118 (34.3)
Smoking mothers should not breastfeed their babies 159 (46.2) 185 (53.8)
The mother should stop breastfeeding if the child has a cold, high temperature, or diarrhea 198 (57.6) 146 (42.4)
Cosmetic surgery of the breast is a contraindication for breastfeeding 80 (23.3) 264 (76.7)

Hendricks et al., 2006; Kimbro, 2006; Ogbuanu, Glover, Probst,
Hussey, & Liu, 2011; Ryan et al., 2006). In this study, 93% of
mothers who initiated breastfeeding reported they had
prematurely ended breastfeeding and this study’s findings
revealed that working mothers are less likely to practice
exclusive breastfeeding, consistent with previous research
(Ogbuanu, Glover, Probst, Liu, & Hussey, 2011; Skafida, 2011).
The rate of exclusive breastfeeding until 6 months in this cohort
was 20.9%, which is slightly higher than the percentage
reported in the United States by Jones, Kogan, Singh, Dee, and
Grummer-Strawn (2011). Although it is expected that mothers
with higher education may fill positions with more work
responsibilities, in this study, a higher percentage of mothers
with higher education practiced exclusive breastfeeding which
may be explained by more accurate knowledge and
understanding of the benefits of exclusive breastfeeding than
mothers with less education. These results were consistent with
previous reports that mothers in the highest categories of
academic skills were more likely to initiate exclusive
breastfeeding (Webb, Sellen, Ramakrishnan, & Martorell, 2009).
Adopting new policies to encourage exclusive breastfeeding is
needed. Previous studies have shown that “breastfeeding friendly”
work environments as well as part-time employment for
breastfeeding mothers enable them to continue breastfeeding for
longer periods of time (Ogbuanu, Glover, Probst, Liu, et al., 2011;
Skafida, 2011). Laws to improve breastfeeding, including extended
paid maternity leave, breastfeeding breaks, and onsite child care
facilities, support working mothers. In Jordan, maternity leave by
law is 10 weeks. The majority of study respondents (61%)
reported that maternity leave should be longer, and only 18.6%
had a daycare facility at their place of work.
Mothers who reported previous breastfeeding experience
had more accurate knowledge about breastfeeding and were
not as sensitive to breastfeeding barriers, which are consistent
with previous reports (Uchendu, Ikefuna, & Emodi, 2009).
These results highlight the need for working mothers with
previous breastfeeding experience to advocate for breastfeeding.
They can serve as role models for new mothers by sharing their
stories, including the obstacles they encountered and how they
achieved breastfeeding success.
More than 80% of working mothers returned completed
questionnaires. This high response rate might be related to the
education of participating mothers, working mothers’ desire to
have their voices heard, or the researchers personally
distributing and retrieving the questionnaires.
The main limitation of this study is that it was focused on
South Jordan and the results cannot be generalized to the
entire country. In South Jordan, most businesses are small to
medium size. Labor laws ask businesses with 20 or more
women employees to maintain a safe child care facility under

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Table 3.  Comparison of Participants’ Knowledge According to Level of Education and Breastfeeding Experience

Level of education: Level of education: Previous No previous

High school or College or higher breastfeeding breastfeeding
below (n = 95) (n = 249) experience (n = 245) experience (n = 99)

Questions Right n (%) Right n (%) p value Right n (%) Right n (%) p value
Workplace Health & Safety

Breastfeeding is the ideal food for newborn babies 95 (100) 246 (98.8) .284 245 (100) 96 (97) .007

Breastfeeding provides the newborn infant with nutritional benefits that 93 (97.9) 244 (98) .953 240 (98) 97 (98) 1.00
formula won’t provide

The nursing mother should consult her doctor before taking any 93 (97.9) 242 (97.2) .716 241 (98.4) 94 (94.9) .067
medication

Breastfeeding reduces the risk of malnutrition and obesity in children 94 (98.9) 241 (96.8) .278 241 (98.4) 94 (94.4) .041

Breastfeeding protects against breast and ovarian cancers 89 (93.7) 245 (98.4) .021 239 (97.6) 95 (96) .421

Breastfeeding helps the uterus contract to its normal size 86 (90.5) 245 (98.4) .001 239 (97.6) 92 (92.9) .039

Breastfeeding helps the mother return to her pre-pregnancy weight 86 (90.5) 237 (95.2) .106 228 (93.1) 95 (96) .308

A child who is breastfed is less likely to get sick compared with formula- 83 (84.7) 207 (83.1) .721 214 (87.3) 76 (76.8) .016
fed children

Breastfeeding reduces constipation 77 (81.1) 218 (87.6) .273 211 (86.1) 84 (84.8) .685

Some foods and beverages such as the ring, anise, and honey increase 81 (85.3) 214 (85.9) .887 215 (87.8) 80 (80.8) .093
breast milk production

Breastfeeding is a method of contraception 63 (66.3) 163 (65.6) .903 173 (70.6) 53 (53.5) .003

Smoking mothers should not breastfeed their babies 36 (37.9) 123 (49.4) .057 111 (45.3) 48 (48.5) .590

The mother should stop breastfeeding if the child has a cold, high 47 (49.5) 151 (60.6) .063 150 (61.2) 48 (48.5) .032
temperature, or diarrhea

Cosmetic surgery of the breast is a contraindication for breastfeeding 21 (22.1) 59 (23.7) .754 53 (21.6) 27 (27.3) .258
May 2017
vol. 65  ■  no. 5 Workplace Health & Safety

Table 4.  Mean Responses of Participants Toward Breastfeeding

Question M ± SD Agree n (%) Disagree n (%)

Health professionals encourage breastfeeding 4.58 ± 0.72 324 (94.2) 20 (5.8)
Breastfeeding is a good way to reduce family expenses 4.41 ± 0.86 313 (91) 31 (9)
Breastfeeding has no negative effects on marital relationships 4.32 ± 0.89 295 (85.8) 49 (14.2)
Mothers who formula feed miss one of the great joys of motherhood 4.21 ± 0.94 266 (77.3) 78 (22.7)
The community encourages breastfeeding 4.19 ± 0.94 275 (79.9) 69 (20.1)
It is not difficult for a breastfeeding mother to care for her family 4.15 ± 0.92 266 (77.3) 78 (22.7)
Working environments are not convenient for breastfeeding 3.99 ± 1.11 260 (75.6) 84 (24.4)
Formula feeding is a better choice for working mothers 3.77 ± 0.87 217 (63.1) 127 (36.9)
I will not breastfeed in the presence of others 3.73 ± 0.91 205 (59.6) 139 (40.4)
Formula feeding is easier than breastfeeding 3.49 ± 0.92 165 (48) 179 (52)
I would feel embarrassed if anyone saw me breastfeeding 3.48 ± 0.90 145 (42.2) 199 (57.8)
Breastfeeding will make mother’s breasts sag 3.83 ± 0.92 142 (41.3) 202 (58.7)
Maternity leave is enough for successful breastfeeding 3.32 ± 1.07 131 (38.1) 213 (61.9)
I don’t like breastfeeding 3.13 ± 0.87 77 (22.4) 267 (77.6)
Formula commercials affected my decision on breastfeeding 3.07 ± 0.94 83 (24.1) 261 (75.9)
Formula feeding is a symbol of wealth 2.81 ± 0.81 47 (13.7) 297 (86.3)
Work places provide designated areas for breastfeeding 2.74 ± 1.06 64 (18.6) 280 (81.4)

the supervision of a qualified nursemaid for children less
than 4 years of age, provided that there are 10 or more
children. A limited number of facilities in this area fulfill
these criteria.
In this study, the time between last delivery and answering
the questionnaire was not recorded. However, the researchers
know that this time interval differed among the respondents.
Recall bias of the respondents should be addressed in a larger
study.
Implications for Occupational Health Nurses
Occupational health nurses focus on promotion and
restoration of health, prevention of illness and injury, and
protection from work-related and environmental hazards
(Explorehealthcareers.org, 2012). Non-initiation or early
cessation of breastfeeding due to maternal work issues could
be viewed as a health hazard. The effects of never
breastfeeding or prematurely ending breastfeeding on
maternal and child health and child cognitive development
are now well established and include an increase in the
incidence of illness and significant health-related costs
(Bartick & Reinhold, 2010; Renfrew et al., 2012). This study
provides evidence of the effect of maternal work on
breastfeeding. Occupational health nurses can work with
breastfeeding mothers to provide the best workplace
environments for these workers.
Conclusion
This is the first study in South Jordan to assess the
knowledge of, attitudes toward, and practices in regard to
breastfeeding by working mothers. Breastfeeding knowledge
among participants was adequate and their attitudes toward
breastfeeding were positive in general. Work-related causes
were responsible for premature cessation of breastfeeding in
approximately 30% of participants. This study provided
direction for health care professionals and policy makers for
planning effective breastfeeding promotion programs and
creating breastfeeding-friendly work environments.

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Table 5.  Participants Mean Responses Regarding Breastfeeding Attitudes in Relation to Level of Education and Previous Breastfeeding Experience

Level of education: Level of education: Previous breastfeeding No previous

High school or below College or higher experience breastfeeding experience
Questions M ± SD M ± SD p value M ± SD M ± SD p value
Workplace Health & Safety

Health professionals encourage breastfeeding 4.53 ± 0.797 4.59 ± 0.684 .487 4.59 ± 0.669 4.54 ± 0.825 .559

Breastfeeding is a good way to reduce family expenses 4.29 ± 1.01 4.23 ± 0.964 .615 4.16 ± 1.012 4.22 ± 1.045 .622

Breastfeeding has no negative effects on marital relationships 4.23 ± 1.046 4.35 ± 0.828 .266 4.33 ± 0.841 4.27 ± 1.018 .574

Mothers who formula feed miss one of the great joys of motherhood 4.22 ± 0.947 4.35 ± 0.828 .266 4.24 ± 0.939 4.12 ± 0.929 .283

The community encourages breastfeeding 4.37 ± 0.876 4.12 ± 0.961 .03 4.16 ± 0.975 4.28 ± 0.858 .286

It is not difficult for a breastfeeding mother to care for her family 4.12 ± 1.04 4.16 ± 0.876 .718 4.23 ± 0.834 3.95 ± 1.063 .001

Work environments are not convenient for breastfeeding 3.86 ± 1.234 4.03 ± 1.058 .205 4.08 ± 1.005 3.75 ± 1.312 .012

Formula feeding is a better choice for working mothers 3.78 ± 0.852 3.76 ± 0.878 .849 3.76 ± 0.807 3.79 ± 1.013 .773

I would not breastfeed in the presence of others 3.78 ± 1.012 3.71 ± 0.869 .857 3.73 ± 0.841 3.74 ± 1.065 .927

Formula feeding is easier than breastfeeding 4.09 ± 1.073 4.06 ± 1.01 .809 3.47 ± 0.832 3.54 ± 1.1 .522

I would feel embarrassed if anyone saw me breastfeeding 3.67 ± 0.994 3.43 ± 0.849 .026 3.51 ± 0.904 3.44 ± 0.883 .513

Breastfeeding will make mother’s breasts sag 3.89 ± 0.937 3.73 ± 0.920 .154 3.42 ± 0.918 3.26 ± 0.932 .146

Maternity leave is not enough for successful breastfeeding 3.45 ± 1.069 3.27 ± 1.073 .165 3.36 ± 1.06 3.23 ± 1.105 .31

I don’t like breastfeeding 3.45 ± 0.931 3.01 ± 0.821 .000 3.15 ± 0.754 3.1 ± 1.12 .632

Formula commercials affected my decision on breastfeeding 3.36 ± 1.193 2.96 ± 0.792 .0004 3.03 ± 0.884 3.17 ± 1.05 .209

Formula feeding is a symbol of wealth 3.21 ± 0.999 2.72 ± 0.69 .000 2.88 ± 0.798 2.79 ± 0.836 .351

Working places provide designated areas for breastfeeding 2.68 ± 1.25 2.75 ± 0.976 .531 2.73 ± 0.989 2.76 ± 1.221 .824
May 2017
vol. 65  ■  no. 5
Figure 1.  Causes of premature breastfeeding cessation (as perceived by the mothers).
Conflict of Interest
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
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Author Biographies
Eyad Altamimi is a pediatric gastroenterologist and an associate
professor of pediatrics. His research interest includes childhood
nutrition and malnutrition prevention.
Reem Al Nsour is a graduate of Medical School at Mutah
University. She is a senior radiology resident with interest in
female medical imaging.
Duaa Al dalaen is an obstetrics and gynecology resident. She
participates in campaigns promoting breastfeeding and
maternal and child health.
Neyaf AlMajali is a senior general surgery resident. Her research
interest focuses on research methodology and disease
epidemiology.