Volume 9, Issue 10, October– 2024 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24OCT357

Factors Associated with Breastfeeding Practice in

Newborns of Moroccan Mothers with SARS-CoV-2
Aslaou Fatima1 Ibrahimi Halima2
Research Team on Health and Nutrition of Mother and Ibn Tofail University Laboratory Biology and Health,
Child, Faculty of Medicine and Pharmacy, Mohammed V Kenitra Morocco and Higher Institutes of Nursing and
University in Rabat; and Higher Institutes of Nursing and Health Technology Professions, Ministry of Health and
Health Technology Professions, Ministry of Health and Social Protection, Rabat, Morroco.
Social Protection, Rabat, Morroco.

Chbabe Milouda3
Institut Supérieur Des Sciences De La Santé, Casablanca-Settat.

Abstract:- The aim of the study is to evaluate the is recognized by public health organizations as the ideal
psychometric characteristics of empowering element for the infant, it appears from the analyzes that 11.6%
breastfeeding women and the association with the of deaths of children under the 5 age, are attributable to
duration of breastfeeding. The study sample was 237 suboptimal breastfeeding practices, of corresponded in 2011
women in the Oued- Eddahab Region of Morocco. The to 804,000 deaths worldwide [3]. In Morocco, despite the
results show that 11% breastfed for less than 3 months, efforts made in terms of information, education and
8.7% breastfed for from 3 to 6 months, and more than communication, early breastfeeding during the half hour after
half (57.4) breastfed for up to one year, while a minority childbirth increased from 48.5% to 26.8% from 1992 to 2011
(11%) breastfed for more than one year. The average age and exclusive breastfeeding fell from 62% to 27.8% for the
of the women surveyed was 28±5.7. With regard to the same period [4]. Having taken into account that the
association between the duration of breastfeeding and the production of breast milk is subject to the burrowing reflex
degree of empowerment of the women surveyed. The and secretory hormones and ejection of secretion, the latter,
treatment of the ordinal qualitative variables was carried which is mainly influenced by the emotional state of the
out under the multiple-choice response nail and by the mother, the decision to breastfeed and its duration, are
Anova test, which calculated the degree of association, by influenced by countless individual and environmental
items. The first dimension records (Item1 : p<0.003, factors[5]. It should be noted that breastfeeding is
p<0.699, p<0.011, p<0.001), as for the second dimension consubstantial with a reduction in sudden infant death
(Item1p<0.000, Item2<0.000, Item3<0.000). For the third syndrome; In addition, breast milk is intimately linked to
dimension, only the association with the second item was better performance on neurocognitive tests. In addition,
significant (p<0.000).as for the last dimension, only the breastfeeding is an important preventive health measure for
milk insufficiency seems to be a determining factor in nursing mothers, by acting on the reduction of the incidence
maintaining breastfeeding. Regarding the comorbidity of breast cancer as well as ovarian cancer, as well as greater
effect of gestational diabetes and Covid-19, the study weight loss during the postpartum period [6]. The success of
identified 12 women with a diagnosis of SARS-CoV-2, of breastfeeding largely depends on the mother's desire to
whom 9 (3.9%) had laboratory/radiology confirmation breastfeed her baby. Based on new analyzes of the
and one had more than 3 symptoms without laboratory psychosocial state of mothers. The concept of
confirmation. Women with a SARS-CoV-2 diagnosis had empowerment has emerged as an inextricable dimension
high rates of gestational diabetes (RR : 1.46; 95% CI, to the promotion of maternal and child health [7]. It
0.74-0.95). designates the way in which the individual increases his
abilities by promoting self-esteem, self-confidence,
Keywords:- Nursing Woman, Breastfeeding Duration, initiative and control [8]. It is directly related to the idea of
Empowerment Dimension, SARS-CoV-2. health promotion [9]. In fact, empowerment as an
approach centered on the individual, has highlighted four
I. INTRODUCTION factors favoring the empowerment of individuals: 1) the
environment, 2) the extent of their skills that make them
Breastfeeding is very important for the health of the capable of overcoming obstacles related to the
human body. Where, it helps maintain good health environment, 3) belief in their own control abilities and 4)
throughout life. Once adults, people who have been breastfed their emotional states [10]. Although that this concept may
often have low blood pressure and lower cholesterol levels, appear abstract, researchers have proposed quantitative
and more rarely suffer from obesity or type 2 diabetes [1]. tools to assess the empowerment of individuals, using
However, only 40% of infants worldwide are exclusively effective Ness measurement instruments [11].
breastfed for the first six months [2]. Although breastfeeding

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Volume 9, Issue 10, October– 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24OCT357

Recognizing that breastfeeding improves IQ, school  Statistical Analysis Data Analysis Tools
attendance, and is associated with higher income as an Data were entered into Excel 2024 and analyzed using
adult, An estimated 2.7 million children die annually from Statistical Package for Social Sciences (SPSS) version 26
under- nutrition related to the cessation of exclusive software. It is a statistical software, which has three windows,
breastfeeding. The aim of this study is to evaluate one of the editor, which allows to create the database, a results
psychometric characteristics of prenatal empowerment window (Output), and a syntax window. Qualitative variables
dimensions and the effect of maternal history in pregnant were expressed as a percentage and the quantitative variables
women with and without gestational diabetes andcovid-19 on average, and standard deviation. We used the Pearson chi-
in southern morocco. square 2 test, and in case of invalidity of this test, and
comparison of two percentages, by Fisher's two-sided exact
 Study Area test, to study the dependence of the epidemiological profiles
The work concerned a sample of 202 nursing women. of breastfeeding women according to their degrees of
They come to the maternal and child health services to empowerment. The test was considered significant when the
vaccinate their children at the Level 1 Urban Health Center p-value (p) is less than 0.05 (p<0.05). In a second time, the
HassanII). The investigation lasted eight weeks. During distributions of the variables between them were taken into
our visit to the CSSB, in collaboration with the responsible account simultaneously to determine the relationships and
doctor, midwives and versatile nurses. The survey was association between the status of breastfeeding and the
based on the mother's health record, which records the dimensions of the empowerment of breastfeeding mothers. A
prenatal follow-up, and postpartum indicating latch on, multivariate analysis was conducted on the effect of maternal
and that of infants. The interviewers consulted the history, specifically SARS-CoV-2 and gestational diabetes.
vaccination registers to identify women coming for the
first time immediately postpartum and to take them aside  Ethical Considerations
for the survey. Each selected woman is interviewed For ethical considerations, written informed consent
separately in a directed way. was obtained from study participants. For the rigor of the
study, the anonymity of the participants was concealed.In
II. METHODS such a way that it is not possible to identify the study
participants, nor to identify them within the meaning of
Before giving the questionnaire to the women Law 09-08 on the protection of individuals in connection
interviewed, it was submitted to a validation committee made with theprocessing of personal data.
up of the head doctor of SRES and the head doctor of the
urban health center to validate it. Then a pre-test was carried  Judgment Criterion
out with a group of 10 women to verify the relevance and The initiation of breastfeeding: Included exclusive
effectiveness of the questionnaire. The questionnaire breastfeeding, and mixed breastfeeding. The duration of
comprising 26 closed and semi-open questions. The questions breastfeeding, expressed in months, covered the interval
essentially allowed us to collect information on the age of the between the date of delivery and the date of weaning (date
woman and her child, her level of education, his work status, of the last feeding) or the date of the study point. The
his practice and behavior during, putting the child to the minimum follow-up was two months.
breast, knowledge of the benefits of breast milk, the age of
the beginning of the diversification of the child's diet and the III. RESULTS AND DISCUSSION
main difficulties encountered during the breastfeeding
experience. Similarly, questions were asked to mothers about The study was carried out on 202 breastfeeding
sources of information on breastfeeding and its benefits for women aged 19 to 41. Given that the SARS-CoV-2 <0.33,
mother and child, as well as the conditions for storing breast the dispersion of the observations is less significant and
milk according to the child's age. At the same time, a case- the age values arecloser to around 28 years ±5.7. Regarding
control study involved prenatal women with a history of the level of education, 20% are illiterate. 35% have a
gestational diabetes and SARS-CoV-2. primary level, 32% have completed secondary school, and
only 4% have a university education of all the participating
 Hypothesis: women, 76.8% do not work outside the home, and only
There is an association between the duration of 23.2% have paid employment. For the duration of
breastfeeding and the levels of empowerment used in the breastfeeding. The basic hypothesis assumes that the
four-dimensional empowerment model (15 items). There is values of the independent variable duration of
an association between prenatal maternal history and breastfeeding, which extends from birth to 18 months,
exposure to SARS-CoV-2. classified into four intervals (<3 months, from 3 to 6
months, from 6 to 12 months and>12 months), are
dispersed by after the normal law.

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Volume 9, Issue 10, October– 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24OCT357

Table 1 Duration of Breastfeeding among the Women Surveyed

Breastfeeding duration Effective Percentage
<3 Month 26 12%
[3.6] Month 75 37%
[6.12] Month 60 31%
>12 Month 41 20%

According to the results of this study, 12% of women corroborate with the results of a study in Scotland on mothers'
did not breastfeed for more than 3 months, while 37% attitudes and knowledge about breastfeeding, which
breastfed for less than 6 months, while half of the women emphasized that better information was needed for expectant
surveyed breastfed for 6 months, and only 20% of women mothers and fathers to overcome potential problems with
breastfed more than twelve months (Table 1).In terms of the breastfeeding [12]. The newborns of mothers with
association between prenatal maternal history and exposure to knowledge of the benefits of colostrum had a longer duration
SARS-CoV-2, the study enrolled 12 women with a diagnosis of breastfeeding and protection against infections (RR: 0.4;
of SARS-CoV-2, of whom 9 (3.9%) had laboratory/radiology 95% CI .1.3; 1.9). Note that feeding ability is a barrier to
confirmation and one had more than three symptoms without breastfeeding [13], [14].
laboratory confirmation (Table 2). The study enrolled 12
women with a diagnosis of SARS-CoV-2, the groups of On the other hand, women with a history of polycystic
women with and without a diagnosis of SARS-CoV-2 had syndrome were less exposed to gestational diabetes (RR 0.02;
similar demographic characteristics. Women SARS-CoV-2had 95% CI, 0.6-0.9), and similarly, women who delivered low
high rates of gestational diabetes (RR: 1.46; 95% CI, 0.74- birth weight infants of less than 2500g were more protected
0.95). In addition, women withgestational diabetes had a high against exposure to gestational diabetes (RR: 0.42; 95% CI,
risk of Preeclampsia (RR: 1.16; 95% CI, 1.04-1.50) and 0.22-0.81).In this regard, a multinational cohort study on
women with a lower rate of spontaneous labor induction and maternal and neonatal morbidity and mortality in 2021 in
a high rate of obstructed labor reflected a high rate of pregnant woman with and without SARS-CoV-2revealed that
gestational diabetes (RR: 1.6; 95% CI, 0.51-0.79).The results the severe neonatal morbidity index among neonates of
of the study on the first dimension of empowerment, which woman with Covid-19 diagnostics was significantly higher
focuses on women'sknowledge of the benefits of colostrum, (RR, 2.66;95% CI 1.69 - 4.18) than in those of woman without
corroborate the results of a study in Scotland on mothers' SARS-CoV-2 diagnostic [15].
attitudes and knowledge about breastfeeding (Table3). They

Table 2 Effect of maternal history SARS-CoV-2 among pregnant women with and without diagnostic GD
No. (%)
Woman withGD Woman withoutGD RR (95% IC)
Characteristics (n=101) (n=101) p-value
SARS-CoV-2 7(58.3) 5(41.7) 1.46 (0.74 to 0.98) <0.0003
Age <25ans 28(46.7) 32(53.3) 1.71 (0.53 to 0.95) <0.0005
Premature<37SA 44(75.9) 14(24.1) 0.70 (0.57 to 0.87) <0.0004
Dystocic delivery 40(81.6) 9(18.4) 1.6 (0,51 to 0.79) <0.0000
Gestation>5 92(65.2) 49(34.8) 0.72 (0.54 to 0.97) <0.0001
ATCD_PCOC 2(40.1) 1(2.4) 0.02(0.6 to 0.9) <0.0003
ATCFD°1D 119(48.3) 2(1.7) 1.35(0.6 to 0.9) <0.0004
Preeclampsia 25(20.7) 6(7.4) 1.16(1.04 to 1.50) <0.0005
Syphilis 5(4.1) 3(3.7) 1.04 (0.94 to 0.98) <0.0001
Low bird weight<2500g 35(28.9) 10(12.3) 0.42 (0.22 to 0.81) <0.0002

Table 3 Association between the Duration of Breastfeeding and Dimensions of Empowerment

Associated factors Multivariate analysis: durée d’allaitement
Items OR IC 95% P-value
Information on skills Advantages of colostrum 0.4 [1.3; 1.9] <0.004
Composition of Milk 2.8 [0.2; 1.6] 0.542
Convenience of use 7.6 [0.7; 2.9] 0.632
Attachement Link 2.3 [0.3; 0.6] 0.003
Communicationskills Transmission of worries 3.5 [1.7; 1.9] <0.001
Application for assistance 8.5 [0,7; 1,5] 0.234
Exchange capacity 2.6 [2.9; 4.3] 0.564
Negotiation skills Freedom of decision 9.7 [1.2; 2.5] 0.875
Friend’s experience 4 [1.6; 4.5] 0.087
religion 4.7 [1.2; 3.4] 0.651

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Volume 9, Issue 10, October– 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24OCT357

Problem-solvingSkills Milk insufficiency 2.5 [2.5; 9.6] <0.003

Return to work 1.4 [1.7; 5.4] 0.654
Painful Nipples 1.5 [1.4; 5.6] 0.673
Esthetic reasons 0.2 [2.3; 7.5] 0.897

IV. CONCLUSION [11]. B. A. Israel, B. Checkoway, A. Schulz, and M.

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