Breastfeeding provides infants with the support they need to grow and develop at their full potential (e.g. better brain development and better immunity) and may also protect the infant from obesity and diabetes later on in life. The importance of breastfeeding is not only for infant health, but also for the mother. Women who breastfeed have a lower risk of breast and ovarian cancer, which are very common among Lebanese women. The World Health Organization recommends infants be exclusively breastfed for the first six months of life, following by continued breastfeeding for at least two years of age. Yet, breastfeeding rates are not optimal in Lebanon. Around 38% of infants are exclusively breastfed during the first month of life and this percentage drops to 2% at six months. Social barriers, such as negative attitudes of people around the mother (her family, husband, friends, physician, colleagues at work, etc.), continue to be major contributors to this problem. Lack of science-based knowledge about how and why to breastfeed among mothers and their surrounding community is another important barrier.
One of several ways to overcome these barriers is to educate Lebanese youth in schools, early on in life, about breastfeeding using age-appropriate educational methods. This approach, named School-Based Breastfeeding Education (SBBE) may help improve the breastfeeding rates in the long-term by helping future adults recognize breastfeeding as a normal topic rather than a taboo, and by giving them the knowledge and skills they need to make informed future decisions about how to feed their infants. This is important even among adults who do not end up being parents themselves, especially in Lebanon where the impact of social pressure on behavior (i.e. pressure from those around us to act in a certain way) is significant.
SBBE in Lebanon is not common and not mandated by the government. Interestingly, even schools in developing countries like the US, Canada and the UK rarely teach about breastfeeding and the methods they use are rarely evidence-based.
In view of the aforementioned issue, the Faculty of Nursing and Health Sciences (FNHS) at Notre Dame University-Louaize (NDU) is conducting a multi-year study in collaboration with The Larsson-Rosenquist Mother-Milk-Infant Center of Research Excellence (LRF MOMI CORE) at the University of California San Diego in two large schools in Lebanon (serving over 7000 students) to understand and address how best to apply SBBE in Lebanon. The project began in 2018 by investigating 200 teachers’ views on how, when and why we can teach about breastfeeding in schools. The FNHS’s findings are the first in Lebanon to show that little to no SBBE is currently taking place, but teachers are ready and willing to learn and teach about SBBE. The majority of teachers believe the topic of breastfeeding should be taught to both boys and girls by both teachers and health care professionals (e.g. doctors and nurses) in high schools. Teachers also reported that breastfeeding should not only be a topic covered in biology classes, but also in classes such as sociology and religion, to start conversations about normalizing breastfeeding.
The FNHS is currently in the next step of this project: working with around 1000 high school students from the same schools above to evaluate how they think about the topic of breastfeeding and what underlying beliefs (positive and negative) drive their attitude towards breastfeeding. This will help develop an education plan to address their specific concerns, one future adult at a time.
The FNHS at NDU and LRF MOMI CORE are the first to spearhead an international research effort to analyze and address the arising problem of limited SBBE in Lebanese schools and to work with the teachers, administrators and students to find a solution for improving the breast feeding rates in Lebanon.