Attitudes and practices of breastfeeding mothers regarding fasting in Ramadan

Objective To investigate the attitudes and practices of breastfeeding mothe rs regarding fasting in Ramadan. Design Cross-sectional observational survey. Setting Well-child care clinic at Ankara University Medical School and a he alth station serving an impoverished population in Ankara, Turkey. Participants Breastfeeding mothers of infants aged 12 months or younger. Main outcome measures Fasting during Ramadan. Results Of the 164 participating mothers, 61 (37%) were from the health sta tion and 103 (63%) from the university clinic. Most mothers were older than 25 years of age (55%), had more than primary school education (64%), a sin gle child (53%), were living in a nuclear family setting (70%), supplementi ng breastfeeding (73%) and fasting (52%). Among the 129 mothers of infants aged 6 months or younger, 22% perceived a decrease in their breast milk and 23% an increase in the amount of solid supplements the infant was receivin g. Belief that breastfeeding mothers should fast (RR = 6.45, 95% CI: 2.44-1 7.06), that fasting does not decrease breast milk (RR = 6.24, 95% CI: 1.85- 21.05), receiving well-child care at the health station (RR = 3.14, 95% CI: 1.33-7.44), giving supplements (RR = 2.82, 95% CI: 1.09-7.27) and having m ultiple children (RR = 2.78, 95% CI: 1.23-6.28) were associated with fastin g, in a logistic regression model. Conclusions Fasting by breastfeeding mothers of infants is common during Ra madan, and rates are affected by beliefs of mothers on the effects of fasti ng on breastfeeding. We believe that child health care providers need to be knowledgeable about religious and cultural phenomena, study the effects of Ramadan fasting and form links with Islamic teachings to find religiously and culturally appropriate methods to combat the possible unfavourable effe cts for infants and children.