Breastfeeding in Iran: prevalence, duration and current recommendations

BACKGROUND The need to promote breastfeeding is unquestionable for the health and development of infants. The aim of this study was to investigate prevalence, duration and promotion of breastfeeding status in Iran with respect to the Baby Friendly Hospital, government actions and activities by the Breastfeeding Promotion Society including comparison with European countries. METHODS This retrospective study is based on data from 63,071 infants less than 24 months of age in all the 30 urban and rural provinces of Iran. The data of breastfeeding rates were collected in 20052006 by trained health workers in the Integrated Monitoring Evaluation System in the Family Health Office of the Ministry of Health to evaluate its subordinate offices. A translated version of a questionnaire, used to assess the current breastfeeding situation in Europe, was used. RESULTS At a national level, 90% and 57% of infants were breastfed at one and two-years of age, respectively. Exclusive breastfeeding rates at 4 and 6 months of age at national level averaged 56.8% and 27.7%. Exclusive breastfeeding rates at 4 and 6 months of age in rural areas were 58% and 29%, and in urban areas 56% and 27%, respectively. The policy questionnaire showed that out of the 566 hospitals across the country 466 hospitals were accredited as Baby Friendly Hospitals, covering more than 80% of the births in 2006. A national board set standards and certified pre-service education at the Ministry of Health. Iran officially adopted the WHO International Code of Marketing of Breast Milk Substitutes in 1991. The legislation for working mothers met the International Labour Organization standards that cover women with formal employment. The Ministry of Health and Breastfeeding Promotion Society were responsible for producing booklets, pamphlets, breastfeeding journal, CD, workshops and websites. Monitoring of breastfeeding rates was performed every four years and funded by the Ministry of Health within the budgets assigned to the health care system. CONCLUSION In comparison to many European Union countries, Iran showed a favorable situation in terms of breastfeeding rates and promotion of breastfeeding. Iran still needs to increase the rate of exclusive breastfeeding during the first six months.