الفهرس 
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Abstract
Summary
Exclusive breastfeeding (EBF) refers to the practice of giving a newborn infant breastmilk only up to the age of six months; thus no other milk or food is given with the exception of vitamin and mineral supplements required for medical reasons breast milk provides nutrients to meet the growth needs and immunological necessities, to protect against infections and subsequent mortality. In light of these benefits, failure to breastfeed is considered a threat for infant survival globally Kokushubira, Kiwanuka & Maluka, (2017). Many studies revealed that EBF practices are attributed to several factors; namely socio-demographic, economic, knowledge, psychosocial, biophysical and socio-cultural factors (Jama et al., 2017).
The present study aimed to assess factors affecting the discontinuation of exclusive breastfeeding among primipara women.the research question was What are the factors affecting discontinuation of exclusive breastfeeding among primipara women?
A descriptive study was used. Subject of this study included 250 primipara women by convenient sample.
Setting
This study carried out at the breastfeeding outpatient clinic at Maternity Hospital Ain Shams University.
Tool of data collection
Tool: Structured interview questionnaire.
• Part I: Assessment of the general characteristics of mothers such as (age, educational level, occupational status for mothers, marital status, residency, type of family, family size, family income, and husband’s educational level).
• Part II: Assessment of obstetric history such as (types of delivery, Place of delivery, number of abortions or, whether they received classes related to health education about breastfeeding during follow up).
• Part III: Assessment of medical history such as (diabetes mellitus, and hypertension).
• Part IV: Assessment of maternal knowledge about breastfeeding (definition of exclusive Bf- time of initiation of BF, benefits, technique, proper position, duration of exclusive breastfeeding, breast problems, sufficient amount of breast milk for the infant and proper time of weaning).
• Part VI: Included factors affecting the discontinuation of exclusive breastfeeding which is divided into four parts.
- Physical factors related to the lactating mother such as (birth complications during labour, breast problems, “mastitis - flat nipple- sore breast- cracked nipple-breast engorgement and/or breast abscess”, mothers tiredness or illness and overweight/obesity).
- Psychological factors: such as (tension, anxiety, postpartum blues, nervousness, intimate partner violence, smoking) etc.
- Social factors: such as (having too many indoor and outdoor responsibilities, caring for ageing family members, reluctance to breastfeed in public, lack of social peer and family support) etc.
- Cultural factors related to myths or taboos about breastfeeding such as (breast milk alone dissatisfy the infant, breast milk doesn’t make the infant gain enough weight, gender of the infant, fear of evil eye, perception of body image and fear of losing physical attraction, small breasts do not produce as much milk as large ones- breastfeeding infant needs extra water, modern formulas as nearly the same as breast milk) and beliefs and attitude (e.g. the misconception that artificial milk is more beneficial, family advice,…………) etc.
The main results of this study can be summarized as follows:
• Regarding general characteristics of the studied sumple, the results revealed that (60.8%) of studied women in the age group from 20 to 30 years with mean± SD (26.27), (80.4%) of them from urban areas and (45.6%) of them had a secondary education, Moreover, (90.4%) of them married and (77.6%) had nuclear families, finally, (49.2%) their Husbands had University educational level.
• Regardng obstetric histoy of the studied sumple, the results revealed that (67.6%) was Caesarean section, (76.8%) of them were delivered at Hospital, and they had no abortion, (64.8%) of them had irregular follow-ups during pregnancy, while (79.6%) of them did not receive health education on breastfeeding before or after birth, regarding family planning methods during breastfeeding, (69.6%) reported that using the family planning methods Also, (62%) of them mention that had breast problems, furthermore, more than half (59.2%) of their Child not suffer from health problems that led to the cessation of breastfeeding.
• Regarding knowledge about exclusive breastfeeding of the studied sumple, the results revealed that, it was showed that (55.6%) of them correct knowledge about benefits of exclusive breastfeeding for child, While (62%) of them had incorrect knowledge about position for breastfeeding, (54%) of them had incorrect knowledge about benefits for mother (64.8%) of them had incorrect knowledge about definition of exclusive breastfeeding, (63.6%) of them had incorrect knowledge about time of initiation and (64.4%) of them had incorrect knowledge about Weaning means.
• Regarding to their physical factors, it was shown that (66.0%) of the studied sample reported that Breast problems and (55.2%) of the studied sample reported that complications during and after childbirth.
• Regarding to their psychological factors, it were revealed that (55.6%) of studied sample reported Postpartum blues and (37.2%) of the studied sample mentioned that irreglar sleep.
• Regarding to their social factors, it was shown that nearly (39.6%) of the studied sample reported abstaining from breastfeeding in public places and (26.8%) of the studied sample mentioned that lack of social and family support.
• Regarding to their cultural factors, it were observed that the (83.2%) of the studied sample mentioned that advice from family members or friends, (64.8%) of the studied sample mentioned that inadequate milk supply and (54.8%) of the studied sample mentioned Modern formulas as nearly the same as breast milk.
• Regarding to total factoes reveals that 38.8% of studied women had physical factors, 32.8% of them had psychological factors, 22% of them had social factors, and 36.8% of them had culture factors affect the discontinuation of exclusive breastfeeding.
• Regarding to relationship between demographic characteristics of studied women and their total knowledge about breastfeeding, it was noticed that there high statistically significant relation between total knowledge about breastfeeding and Age& Educational level at p value (<.001**), moreover, there was a statistically significant relation between Occupation& Type of family at p value (< .005*), on other hand, there was a no statistically significant relation between total knowledge and other demographic characteristics at p value (> .005).
• Regarding to correlation between studied factors and total knowledge reveals that there was slight significant relation between psychological factor and social factors with total knowledge at p value <0.05*. Meanwhile, there was no significant relation between physical and culture factors at p value >0.05.