Breastfeeding provides the newborn with the ideal nutrition that secures optimal growth and development. Exclusive breastfeeding has been shown to be the most effective public health measure in developing countries reducing under-five mortality by 13% [1]. Exclusive and early initiation of breastfeeding remains the major influences on the duration of breastfeeding [2, 3]. In order to protect, promote and support breastfeeding practice in the community, the Lebanese ministry of Health and Social Services, in collaboration with UNICEF and WHO, launched the Baby Friendly Hospital Initiative (BFHI) in 1991. Currently, more than 156 countries around the world implement BFHI amounting to more than 20,000 hospitals [4]. Evidence reveals that implementation of BFHI increases the exclusivity and duration of breastfeeding among women [5].

Lebanon is a country that suffers from declining breastfeeding rates. Whereas initiation rates range between 63.8% and 96%, exclusive breastfeeding in babies less than one month of age is estimated at 58.3% [6,7], dropping further to 2% at 6 months [8], one of the lowest rates in the MENA region. Despite governmental efforts aiming at implementation of the ten steps of BFHI, no hospital in Lebanon has been designated as “Baby Friendly” yet. Moreover, none of the 10 steps is routinely practiced in any hospital of the country [9]. We have observed that most Lebanese women are unfamiliar with the term Baby Friendly Hospital and are unaware of the Skin-to-Skin Contact or Kangaroo Care practices.

The objective of this study is to assess the knowledge of Lebanese pregnant women about BFHI steps, and explore their attitudes towards, and acceptance of Baby Friendly Hospitals, Skin-to-Skin Contact and Kangaroo Care practices. We expect that information derived from this study will shed light on knowledge gaps existing in the Lebanese context about those practices. It will also help identify the barriers for implementation of the BFHI steps and assess acceptance of BFHI, skin-to-skin contact and kangaroo care among Lebanese women.

Participants: Healthy primigravid or multigravid pregnant women visiting the clinics participating in the survey.

Study design: A cross-sectional survey.    

Setting: Obstetrics clinics chosen randomly from the list of the Lebanese Society of Obstetrics and Gynecology. We will aim to have a representative sample of clinics from each Mouhafaza.