In 2020, nearly every mother in Lebanon—96 percent—initiated breastfeeding after birth, yet only about 15 percent continued breastfeeding exclusively for the first six months. This sharp decline is not merely a matter of personal choice but reflects deeper systemic and social barriers that make it unsustainable for many mothers.

A new study by faculty from LAU’s Alice Ramez Chagoury School of Nursing, the Department of Nutrition and Food Science at the School of Arts and Sciences, and the Gilbert and Rose-Marie Chagoury School of Medicine, in partnership with national and international universities, explores why so many mothers stop breastfeeding early despite strong initial intentions.

Published in Food Science & Nutrition, the research titled “Factors Associated With Breastfeeding Outcomes in Lebanon” identifies critical gaps in hospital practices, workplace support and policy enforcement, calling for crucial interventions supported by the WHO to reverse this trend.

Led by Dr. Bahia Abdallah, assistant dean and Nursing Program director at LAU, the study surveyed 280 Lebanese mothers of children under five years old to determine how national policies, healthcare provider (HCP) support, and cultural and socioeconomic conditions affect breastfeeding outcomes.

“We conducted this study because the decline in breastfeeding signals a public health issue and points to deeper social and system-level problems,” explained Dr. Abdallah. “We wanted to understand why, despite strong initiation rates, so many mothers stop breastfeeding early, and what can be done at the national and institutional levels to change that.”

The researchers identified multiple factors influencing breastfeeding duration and exclusivity, including cultural norms, workplace pressures, limited access to lactation support, and inconsistent hospital practices. Working mothers, unplanned pregnancies, lack of emotional and social support, and inadequate prenatal education and postpartum services were among the leading causes mothers cited for switching to formula feeding.

The study also found that mothers who received prenatal education about breastfeeding—especially during the third trimester—had significantly higher odds of initiating early breastfeeding. Moreover, there was a “positive association between normal delivery, skin-to-skin contact (SSC), and early initiation,” emphasizing the importance of hospital-based interventions.

“Education and support make a measurable difference,” said Dr. Abdallah. “Our findings show that when mothers receive consistent guidance during pregnancy, and when hospitals implement WHO-recommended practices, such as immediate SSC after birth, it encourages exclusive breastfeeding from the start. Additionally, with lactation support from different healthcare professionals, breastfeeding outcomes improve significantly.”

Although Lebanon has introduced several national initiatives, such as the Infant and Young Child Feeding (IYCF) Program and the Baby Friendly Hospital Initiative (BFHI) in partnership with the WHO and UNICEF, the study found gaps in enforcement and monitoring.

According to the researchers, “the inconsistency by hospitals and health workers in applying national breastfeeding policies, as well as violations of Lebanon’s Code for the Promotion of Breastfeeding and Regulation of Marketing of Breast-Milk Substitutes,” continue to undermine national efforts.

“We have policies on paper,” noted Dr. Abdallah, “but their implementation is fragmented. To truly support mothers, we need stronger accountability mechanisms, wider adoption of Baby Friendly Hospital standards, and continuous training for healthcare professionals.”

Based on the findings, the authors urged a comprehensive national strategy to strengthen breastfeeding practices across Lebanon and empower HCPs through expanded training and resources.

Among the key recommendations, the authors called for the integration of a structured breastfeeding support system into prenatal and postnatal care, and raising awareness about national breastfeeding support services, including the Lebanese Ministry of Public Health’s hotline.

Moreover, the scholars underlined the need for more certified Baby Friendly Hospitals and called for integrating the WHO/UNICEF 40-hour BFHI training into hospital accreditation standards. Finally, the study recommended strict enforcement of existing laws such as Law 47/2008 to regulate the marketing of breast-milk substitutes.

“This is not just about promoting breastfeeding; it’s about building systems that empower mothers and protect public health,” noted Dr. Abdallah. “Lebanon has the frameworks in place; now we need collective commitment to make them work.”

To support national efforts, LAU has reinforced its commitment to advancing public health through several initiatives, policies and hands-on learning. The university has integrated breastfeeding and prenatal/postnatal care into the nursing and nutrition curricula, while faculty have published content that highlights breastfeeding “as a key investment in health and sustainability, strengthening visibility on campus and beyond,” she added.

Among the initiatives championed by LAU is a breastfeeding support room on the Beirut campus. The initiative, led by the Arab Institute for Women and the school of nursing, is part of the university’s gender equality plan.

“LAU also runs awareness sessions and refers mothers to breastfeeding support hotlines,” remarked Dr. Abdallah. “Through seminars and awareness events such as Unlocking the Path to Successful Lactation and Breastfeeding, LAU engages students and the LAU community in current BF-knowledge and support practices.”

“Furthermore, by supporting maternity and paternity leave policies, the university ensures that families have the time and space for early bonding and breastfeeding,” she added.

To browse more scholarly output by the LAU community, visit our open-access digital archive, the Lebanese American University Repository (LAUR).