A Qualitative Exploration of the Determinants of Exclusive Breastfeeding (EBF) Practices in Wajir County, Kenya

Abstract

Background: The World Health Organization recommends exclusive breastfeeding for the first six months of life. A qualitative study was conducted to assess the factors that influence the practice of exclusive breastfeeding amongst mothers attending Wajir County Hospital, Kenya. Method: This study was part of a cross-sectional study to compare the exclusive breastfeeding rates amongst primiparous and multiparous mothers with infants under 6 months old attending Wajir County Hospital. Focus group discussions and key informant interviews were conducted to collect information on exclusive breastfeeding and related factors. Four focus group discussions were conducted with mothers who exclusively breastfed and the same number with mothers who did not exclusively breastfeed their babies. Key informant interviews were conducted with nine healthcare providers. The data were transcribed, and a content analysis identified common themes and inferences. Results: The exclusive breastfeeding rate among the mothers in the larger study was 45.5%. There was no disparity between the practice of exclusive breastfeeding between primiparous and multiparous mothers. Despite the high knowledge and positive attitudes towards exclusive breastfeeding of most mothers, the practice of exclusive breastfeeding was unsatisfactory. The major hindrances identified were cultural barriers propagated by mothers-inlaw and traditional birth attendants; the belief that babies cannot live without water; and a few unsupportive health workers. The uptake of exclusive breastfeeding was enhanced by Islamic teaching on breastfeeding, education from a few supportive healthcare providers; support from husbands; and positive deviance among some lactating mothers who practiced exclusive breastfeeding.

The role of maternal ideations on breastfeeding practices in northwestern Nigeria: a cross-section study

“…It has also been well documented that when healthcare personnel provide encouragement and support on breastfeeding to women, the likelihood of initiating and sustaining breastfeeding increases [54,55]. Health providers' supportive influence was positively associated with EBF practice but not early initiation of breastfeeding.…”

“…Our findings are also consistent with previous reviews of randomized controlled trials [56] that showed professional-led support from health providers had a greater impact on the practice of EBF compared to peer-led support. SBC programs need to promote the importance of utilizing health facilities for delivery in the communities and also expand breastfeeding promotion through health providers by specifically targeting women during ANC counseling sessions [55].…”

Factors influencing exclusive breast feeding among women attending maternal and child health clinic at Kyanamira health centre 111, Kabale district

“…A Kenyan study also cited cultural factors such as babies failure to thrive without water, unsupportive mothers in-law, and clan elders threatening to disown mothers who practice EBF. 15 Negative community perception could also be due to the less community sensitization on EBF.…”

Determinants of Breastfeeding Practices Among Mothers Attending Maternal and Child Health Clinic at Pumwani Hospital Nairobi

“…In a study carried out in Rural Kenya, maternal age was associated with breastfeeding practices as mothers of lower age did not practice exclusive breastfeeding (Talbert et al, 2020). Additionally, a study conducted by Mohamed et al (2020) in the North-Eastern region of Kenya indicated that older mothers were more likely to breastfeed. Conversely, younger mothers were more likely to practice exclusive breastfeeding, as Mututho et al (2017)reported in a study conducted in Nairobi.…”