Barriers and Opportunities for Improved Exclusive Breast-Feeding Practices in Tanzania: Household Trials With Mothers and Fathers

Abstract

Background: Effective promotion of exclusive breast-feeding (EBF) is needed to improve child nutrition and survival. Objective: We explored barriers and facilitators to EBF in rural Tanzania and assessed parents’ willingness and ability to try specific recommended EBF practices plus strategies for men to support breast-feeding. Methods: We conducted Trials of Improved Practices in 36 households with infants <6 months. Fathers participated in focus group discussions on ways to support breast-feeding. Fathers and mothers were individually interviewed 2 and 3 times, respectively, about their willingness to try and experience with selected new practices. We analyzed data thematically. Results: Common barriers to EBF were (1) use of gripe water and traditional medicines for perceived symptoms of infantile distress; (2) mothers’ workloads and time away from infants, limiting availability for EBF; and (3) water given for perceived thirst. Although several mothers expressed concerns about breast-milk insufficiency, few were giving other foods. After counseling, most mothers reported breast-feeding more optimally. Some reported improved breast-milk supply. Fathers saw their roles as providing food to mothers to ensure sufficient breast-milk and encouraging new practices. Dominant gender roles and work away from home were barriers even if fathers were willing to help with household chores. Fathers mostly provided emotional support or encouraged others to help with chores. Conclusion: Exclusive breast-feeding promotion needs to address concerns about infantile distress and help parents develop effective soothing techniques while avoiding nonprescribed medicines. Engaging men in EBF interventions could help change social norms and facilitate men’s involvement in improving breast-feeding practices.

A systematic review of qualitative research on barriers and facilitators to exclusive breastfeeding practice in sub-Saharan African countries

“…Mother’s formal (employment) and informal work schedules [ 26 – 33 ] 1.1.2 Perceived breast milk insufficiency [ 26 – 28 , 31 – 38 ] 1.1.3 Concerns of effects on mother’s appearance [ 28 , 31 , 38 , 39 ] 1.1.4 Poor understanding/lack of awareness of EBF benefits [ 32 , 34 , 35 , 40 ] 1.1.5 Being HIV positive or fear of transmitting HIV infection to the child [ 31 , 32 , 34 , 36 ] 1.1.6 Schooling or resuming school or work [ 29 , 33 , 36 , 37 , 41 ] 1.1.7 Poor maternal nutrition [ 29 , 32 – 34 , 41 ] 1.1.8 Maternal perceived discomfort and embarrassment [ 26 , 28 , 29 , 31 , 33 , 39 ] 1.1.9 Reluctance to breastfeed in public/disapproval of public breastfeeding [ 29 , 31 , 33 , 37 ] 1.1.10 Refusal of mothers to breastfeed for several other reasons …”

Gambaran Usia, Paritas, Tingkat Pendidikan, Status Pekerjaan, Dukungan Suami dan Tingkat Pengetahuan Ibu dalam Pemberian ASI Eksklusif

“…Hasil penelitian menjelaskan dengan adanya dukungan dari suami, maka emosional ibu akan stabil dan termotivasi untuk memberikan bayinya dengan gizi yang baik yaitu ASI eksklusif, dibuktikan dengan sangat sedikit bayi yang diberikan makanan tambahan setelah diberikan edukasi kepada para suami untuk memberikan dukungan kepada istri untuk memberikan ASI secara eksklusif (Matare et al, 2019).…”

Breastfeeding self-efficacy in adult women and its relationship with exclusive maternal breastfeeding

“…The breastfeeding practice is a complex process that goes beyond biological determinism, and the woman’s decision to breastfeed or not also involves social, cultural, economic, and psychological factors ( 5 ) . A study carried out in the Federal District (Brazil) found that the causes for early weaning were related to the beliefs of weak milk and to the women’s need to return to work ( 6 ) .…”