Barriers to exclusive breast feeding, the missing links: a cross sectional study from Puducherry, India

Abstract

Background: Breast milk, the first natural food for a new-born, provides all the energy and essential nutrients an infant requires for the first 6 months of life. The NHFS -4 survey shows only 45.5% of children are exclusively breastfed (EBF) in Puducherry. This study aims at assessing the socio-demographic characteristics associated with exclusive breastfeeding in a tertiary hospital in Puducherry and identify the barriers in the promotion of exclusive breastfeeding.Methods: Community-based cross-sectional study at a tertiary hospital in Puducherry. Sample size: 115 mothers of 6 months to 2-year-old children, born term gestation with a birth weight of >2.5 kg, attending the Paediatric OPD. Questionnaire-based study comprising of socio-demographic and parameters pertaining to exclusive breast-feeding.Results: Only 44.3% of the mothers have exclusively breastfed in the first 6 months. Shorter duration of spacing between births and caesarean section had significant negative association with exclusive breast-feeding. Most of the mothers received postnatal counselling on breast-feeding (94%) of which 58% were by health care personnel. Despite that, only a sixth (19%) of them were well versed with proper breastfeeding techniques. Poor secretion (45.3%), sore/inverted nipple (23.5%) amounted to the most common of the barriers. Among working mothers, 42.9% attributed their jobs as the cause for early weaning.Conclusions: The prevalence of exclusive breastfeeding is still low even among a literate study group. There were no significant association with socio-demographic factors found, but lacunae were identified. A more objective post-natal counselling to mothers involving their caregivers may improve the current scenario.

Barriers in utilization and provisioning of obstetric care services (OCS) in India: a mixed-methods systematic review

“…Several studies showed that pre-lacteal feeding rituals were major barriers to exclusive breastfeeding. The practice of giving newborn babies pre-lacteal feeds like jaggery, honey, sugar water, cow milk, and ghee was observed by many previous studies [ 27 , 47 , 49 – 51 , 54 ].…”

“…Lack of counselling on proper breastfeeding practice and their benefits were major barriers to delay in breastfeeding initiation or exclusive breastfeeding [ 20 , 21 , 49 , 53 ]. Additionally, it was observed that mothers who devoted their maximum time to domestic chores did not have time to adhere to early breastfeeding [ 24 ].…”

Addressing barriers in utilization and provisioning of obstetric care services (OCS) in India: A mixed method systematic review

“…Furthermore, lack of counselling on proper breastfeeding practice and its bene ts were major barriers towards delay in breastfeeding initiation or exclusive breastfeeding [20,21,43,52]. Additionally, due to increased domestic workload, mothers did not have proper time to adhere to early breastfeeding [24].…”

“…Note: N.A: Not available; NFHS: National Family Health Survey; DLHS: District Level Health Survey; CNSG: Comprehensive Nutrition Survey in Gujarat; FGD: Focus group discussion; IDI: In-depth interviewIndividual and interpersonal barriersA total of 30 studies, including seventeen quantitative[2,4,5,9,11,18,21,22,24,[28][29][30]40,[43][44][45][46], ten qualitative[1,8,23,26,35,50,52,53,57,58] and three mix-method studies…”