Barriers to Exclusive Breastfeeding for Mothers in Tswelopele Municipality, Free State Province, South Africa: A Qualitative Study

Abstract

Despite the numerous advantages of exclusive breastfeeding (EBF), the practice remains infrequently adopted in certain countries and is also associated with context-specific obstacles. Consequently, this study explores the experiences and opinions of mothers about the barriers and support systems of exclusive breastfeeding (EBF), in a bid to promote this practice in the Tswelopele Municipality of the Free State Province of South Africa. In-depth individual, semi-structured interviews were conducted with 16 mothers, using an audio recorder after receiving their permission to record the interviews. The analysis of the collected data revealed that opinions clustered around four topics: mother-related barriers to EBF, baby-related barriers to EBF, support systems to enhance EBF, and complications caused by barriers to EBF. The findings from these themes and sub-themes imply that the maternal factor is strongly influenced by other factors regarding the success or failure of this practice. These include extreme breast discomfort, maternal illness, the fear that the mother’s milk supply is insufficient, a lack of understanding about EBF, and the influence of different cultural factors. When mothers encounter difficulties with breastfeeding, these challenges may impede their ability to practice EBF. In addition, while some participants were eager to breastfeed their babies and continued EBF for a period of six months, their infant’s health and behavioral issues prevented them from doing so. Some of these problems included infant sickness and crying. From the prenatal to the postnatal period, mothers and their families should have access to breastfeeding education and counseling, along with sufficient time to make informed infant nutrition decisions. During counseling sessions, conversations with these stakeholders should focus on fostering a realistic understanding regarding what to expect when breastfeeding for the very first time, debunking breastfeeding-related misconceptions, and addressing inaccurate information and concerns. In addition, health professionals must be empathic and respectful of the mother’s traditions and cultures and must also educate mothers and their families on the importance of EBF. Our list of themes and sub-themes could be utilized to enlighten exclusive breastfeeding challenges and potential mitigation efforts, not only in Tswelopele Municipality, South Africa but also in a number of other geographical contexts.

Sociocultural context of exclusive breastfeeding in Africa: A narrative review

“…29 A similar finding was reported in South Africa. 48 Natural events like lactation failure, maternal illness, 7 breast engorgement, sore nipple, and BM insufficiency negatively impacted the practice of EBF hence alternatives like artificial feeding were used to replace natural BF. 49 Other biological factors are neonatal illnesses (first 28 days).…”

“…49 Other biological factors are neonatal illnesses (first 28 days). 7 EBF was found to be difficult when the infant is admitted in a Neonatal Intensive Care Unit (NICU) where replacement feed is usually introduced, 7 or when the infant has a low birth weight. 50 Low birth weight, without neonatal illness, did influence EBF negatively in Ghana.…”

“…2 , 4 Although EBF has many benefits, it is not commonly practised in several African countries as a result of context‐specific challenges. 3 , 5 , 6 , 7 The practice of EBF in many low‐ and middle‐income 8 and global settings 9 is low. Thus, EBF is a global health discourse because over 200 million African children suffer from malnutrition which is the second leading cause of death after malaria 10 despite the abundance of human milk.…”

Nurturing a healthy future: The impact of the mothers\' absolute affection (MAA) programme on infant and young child feeding

“…It addresses mother nutrition, emotional support, and removing obstacles that can prevent breastfeeding. 4 5. Complementary feeding: In order to guarantee the best possible nutrition for children after the first six months, the MAA Programme encourages the introduction of wholesome supplemental meals during nursing.…”

“…This data-driven methodology helps to efficiently focus resources and fine-tune plans. [3][4][5] Improved breastfeeding rates and baby nutrition indices show the MAA Programme's effectiveness. It has aided in improving child health and lowering child mortality rates.…”