Breastfeeding practices, beliefs, and social norms in low-resource communities in Mexico: Insights for how to improve future promotion strategies

Abstract

IntroductionBreastfeeding is recommended exclusively for the first 6 months after birth, with continued breastfeeding for at least 2 years. Yet prevalence of these recommendations is low globally, although it is an effective and cost-effective way to prevent serious infections and chronic illness. Previous studies have reported that social support greatly influences breastfeeding, but there is little evidence on perceived social norms in Mexico and how they affect actual behavior.ObjectiveOur objective was to investigate breastfeeding intention, practices, attitudes, and beliefs, particularly normative, among low-resource communities in central and southern Mexico.MethodsWe performed a secondary analysis using the theory of planned behavior with cross-sectional data, which included semi-structured individual interviews with fathers (n 10), 8 focus groups with mothers (n 50), and 8 focus groups with women community leaders (n 44) with a total of 104 participants. Our data also included a quantitative survey among pregnant women and mothers (n 321).ResultsWomen reported supplementing breast milk with water and teas soon after birth, as well as introducing small bites of solid food a few months after birth. Social norms appeared to support breastfeeding, but not exclusive breastfeeding or breastfeeding for periods longer than about a year. This may be partially explained by: a) behavioral beliefs that for the first 6 months breast milk alone is insufficient for the baby, and that water in addition to breast milk is necessary to hydrate an infant and b) normative beliefs related to the appropriateness of breastfeeding in public and as the child gets older.ConclusionsFuture strategies should focus on positively influencing social norms to support recommended practices, and emphasize the specific reasons behind the recommendations. Future efforts should take a multi-pronged approach using a variety of influences, not only directed at healthcare providers but close family members, including fathers.

Breastfeeding Counseling Based on Formative Research at Primary Healthcare Services in Mexico.

“…The primary obstacles reported for breastfeeding in this study aligns with results of previous research from the region (12,(18)(19) and other populations (20)(21). Even though they had the option of adding another obstacle that was not listed, all the participants who reported having some di culty with breastfeeding selected one of the 10 options presented.…”

Dietary Knowledge and Myths Vary by Age and Years of Schooling in Pregnant Mexico City Residents

“…In general, we could observe that the age and education years explained the myth scores, especially for certain myths. For example, younger participants in our study, women with the lowest levels of education and lower socioeconomic status, and fewer previous pregnancies were most likely to believe that "a frightened or angry mother should not nurse a baby" and "drinking atole or beer enhances maternal milk production", as showed by Swigart et al, in low-income communities in Mexico [36]. On the other hand, it has been reported that older mothers held fewer myths; the reason may be due to that they have more experience [10].…”

Effectiveness of targeting fathers for breastfeeding promotion: systematic review and meta-analysis

“…Promotion of breastfeeding needs multilevel supportive measures with interventions being implemented through several channels [ 17 ]. Fathers have been named as one recommended target in promoting breastfeeding [ 22 , 23 ]. Qualitative research findings have revealed some domains of the father’s role in breastfeeding [ 24 ].…”