Insights on exclusive breastfeeding norms in Kinshasa: findings from a qualitative study

Abstract

Background For optimal growth and development, the World Health Organization recommends that children be exclusively breastfed for the first 6 months of life. However, according to the nationally-representative 2013–2014 Demographic and Health Survey, under 50% of babies in the Democratic Republic of Congo are exclusively breastfed. Although breastfeeding was common in the capital city of Kinshasa, one in five newborns received alternatives to breastmilk during the first 3 days of life. This analysis aimed to identify social norms influencing exclusive breastfeeding, the role of a young first-time mother’s (FTM’s) social network for her choice to exclusively breastfeed, and perceived social sanctions associated with breastfeeding practices in Kinshasa. Methods The qualitative analysis was based on a vignette presented during 14 focus group discussions, with a purposively selected sample (n = 162) of FTMs age 15–24, and the male partners, mothers and mothers-in-law of FTMs age 15–24 in three health zones in Kinshasa in 2017. Thematic content analysis was performed to identify concepts and patterns in the participants’ discussions. Results Overall, community norms were not supportive of exclusive breastfeeding. The main barriers to exclusive breastfeeding were the belief held by most FTMs that exclusive breastfeeding was an uncommon practice; the desire to avoid negative sanctions such as name-calling and mockery for refusal to give babies water in the first 6 months of life; the desire to please key members of their social networks, specifically their mothers and friends, by doing what these influencers expected or preferred them to do; FTMs’ own lack of experience with infant feeding; and trust placed in their mothers and friends. Conclusion Social norms can be maintained by the belief about what others do, perceived expectations about what individuals ought to do, the negative sanctions they can face and their preference to conform to social expectations. Thus, addressing cultural beliefs and targeting sensitization efforts to key influencers that provide support to FTMs are needed to promote exclusive breastfeeding in Kinshasa. In doing so, strategies should address the barriers to exclusive breastfeeding including related misconceptions, and improve FTMs’ self-efficacy to overcome the influence of others.

Sociocultural context of exclusive breastfeeding in Africa: A narrative review

“…A study in DRC indicated that traditional norms and perceived expectations had strong positive impacts on African mothers' beliefs, attitudes and practices associated with EBF. The authors likewise noted that the beliefs and attitudes held by the social support networks that a woman has had a major influence on her decisions to practice EBF 53 . Same was true for mothers in Ghana 54…”

Escalate Milk Production: The Amazing Advantages of Marmet and Acupuncture Techniques

“…However, several variables are not controlled but can affect the success of marmet techniques [36] and acupuncture techniques [37], in addition to other factors that can directly trigger production or inhibit breast milk production. The triggers for the problem of breast milk production in mothers that cannot be controlled in this study include nutritional patterns, activity patterns, psychological conditions, frequency of expressing breast milk, breast care, use of contraceptives [4], [16], [36], [38] in addition to the baby's ability to suck [9].…”

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Mothers’ knowledge and practices on breastfeeding and complementary feeding in an urban slum area and rural area in Kenya: A cross-sectional interview study

“…Global trends in food consumption and peer pressure may drive mothers to act against recommendations (Berhane et al, 2018). Mothers may desire to please key members of their social network to avoid negative sanctions, as seen in Congo, where refusal to give a baby water during the first 6 months was seen as socially unacceptable (Wood et al, 2020). Additionally, while access to information from the internet can be beneficial, media literacy may be poor (Kuyinu et al, 2020).…”