'No sister, the breast alone is not enough for my baby' A qualitative assessment of potentials and barriers in the promotion of exclusive breastfeeding in southern Zambia

Abstract

BackgroundAppropriate feeding practices are of fundamental importance for the survival, growth, development and health of infants and young children. The aim of the present study was to collect baseline information on current infant and young child feeding practices, attitudes and knowledge in Mazabuka, Zambia, using a qualitative approach.MethodsThe study was conducted in Mazabuka, 130 km south of Lusaka in Zambia in January and February in 2005. Nine focus group discussions with mothers and a total of 18 in-depth interviews with fathers, grandmothers, health staff and traditional birth attendants were performed in both rural and urban areas.ResultsBreastfeeding was reported to be universal, the use of pre-lacteal feeds appeared to be low, colostrum was rarely discarded, and attitudes to and knowledge about exclusive breastfeeding were generally good. However, few practised exclusive breastfeeding. The barriers revealed were: (1) the perception of insufficient milk, (2) the fear of dying or becoming too sick to be able to breastfeed, (3) convention, (4) the perception of 'bad milk' and (5) lack of knowledge on the subject. The health staff and traditional birth attendants were the most important actors in transmitting knowledge about infant feeding to the mothers. Both categories appeared to have updated knowledge on child health and were well respected in the society. Fathers and grandmothers tended to be less knowledgeable on novel subjects such as exclusive breastfeeding and often showed a negative attitude towards it. At the same time they had considerable authority over mothers and children and infant feeding decisions. The rural population was in general less educated and more prone to conventional non-exclusive feeding practices.ConclusionThe message that exclusive breastfeeding (EBF) is beneficial for child health had reached the health workers and was taught to mothers. However, conventions and expectations from family members in this Zambian community were important barriers in preventing the message of EBF from being translated into practice. The deep-rooted beliefs that prohibit EBF need to be addressed in projects and campaigns promoting EBF.

Failed Breast Feeding among Egyptian Women at One Month Postpartum: A Cross-Sectional Community Based Study

“…Most of the problems reported by mothers who discontinued breast feeding were similar to those reported in previous surveys [9,15,17] and many were found to be preventable. Women need more accurate information about the process of breastfeeding.…”

“…Appropriate feeding practices are of fundamental importance for the survival, growth, development, health and nutrition of infants and young children. It is argued that promotion of exclusive breastfeeding is the most effective child health intervention currently feasible for implementation at population level in low-income countries [8,9]. Of the women who initiate breastfeeding, many cease in the first month following birth for reasons that might be avoided.…”

Facilitators and Barriers to Exclusive Breastfeeding in Thailand: A Narrative Review

“…Support from family members (i.e. grandparents or the husband) was shown to have a positive impact on EBF, and this has been found in other studies [114,116,121,122,128,129]. Lack of family support was also identified as barrier in a study in India [130].…”

“…In addition, Thai grandmothers trying to feed infants water, rice, and fruit can negatively impact on EBF duration. Similar traditional behaviors have also been reported in the Middle East, Southern Africa, East Africa, China and Brazil [113,123,128,131]. In Zimbabwe, water as well as herbal concoctions, are given to children with the belief that they could improve their health [114].…”

Knowledge and Practice Regarding Breastfeeding among Mothers Attending Immunization Clinic in Nepalgunj Medical College Teaching Hospital

“…In our study, only 38% of the mothers knew that colostrum needs to be given which is very low compared to others studies in India where the importance of colostrum was known to 75-90% of the 33,34 mothers . The mother's perception of "no enough breast milk" is a wellknown problem hindering optimal EBF practice in many 35,36 communities . A key reason, however, why a child could remain hungry is not because breast milk is insufficient but because women do not spend adequate time on breast feeding due to the pressure of house work or are not aware that the milk should be exhausted from one breast before feeding from 37 the second breast .…”