Promoting breastfeeding in rural Gambia: combining traditional and modern knowledge

Abstract

Sub-optimal breastfeeding practices still prevail in many countries, especially in traditional rural communities. Despite high breastfeeding initiation rates and long total duration of breastfeeding, exclusive breastfeeding is a rare practice. In the present study, quantitative methods were used to identify current infant feeding practices in 12 rural communities in The GAMBIA: Results indicated that delayed initiation of breastfeeding, prelacteal feeding and failure to practice exclusive breastfeeding were widespread. Qualitative data further indicated that current beliefs and practices were strongly influenced by traditional beliefs and practices. These were kept very much alive by elders, both women and men, including husbands. The results also showed an unexpected support for bottle-feeding from both male and female elders who considered it part of the modernization process. A strategy for promoting early initiation of breastfeeding, feeding of colostrum and exclusive breastfeeding for 6 months in rural communities should therefore incorporate traditional beliefs and practices into modern messages on optimal breastfeeding. Traditional beliefs and practices in the study setting that could be used in this way included knowledge from the population's acquaintance with the newborns of their livestock. It also included the traditional practice of mothers taking their very young children with them when going to work in the fields. The paper suggests such a strategy by developing a matrix to establish linkages between modern and traditional knowledge on a specific practice. Such linkages facilitate the acceptance of recommendations on infant feeding by mothers in these communities. The strategy recommends an expanded target group to include elders and husbands, as the data show that these groups are highly influential in matters regarding patterns of child feeding.

Impact of counselling on exclusive breast-feeding practices in a poor urban setting in Kenya: a randomized controlled trial

“…Results of qualitative data from the study (20) (data not shown) illustrate that the major challenges to the practice of EBF, even after the intensive counselling received, were: cultural perceptions about EBF resulting from family and societal pressure to introduce complementary feeding; the misconception about inadequacy of breast milk production; practical perceptions about the excessive demands on maternal time against other competing responsibilities; and maternal absence from home for long periods of time. Similar findings have been reported in other studies (21)(22)(23) . The present study shows that changing the mind-set of mothers to practise EBF requires intensive home-based breast-feeding support.…”

Assessing neonatal care practices in rural Nepal

“…We did not study the causes of the high rates of non-exclusive breastfeeding, but other studies demonstrate this is due to cultural beliefs, insufficient breast milk production, and maternal illness. 13,14 One potential cause may be difficulty in breast milk production as reported by nearly a quarter of the mothers. Another potential etiology may be given that Daman is a farming community, newly delivered mothers often returned to their field work as was observed, but this data was not exclusively collected.…”

Sociocultural factors influencing breastfeeding practices in two slums in Nairobi, Kenya

“…Several studies have also emphasized the need to understand and incorporate cultural beliefs and practices in design and implementation of health and nutrition interventions [19–21]. The Global Strategy for Infant and Young Child Feeding further emphasizes on the need for those involved in promoting breastfeeding to understand the sociocultural and environmental circumstances around breastfeeding [8].…”