Abstract
BackgroundThe practice of exclusive breastfeeding is still low despite the associated benefits. Improving the uptake and appropriating the benefits will require an understanding of breastfeeding as an embodied experience within a social context. This study investigates breastfeeding practices and experiences of nursing mothers and the roles of grandmothers, as well as the work-related constraints affecting nurses in providing quality support for breastfeeding mothers in Southwest Nigeria.MethodsUsing a concurrent mixed method approach, a structured questionnaire was administered to 200 breastfeeding mothers. In-depth interviews were also held with breastfeeding mothers (11), nurses (10) and a focus group discussion session with grandmothers.ResultsBreastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. Only a small proportion (19%) of the nursing mothers practiced exclusive breastfeeding. The survey showed the major constraints to exclusive breastfeeding to be: the perception that babies continued to be hungry after breastfeeding (29%); maternal health problems (26%); fear of babies becoming addicted to breast milk (26%); pressure from mother-in-law (25%); pains in the breast (25%); and the need to return to work (24%). In addition, the qualitative findings showed that significant others played dual roles with consequences on breastfeeding practices. The desire to practice exclusive breastfeeding was often compromised shortly after child delivery. Poor feeding, inadequate support from husband and conflicting positions from the significant others were dominant constraints. The nurses decried the effects of their workload on providing quality supports for nursing mothers.ConclusionBreastfeeding mothers are faced with multiple challenges as they strive to practice exclusive breastfeeding. Thus, scaling up of exclusive breastfeeding among mothers requires concerted efforts at the macro, meso and micro levels of the Nigerian society.
Highlights
The practice of exclusive breastfeeding is still low despite the associated benefits
The in-depth interviews with nurses were conducted in English at the health facility, whilst the interviews with nursing mothers and the focus group discussion with grandmothers were conducted in Yoruba language at preferred locations
In Davies-Adetugbo’s study on awareness and relevance of colostrum among nursing mothers in a rural Yoruba community in Nigeria, colostrum was perceived as milk that had stayed in the breast during the 9 months of pregnancy and become stale [35]
Summary
The practice of exclusive breastfeeding is still low despite the associated benefits. Improving the uptake and appropriating the benefits will require an understanding of breastfeeding as an embodied experience within a social context. The median exclusive breastfeeding period in Southwest Nigeria by months in the year 2003 was 7 months. Early initiation of breastfeeding among women in the region was 12.7% in 2003, but increased to 35.5% in the year 2008 [6]. All these figures are far below the 90% level recommended by the WHO [7]. Nigeria has the highest under-five rural mortality rate of 242.7 per 1,000 among selected sub-Saharan Africa countries [9]
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