Using the Socio‐Ecological Framework to determine Breastfeeding Obstacles in a Low‐income Population in Tijuana, Mexico: Individual Factors

Abstract

BackgroundIn Mexico, breastfeeding rates are one of the lowest of Latin America, with 14.4% of infants under 6 months being exclusively breastfed. Our objective was to identify the main obstacles to breastfeeding in a low‐income population in Tijuana, Mexico. We assess individual factors in this study, which are those associated directly to the mother, infant and the 'mother‐infant dyad'.MethodsWe used a socio‐ecological framework to determine factors affecting breastfeeding practices. In four low‐income communities in Tijuana we conducted focus groups and interviews with mothers, fathers, grandparents, and key informants. Interview notes and focus group transcripts were then studied in depth independently by three researchers. The primary analytic technique was constant comparison.ResultsOne hundred twenty‐nine subjects participated in this study: six focus groups (n = 53) and 51 interviews among mothers, fathers, and grandparents, as well as 25 interviews among key informants. Main individual obstacles to breastfeeding were perception of inadequate milk, pain, aesthetics, lack of time, comfort, baby's dissatisfaction and breastfeeding maintenance difficulties. Socio‐structural factors such as the biomedical discourse about milk as a product interact with individual factors to impact breastfeeding behavior.ConclusionsThis study showed that women in low‐income communities in Tijuana face multiple obstacles to breastfeeding at the individual level. This information can help to develop culturally‐ appropriate educational material to promote breastfeeding. Additionally, institutional and social structural changes are needed in order to increase breastfeeding rates.