Why are breastfeeding rates declining in Iran? A qualitative study on three centers in Tehran

Abstract

Background and objective: This qualitative study was conducted to identify obstacles to breastfeeding and provide strategies for promoting its practice in Tehran based on the experiences and perceptions of breastfeeding mothers. Methods: Data were first collected through focus group discussions with 51 breastfeeding mothers admitted to Vali Asr Hospital in the Imam Khomeini Hospital Complex and two health centers in Tehran. We held follow-up in-depth interviews with 26 mothers over a year postpartum or until breastfeeding was discontinued. Results: The most important barriers to breastfeeding were (1) Physical condition of the mother, including lack of vigor, physical weakness, weight loss, inappropriate nutrition, nipple-related problems, inadequate breast milk, changes in body shape, and maternal and neonatal diseases. (2) Health care system, including (a) Hospital-related problems included (i) Providing educational services related to breastfeeding, (ii) Problems related to the behaviors of hospital staff, and breastfeeding problems related to cesarean delivery. (3) Emotional and psychosocial aspects of breastfeeding, including emotional support from husband and family, dislike of breastfeeding in public places, stress and mental pressure, and maternal employment. Conclusion: Politicians in the field of health can exert a considerable effect on breastfeeding practice and its continuation by providing early intervention designed to increase awareness of breastfeeding among young girls, training health staff in offering breastfeeding support, and ensuring contact between mother and infant. Also, provide support services, such as extended maternity leaves, daycare facilities in the workplace, and breastfeeding counseling centers. Further research is needed to assess the effectiveness of the interventions currently proposed in the Iranian context.