Barriers To Exclusive Breastfeeding Research Articles

Knowledge, Attitude and Practice on Exclusive Breastfeeding among Mothers of a Private Hospital at Sarawak, Malaysia

Exclusive breastfeeding (EBF) is recommended by the World Health Organization (WHO) starting within one hour of birth until a baby is six months old to achieve optimal growth, development and health. Breastfeeding can be continued up to 2 years of age, completed with nutritious complementary foods and water. The rate remains low in many countries, including Malaysia. It is important to understand barriers of exclusive breast feeding to tackle these issues and improve maternal and child health. This cross-sectional study was conducted in 2021, including all mothers with children aged 1 to 36 months attending the paediatric clinic in KPJ Kuching Specialist Hospital, Sarawak. In this study, data were collected using an eelectronic questionnaire via Google form and compiled with Statistical Package Social Sciences (SPSS) software version 23. A total of 351 questionnaires were completed. Overall findings on the knowledge of exclusive breastfeeding among mothers showed 92.3% agreed breastfeeding helps reduce the incidence of child abuse and neglect, and 94.3% showed exclusive breastfeeding must be practised until the infant is six months old. There was a significant relationship between maternal age and knowledge (p-value 0.013), employment status and the relationship between knowledge (p-value 0.001), monthly household and attitude (0.021). Attentive education for primigravida and widespread local community education and support may help improve breastfeeding continuation rates. The provision of workplace facilities by providing workplace day care may assist in overcoming the barriers to preventing exclusive breastfeeding continuation once back at work.

Barriers of exclusive breastfeeding among mothers attending primary health-care centers in Jazan, Saudi Arabia.

Exclusive breastfeeding (EBF) describes infants who were only breastfed for 6 months. Many Saudi mothers have suboptimal breastfeeding practices. Therefore, this study aims to assess breastfeeding knowledge and determine barriers to EBF among mothers attending primary health care centers in Jazan City. A descriptive cross-sectional study was done that included all mothers attending the PHC centers. Data were collected through a self-administered questionnaire. Most study participants understand breastfeeding's health benefits for babies and mothers, but most believe that synthetic milk is the best alternative for working mothers to feed their babies. A percentage of 66.7 of mothers practiced breastfeeding during the first 6 months of the child's life. EBF shows a significant relationship with knowledge and barriers. Sixty percent of mothers have never had any information about breastfeeding; the primary source was from their mothers and only 31.4% from hospital staff. Most respondents disagreed with statements of barriers to EBF, which elicits an unexpected response. Most participants have good knowledge concerning breastfeeding benefits for both mother and infant and disagreed on the mentioned barriers for EBF that include lack of breastmilk, deficiency of information, and working conditions.

The Role of Motor Coordination, ADHD-Related Characteristics and Temperament among Mothers and Infants in Exclusive Breastfeeding: A Cohort Prospective Study.

Although exclusive breastfeeding is recommended for the first 6 months of life, breastfeeding rates are low. Motor skills and ADHD-related characteristics have not yet been examined as breastfeeding barriers. The aim of this study was to explore whether mothers’ and infants’ motor skills, mothers’ ADHD-related characteristics and infants’ temperament are associated with exclusive breastfeeding at 6 months after birth. Participants were 164 mothers and their infants recruited 2 days after birth. Mothers completed a demographic and delivery information questionnaire, the Infant Feeding Intentions Scale and the Iowa Infant Feeding Attitude Scale. At 6 months, mothers completed the Adult DCD (developmental coordination disorder)/Dyspraxia Checklist, the Adult ADHD (attention deficit hyperactivity disorder) Self-Report Scale Symptom Checklist-v1.1, and the Infant Characteristics Questionnaire, and provided information about their breastfeeding status. They were then divided into two groups accordingly: EBF (exclusive breastfeeding) and NEBF (non-exclusive breastfeeding). Infants were observed using the Test of Sensory Functions in Infants and the Alberta Infant Motor Scale. At 6 months, NEBF mothers reported higher prevalence of DCD (10.2% vs. 1.9%, χ2 = 5.561, p = 0.018) and ADHD (20.3% vs. 8.6%, χ2 = 4.680, p = 0.030) compared to EBF mothers. EBF infants demonstrated better motor coordination (t = 2.47, p = 0.016, d = 0.511), but no temperament differences compared to NEBF infants. Maternal DCD, ADHD and poor infant motor coordination are associated with non-exclusive breastfeeding and may become exclusive breastfeeding barriers. These findings may assist in identifying women at risk of not exclusively breastfeeding and encourage tailoring interventions for achieving higher exclusive breastfeeding rates.

Barriers and support to exclusive breastfeeding in Sukoharjo district, Central Java province, Indonesia: a qualitative study

PurposeThe World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of a child's life. However, while the national coverage was 61.33%, the coverage in Sukoharjo was 39.33%. Effective intervention is needed to promote the importance of exclusive breastfeeding, and this requires knowledge of the barriers and support structures in place. This study analyzed the supports and barriers of exclusive breastfeeding in Sukoharjo, Central Java, Indonesia.Design/methodology/approachThis qualitative study used in-depth interviews conducted from December 2017 to March 2018. The population consisted of 33 informants (29 mothers with babies over six months of age, a pregnant mother, two midwives working in the community health center and a staff member in the district health department).FindingsThere were barriers to and support for exclusive breastfeeding in Sukoharjo, Central Java province, Indonesia. The district already has support systems in place, while the barriers emerge from society, the baby's condition, environmental and other sources. The government has tried to overcome the barriers.Research limitations/implicationsThe limitation of this study was that the triangulation method was not utilized. However, the use of various informants strengthened the findings.Practical implicationsThe district government, especially the health department, needs to establish a program to evaluate existing exclusive breastfeeding support programs thoroughly. Smarter and more comprehensive interventions may be needed, for example, by integrating various supports into one activity. For researchers, the findings of this study imply that they can conduct experimental community research using the framework of the two aforementioned theories of behavior change. For example, investigation of combining the support of trained peers with the presence of family members such as the grandmothers of the babies. If both types of support are conducted concurrently, it may strengthen support and reduce barriers from either inside or outside the home.Social implicationsThe district government, especially the health department, needs to establish a program to evaluate existing exclusive breastfeeding support programs thoroughly. Smarter and more comprehensive interventions may be needed, for example, by integrating various supports into one activity. For researchers, the findings of this study imply that they can conduct experimental community research using the framework of the two aforementioned theories of behavior change. For example, investigation of combining the support of trained peers with the presence of family members such as the grandmothers of the babies. If both types of support are conducted concurrently, it may strengthen support and reduce barriers from either inside or outside the home.Originality/valueThere are barriers to exclusive breastfeeding in Sukoharjo, but the government has made effective attempts to overcome them. The support systems in place were in line with the theory of planned behavior (TPB) and social cognitive theory (SCT).

Enablers and barriers of exclusive breastfeeding among employed women in low and lower middle-income countries

ObjectiveThis systematic review and narrative synthesis aims to explore the specific facilitators and barriers of exclusive breastfeeding (EBF) among employed mothers in low and lower middle-income countries. MethodsPrimary quantitative and qualitative studies undertaken in low and lower middle-income countries published from 2003 to 2019 were included in the review. Two reviewers independently assessed each article for eligibility using standardized critical appraisal instruments from the Joanna Briggs Institute. ResultsSeven papers were included in this review. The enabler and barrier factors to EBF are summarized into three categories including maternal factors (such as mode of delivery, number of children, knowledge and attitude on breastfeeding), social factors (such as support from husband, family and child day care), and work-related factors (such as duration of maternal leave, flexibility of work, and availability of physical facilities). ConclusionTo increase EBF among employed women, employers should support them by offering flexible working hours, a minimum of six months maternity leave and providing breastfeeding facilities. Support from family and maternal factors were important factors that could positively affect EBF. Identification of modifiable barrier and facilitator factors may contribute to successful EBF in employed women thereby reducing mortality and morbidity in countries with limited resources.

Exclusive breastfeeding in first-time mothers in rural Kenya: a longitudinal observational study of feeding patterns in the first six months of life

BackgroundExclusive breastfeeding up to 6 months of age is recommended by the World Health Organization as the optimal mode of infant feeding, providing adequate nutrition for the baby and protection against infectious diseases. Breastfeeding can be adversely affected by individual, cultural and socio-economic factors. The study aimed to explore barriers of exclusive breastfeeding in the first 6 months of life among first-time mothers in rural Kenya.MethodsAn observational longitudinal design aimed to provide rich data on breastfeeding behaviour. Twenty pregnant first-time mothers were recruited through antenatal clinics and snowballing. Mothers were visited nine times at home from late pregnancy, at 1 week and 2 weeks post-delivery, then monthly until the baby was aged 6 months. Visits were conducted between November 2016 and April 2018. At the first visit, participants were asked about breastfeeding intentions and infant feeding education received. At each postnatal visit, direct observation of breastfeeding, a recorded semi-structured interview on feeding, mother’s and baby’s health was performed. Interviews were transcribed, checked, content was grouped into categories and analyzed using a qualitative descriptive approach.ResultsMost participants were adolescent (75%) and unmarried (65%). All 20 mothers intended to and did breastfeed, however additional fluids and semi-solids were commonly given. Only two mothers exclusively breastfed from birth up to 6 months of age. Prelacteal feeds, home remedies and traditional medicine were given by over a third of mothers in the first week of life. Concern over babies’ bowel habits and persistent crying perceived as abdominal colic led to several mothers receiving advice to give gripe water and traditional remedies. Early introduction of maize porridge from 3 months of age because of perceived hunger of the child was recommended by other family members. Breastfeeding observation showed persistent problems with positioning and attachment of infants.ConclusionsExclusive breastfeeding from birth to 6 months was uncommon. Prioritization of capacity to detect mothers with breastfeeding problems and provide breastfeeding education and support is necessary, particularly during the antenatal and early postnatal period. It is important to engage with other women resident in the household who may offer conflicting feeding advice.

Knowledge, practice and barriers of exclusive breastfeeding among mothers in East Khasi hills district, Meghalaya, India: A mixed method study

Knowledge, practice and barriers of exclusive breastfeeding among mothers in East Khasi hills district, Meghalaya, India: A mixed method study

Factors Determining Implementation of Exclusive Breastfeeding in South Western Oromia, Ethiopia

Breast milk is an optimal nutrition with no substitute for an infant. Exclusive breastfeeding for the first 6 months of age provides huge benefits for both infants and mothers. However, its practice is affected by several factors attributed to mothers, family, and society and health service providing institutions. These factors can be facilitative or hindrances. Identifying facilitative factors are important to achieve sustainable practice of exclusive breastfeeding. Therefore, the aim of this study was to identify facilitative factors determining the prevalence of exclusive breastfeeding in South-western Oromia, Jimma, and Woliso towns. A cross-sectional study was conducted by using both quantitative and qualitative study approaches. A total of 135 mother–infant pairs attending maternal and child health (MCH) services at public hospitals in the two selected towns were interviewed. Additional data was obtained from key informants and focus group discussants and through observations of mother–infant conditions. The data obtained through survey was analyzed with Statistical software Package for Social Science (SPSS v. 20), and the qualitative data was analyzed thematically. The data shows a breast milk initiation of 100% at the study site, out of which 80% of them were exclusively breastfed up to the age of 2 months, but only 48.9% of them continue exclusively breastfeeding up to the age of 6 months. The study identified knowledge of mothers, family support, antenatal and postnatal service and counseling, and arrangement of nursery at work as facilitative factors. In contrast, mothers’ perception of insufficient milk and socio-cultural influences were identified as barriers of exclusive breastfeeding. This study identified several personal and social facilitating factors that can contribute to exclusive breastfeeding and help to devise policy direction promoting exclusive breastfeeding.

Breastfeeding rates and barriers: a report from the State of Qatar

ObjectiveThe aim of the study was to outline breastfeeding barriers faced by women residing in the State of Qatar.MethodsA cross-sectional study through a telephone interview was conducted at Hamad Medical Corporation, the only tertiary care and accredited academic institution in the State of Qatar. Mothers of children born between the period of January 1, 2012 and December 31, 2012 in the State of Qatar were contacted.ResultsOf the total 840 mothers who were contacted for the telephone survey, 453 mothers agreed to be interviewed (response rate 53.9%), while 364 (43.3%) did not answer the phone, and 21 (2.5%) answered the phone but refused to participate in the study. The overall breastfeeding initiation rate among the mothers was 96.2%, with 3.8% mothers reporting that they had never breastfed their baby. The percentage of mothers who exclusively breastfed their children in the first 6 months was 24.3%. The most common barriers to breastfeeding as perceived by our participants were the following: perception of lack of sufficient breast milk after delivery (44%), formula is easy to use and more available soon after birth (17.8%), mom had to return to work (16.3%), lack of adequate knowledge about breastfeeding (6.5%), and the concept that the infant did not tolerate breast milk (4.9%).ConclusionExclusive breastfeeding barriers as perceived by women residing in the State of Qatar, a wealthy rapidly developing country, do not differ much from those in other nations. What varies are the tremendous medical resources and the easy and comfortable access to health care in our community. We plan to implement a nationwide campaign to establish a prenatal breastfeeding counseling visit for all expecting mothers.

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

The six months exclusive breastfeeding rate in Thailand has decreased from 15.1 % in 2009 to 12.3 % in 2013. It is important to identify what the facilitators and barriers to exclusive breastfeeding in Thailand. This narrative review aimed to identify facilitators and barriers to exclusive breastfeeding in Thailand. A narrative review was conducted by searching through the following data bases: Medline, CINAHL, Embase, Google scholar and Thai journal online between 2001 to the fourth week of September 2016. Searching terms are exclusive breastfeeding and Thailand. Inclusion criteria were that they focused on facilitators and barriers of exclusive breastfeeding - specifically relating to Thailand in all languages. Exclusion criteria were studies which not related with facilitators and barriers to exclusive breastfeeding in Thailand. Narrative data extraction was conducted, with data analyzed thematically. The result revealed that 74 studies were thematically analyzed using five identified themes: mother factor, family support, situation and social context, infant factor, and healthcare profession and healthcare service. Conclusion: The factors described in the study are corroborated by international findings. In difference context, identifying specific practical guideline based on the themes identified, in order to make suggestions amid policy planning for the promotion, protection, and support of exclusive breastfeeding in Thailand, is now in deed of exploration.

Delineating Exclusive Breastfeeding Barriers: Experience from a Wealthy Developing Country

Delineating Exclusive Breastfeeding Barriers: Experience from a Wealthy Developing Country

Exclusive breast feeding (EBF) in Jordan: Prevalence, duration, practices, and barriers

Objectiveof this study is to investigate the prevalence, duration, practices and barriers of Exclusive breast feeding (EBF) among Jordanian mothers in three major governorates. Designlongitudinal, prospective design was used in this study. Settings and participantsconvenience sample of 572 pairs of postpartum mothers–infants were recruited from postpartum wards at three governmental hospitals and three private hospitals in major Jordanian governorate. Measurements and findingsdata were collected in two phases. In the first phase, trained research assistants conducted face to face structured interviews with participating mothers at the hospital. In the second phase, the research assistants conducted follow up phone interviews at the end of first, fourth and sixth months after birth. The findings of this study showed that the prevalence of EBF as recommended by WHO was 1%. The average duration of EBF was one month. The main barriers of EBF were: infants feel hungry after breast feeding, short period between pregnancies, and breast problems. Key conclusionspostpartum mothers initiated EBF practice within the first hour after giving birth; however, this practice declined gradually as the infant grew up within the first six months after birth. Implications for practice: antenatal education sessions in the Jordanian governmental hospitals about EBF are required to meet the WHO recommendations. Furthermore, midwives and nurses have to focus on effective breast feeding process to overcome the barriers of EBF during antenatal education and postnatal care.

Barriers of Exclusive Breast Feeding in Healthy Term and Late Preterm Neonates

Background: Millions of deaths can be averted by scaling up exclusive breast feeding, EBF rate. By end of 2 months only 69% of mothers and by 4-6 months only one quarter of mothers are giving EBF to their babies.Factors influencing non-initiation or early cessation of exclusive breastfeeding had already been evaluated under NFHS data but only for babies born in community settings, these factors need to be investigated for the neonates born out of community settings. Objective:To identify risk factors for early cessation of exclusive breast-feeding. Setting: Teaching Hospital in north India. Subjects:Mothers giving birth to term or late pre-term healthy neonates were enrolled within 48 h after delivery and followed up till 6th postnatal week. Results:A total of 350 mothers were enrolled. At the end of 1st, 2nd and 6th week the proportion of EBF decreased to 95%, 93.3% and 75.8% respectively. Risk factors associated with early cessation of exclusive breastfeeding were cesarean section at end of first week (RR: 3.06,95%CI: 1.03-9.08) and primiparity at end of six weeks (RR: 1.95, 95%CI: 1.01-3.79). Conclusion:Cesarean section and first time mothers need more counseling on exclusive breast-feeding.

Overcoming barriers to breastfeeding: suggested breastfeeding promotion programs for communities in eastern Nova Scotia.

The 1994 rate of initiation of breastfeeding in eastern Nova Scotia was 41%. The purpose of this study is to assess both perceived barriers to breastfeeding as well as the need for programs to promote breastfeeding in this region. Seventy randomly selected subjects (67 F, 3 M) responded to a questionnaire about regional breastfeeding practices. Results showed that perceived barriers to breastfeeding included lack of knowledge about breastfeeding management (35.8%) and lack of support (29.9%). Barriers to exclusive breastfeeding for 6 months included going back to work (76.5%) and lack of support (39.2%). To promote exclusive breastfeeding for 6 months, participants recommended access to: prenatal classes (98.5%), nurse follow-up following hospital discharge (95.3%), and availability of lactation consultants (88.3%). When proposed promotion programs were implemented, breastfeeding initiation increased to 60.5% and duration rates increased to 4 months (90.2%). Regional barriers to breastfeeding can be partly alleviated through educational and support programs.