Date Published: May 2, 2019
Publisher: Public Library of Science
Author(s): Anthony Mwinilanaa Tampah-Naah, Akwasi Kumi-Kyereme, Joshua Amo-Adjei, Sphiwe Madiba.
Mothers are recommended to exclusively breastfeed their infants for the first six months of their lives. Also, after the sixth month, breastfeeding should continue with added complementary foods to the diets of children. Studies designed to sought the views of mothers on breastfeeding practices are limited. The aim of this study was to explore challenges to breastfeeding practices by considering spatial, societal and maternal characteristics in Ghana. Twenty mothers aged 15–49 years were interviewed purposively in selected communities within two regions of the country. Thematic content analytical procedures were applied to interpret and present findings. Challenges (to both exclusive breastfeeding and complementary feeding) spanned across spatial (home and work places), societal, and maternal characteristics. Key themes identified were in relation to household chores, work schedules, family influence, low breast milk production, swollen breasts or sore nipples, access to food items and preparation or giving foods. Addressing these challenges would require co-creation of supportive environments between couples and significant others as well as tackling institutional barriers that obstruct adequate breastfeeding among mothers. On complementary feeding, there is the need to form community health volunteers help educate mothers more on how to appropriately use local foods to feed their children.
The importance of breastfeeding practices for a healthy growth and development of infants and young children have been presented in numerous policy documents [1–2]. Breastfeeding practices are categorized into two broad aspects; exclusive breastfeeding and complementary feeding . For each of these aspects, guidelines are stipulated as to how to appropriately practice each of them to yield maximum outcomes for the good health of children. For instance, mothers are encouraged to exclusively breastfeed their infants for the first six months of their lives. It is worth mentioning that breastfeeding is much more than giving infants and young children breast milk. Breastfeeding is a complex adaptive process that bonds a mother and her child. During this process, physical, biochemical, hormonal, and psychological exchanges occur to facilitate the transfer of needed essential nutrients between the mother and her child . After six months of exclusive breastfeeding, breastfeeding should still continue with added complementary foods as recommended by World Health Organization .
The interviews conducted provided insight into the views of breastfeeding mothers in relation to challenges they encounter in their bid to exclusively breastfeed as well as complementarily feed their children. This study identified nursing mothers’ engagement in performing household chores (especially cooking and fetching water) as challenges to practicing optimum exclusive breastfeeding. Nursing mothers being overwhelmed at combining exclusive breastfeeding and household chores can be attributed to weak social support systems. This in the light of increasing urbanization is leading to the rise of nuclear families compared to larger family systems (extended families) that use to offer needed social support for nursing mothers in Ghana . The disintegration of larger families into smaller ones sometimes poses constraints that tend to hinder the practice of exclusive breastfeeding. In the Ghanaian context, extended families accommodate several relatives (aunties, cousins, nieces) who are mostly willing to offer assistance to nursing mothers. As communities get urbanized, supports from these relatives diminish or are unavailable. On the other hand, by tradition, husbands are not supposed to take part or assist in household chores since these activities are highly gendered towards females. Where necessary, some husbands offer minimal assistance in household chores that may not be enough to relief the burden on mothers. The absence or limited assistance nursing mothers get in performing household chores in most contemporary Ghanaian homes tend to negatively influence how their infants are exclusively breastfed including those who are complementarily fed.
Findings suggest that mothers encountered exclusive breastfeeding challenges at home, with work schedules within their societies, and in relation to their health status. In order to address these challenges, we suggest the creation of awareness through especially radio for family members and other significant others to enable them provide adequate support for exclusive breastfeeding mothers. Also, increasing maternity leave to at least four months for expectant and nursing mothers by authorities in the country would reduce challenges nursing mothers have at work places. On complementary feeding, a platform should be created for midwives and community health nurses to provide further education on how to adequately and appropriately use local foods to feed their children. Besides, the provision of suitable feeding cubicles for breastfeeding or feeding children at work places by authorities would be a positive measure to ensuring mothers feed their children with ease.