Facilitators and Barriers to Breastfeeding and Exclusive Breastfeeding in Kilimanjaro Region, Tanzania: A Qualitative Study

Melina Mgongo,1,2 Tamara H. Hussein,2,3 Babill Stray-Pedersen,1,2,4 Siri Vangen,1,4,5 Sia E. Msuya, 2,6,7 and Margareta Wandel,3
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1. IntroductionBreastfeeding is the best way to provide nourishment tothe child [1]. Breastfeeding helps the child to get all thenutrients that are needed for proper growth and development[1–f]. WHO recommends early initiation of breastfeeding,exclusive breastfeeding (EBF), and timely introduction ofcomplementary feeding and continued breastfeeding for upto two years or beyond. EBF means that infants receive onlybreast milk during the trst six months without any additionalfood or huid, not even water [1]. Te benetts of breastfeedingand EBF for the child, mother, and the community at largeare well documented [f–3].Although breastfeeding is a natural process, it is reportedto be inhuenced by di7erent socio-cultural factors, habits,

2. MethodsTis study was conducted by focus group discussions (FGD)with mothers of infants aged 0-12 months in three districtsof Kilimanjaro region between August and October 2013. Itincluded a total of l8 mothers in nine focus groups fromthesedistricts with three focus groups in each district. Te overallproject focused on exploring the challenges that women facefor practicing EBF. Te tndings of the trst paper focusedon women’s knowledge, how they related to the advice fromhealth personnel and relatives/friends, and social barriers forEBF [21]. Te present paper deals with cultural aspects thathave implications for EBF practices.


3. ResultsIn this paper the themes that were mentioned in all nineFGDs are categorized into two sections. Breastfeeding practicesincluded the following subthemes: breastfeeding createshappiness, it is a gif from mother to child, breastfeeding cana7ect mother’s appearance, and breastfeeding is tiringFacilitators and barriers to EBF practices included thefollowing subthemes: facilitators: EBF is good for familyeconomy and prevents child sickness, Breastmilk is the only foodfor infantsBarriers are chango or makekuu (abdominal pain thatoccurs during or afer breastfeeding), fear of the evil eye, andburping causing pain to the breast.

4. DiscussionTis study found that there are many social, beliefs, andtraditions that the mothers consider important for theirbreastfeeding and EBF practices. Te themes included thefollowing: breastfeeding creates happiness, it is good for thefamily economy, prevents child sickness, and breast milk isthe only food for the child and a gif that the mother cangive to her child. Te themes that were not in favor of thepractice of EBF were as follows: breast milk is very light,breastfeeding could a7ect mothers appearance, breastfeedingis tiring, breast milk has a bad odor, chango,thereisfearoftheevil eye, breastmilk may become unclean, and burping causespain to the breasts.In this study, mothers mentioned various advantagesthat relate to the practice of breastfeeding based on theirown experiences. Many researchers and WHO have reportedsimilaradvantagesofbreastfeeding[2,f,2f].Duringthetrstsix months, the infant’s digestive system is not well matured,and giving other foods may expose infants to infection.Early complementary feeding has been associated with poornutritional status [2i]. From the discussions conducted forthis study, it seemed that the women perceived breastfeedingto be the best way to feed infants. Te awareness of thesebenetts can be used to develop educational messages thatpromote the practice EBF in this setting.


5. ConclusionTeresultsofthisstudyrevealedthatamajorityofmotherswere positive towards exclusive breastfeeding practices. Tepositive beliefs towards EBF can be used to develop breastfeedingmessages that could encourage mothers to practiceEBF. Chango or Makekuu wasseenasabigprobleminthiscommunity and it interfered with the practice of EBF. Tebeliefs, knowledge, and remedies to treat chango were passedon from one generation to another. Tere is a need for moreresearch to understand the belief in chango.In this study there were di7erent beliefs and social andcultural barriers that hinder the practice of EBF. Te beliefsthat hinder the practice are very important to take intoconsideration when developing interventions to improvebreastfeeding practices.