Skip to main content
Top
Published in: International Breastfeeding Journal 1/2016

Open Access 01-12-2016 | Research

Challenges and predictors of exclusive breastfeeding among mothers attending the child welfare clinic at a regional hospital in Ghana: a descriptive cross-sectional study

Authors: Abigail Kusi-Amponsah Diji, Victoria Bam, Ernest Asante, Alberta Yemotsoo Lomotey, Samuel Yeboah, Haim Acquah Owusu

Published in: International Breastfeeding Journal | Issue 1/2016

Login to get access

Abstract

Background

The challenges and predictors of exclusive breastfeeding (EBF) have been examined in many parts of the world. Considering the socio-cultural dynamics and the few research studies in Ghana, the factors that hinder and predict EBF practice in other countries may be different in the Ghanaian setting. The study therefore sought to assess the challenges and predictors of EBF among mothers attending a child welfare clinic at a regional hospital in Ghana.

Methods

A descriptive cross-sectional study was carried out between January and March, 2015 to elicit information from 240 mothers who were sampled using simple random sampling technique. A validated structured questionnaire was used in collecting data on participants’ socio-demographic characteristics and reported breastfeeding practices. Participants’ breastfeeding challenges were rated on a Likert scale from 1 (not at all), 2 (mild), 3 (moderate), 4 (severe) to 5 (unbearable). In this study, EBF refers to birth of the infants up to six months.

Results

The top three breastfeeding challenges of mothers were: belief that breast milk alone was not sufficient in meeting their babies’ nutritional needs [mean 3.43 (standard deviation {SD} 1.35)], short maternity leave period [mean 3.41 (SD 1.29)], and socio-cultural pressure to introduce water and artificial feeds [mean 3.39 (SD 1.28)]. Independent predictors of EBF were: infant’s age [Adjusted Odds Ratio (AOR) 0.82 (95% Confidence Interval [CI] 0.71, 0.95)], and self-employment [AOR 2.67 (95% CI 1.11, 6.41)].

Conclusion

Mothers are confronted with numerous EBF challenges both at the individual and societal levels, and stakeholders need to consider these in order to support breastfeeding mothers to maximize outcomes. Reviewing the labour laws on Ghana’s maternity leave to accommodate an extended maternity leave in addition to the employee’s annual leave could further improve EBF practice rates.
Appendix
Available only for authorised users
Literature
1.
go back to reference Qureshi AM, Oche OM, Sadiq UA, Kabiru S. Using community volunteers to promote exclusive breastfeeding in Sokoto State, Nigeria. Pan Afr Med J. 2011;10:8. Qureshi AM, Oche OM, Sadiq UA, Kabiru S. Using community volunteers to promote exclusive breastfeeding in Sokoto State, Nigeria. Pan Afr Med J. 2011;10:8.
2.
go back to reference Redshaw M, Henderson J. Learning the hard way: expectations and experiences of infant feeding support. Birth. 2012;39:21–9.CrossRefPubMed Redshaw M, Henderson J. Learning the hard way: expectations and experiences of infant feeding support. Birth. 2012;39:21–9.CrossRefPubMed
3.
go back to reference Boyer K. Affect, corporeality and the limits of belonging: Breastfeeding in public in the contemporary UK. Health Place. 2012;18:552–60.CrossRefPubMed Boyer K. Affect, corporeality and the limits of belonging: Breastfeeding in public in the contemporary UK. Health Place. 2012;18:552–60.CrossRefPubMed
4.
go back to reference Andrew N, Harvey K. Infant feeding choices: experience, self-identity and lifestyle. Matern Child Nutr. 2011;7:48–60.CrossRefPubMed Andrew N, Harvey K. Infant feeding choices: experience, self-identity and lifestyle. Matern Child Nutr. 2011;7:48–60.CrossRefPubMed
5.
6.
go back to reference Ludlow V, Newhook LA, Newhook JT, Bonia K, Goodridge JM, Twells L. How formula feeding mothers balance risks and define themselves as “good mothers.”. Health Risk Soc. 2012;14:291–306.CrossRef Ludlow V, Newhook LA, Newhook JT, Bonia K, Goodridge JM, Twells L. How formula feeding mothers balance risks and define themselves as “good mothers.”. Health Risk Soc. 2012;14:291–306.CrossRef
7.
go back to reference Dewey KG. Maternal and fetal stress are associated with impaired lactogenesis in humans. J Nutr. 2001;131:3012S–5.PubMed Dewey KG. Maternal and fetal stress are associated with impaired lactogenesis in humans. J Nutr. 2001;131:3012S–5.PubMed
9.
go back to reference Kimani-Murage EW, Madise NJ, Fotso J-C, Kyobutungi C, Mutua MK, Gitau TM, Yatich N. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health. 2011;11:396.CrossRefPubMedPubMedCentral Kimani-Murage EW, Madise NJ, Fotso J-C, Kyobutungi C, Mutua MK, Gitau TM, Yatich N. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health. 2011;11:396.CrossRefPubMedPubMedCentral
11.
12.
go back to reference Aidam BA, Perez-Escamilla R, Lartey A, Aidam J. Factors associated with exclusive breastfeeding in Accra, Ghana. Eur J Clin Nutr. 2005;59:789–96.CrossRefPubMed Aidam BA, Perez-Escamilla R, Lartey A, Aidam J. Factors associated with exclusive breastfeeding in Accra, Ghana. Eur J Clin Nutr. 2005;59:789–96.CrossRefPubMed
13.
go back to reference Aidam BA, Perez-Escamilla R, Lartey A. Lactation counseling increases exclusive breast-feeding rates in Ghana. J Nutr. 2005;135:1691–5.PubMed Aidam BA, Perez-Escamilla R, Lartey A. Lactation counseling increases exclusive breast-feeding rates in Ghana. J Nutr. 2005;135:1691–5.PubMed
14.
15.
go back to reference Aborigo RA, Moyer CA, Rominski S, Adongo P, Williams J, Logonia G, Affah G, Hodgson A, Engmann C. Infant nutrition in the first seven days of life in rural northern Ghana. BMC Pregnancy Childbirth. 2012;12:76.CrossRefPubMedPubMedCentral Aborigo RA, Moyer CA, Rominski S, Adongo P, Williams J, Logonia G, Affah G, Hodgson A, Engmann C. Infant nutrition in the first seven days of life in rural northern Ghana. BMC Pregnancy Childbirth. 2012;12:76.CrossRefPubMedPubMedCentral
16.
go back to reference Ku C, Chow SK. Factors influencing the practice of exclusive breastfeeding among Hong Kong Chinese women: a questionnaire survey. J Clin Nurs. 2010;19(17/18):2434–45.CrossRefPubMed Ku C, Chow SK. Factors influencing the practice of exclusive breastfeeding among Hong Kong Chinese women: a questionnaire survey. J Clin Nurs. 2010;19(17/18):2434–45.CrossRefPubMed
17.
go back to reference Nkala T, Msuya S. Prevalence and predictors of exclusive breastfeeding among women in Kigoma region, Western Tanzania: a community based cross-sectional study. Int Breastfeed J. 2011;6:17.CrossRefPubMedPubMedCentral Nkala T, Msuya S. Prevalence and predictors of exclusive breastfeeding among women in Kigoma region, Western Tanzania: a community based cross-sectional study. Int Breastfeed J. 2011;6:17.CrossRefPubMedPubMedCentral
18.
go back to reference Setegn T, Belachew T, Gerbaba M, Deribe K, Deribew A, Biadgilign S. Factors associated with exclusive breastfeeding practices among mothers in Goba district, south east Ethiopia: a cross-sectional study. Int Breastfeed J. 2012;7:17.CrossRefPubMedPubMedCentral Setegn T, Belachew T, Gerbaba M, Deribe K, Deribew A, Biadgilign S. Factors associated with exclusive breastfeeding practices among mothers in Goba district, south east Ethiopia: a cross-sectional study. Int Breastfeed J. 2012;7:17.CrossRefPubMedPubMedCentral
19.
go back to reference Rattray J, Jones MC. Essential elements of questionnaire design and development. J Clin Nurs. 2007;16:234–43.CrossRefPubMed Rattray J, Jones MC. Essential elements of questionnaire design and development. J Clin Nurs. 2007;16:234–43.CrossRefPubMed
20.
go back to reference Cochran GW, Snedecor WG. Statistical methods applied to experiments in agriculture and biology. With chapter 17 on sampling by William G. Cochran. 5th ed. Iowa: The Iowa State University Press; 1959. Cochran GW, Snedecor WG. Statistical methods applied to experiments in agriculture and biology. With chapter 17 on sampling by William G. Cochran. 5th ed. Iowa: The Iowa State University Press; 1959.
21.
go back to reference Krishna R, Maithreyi R, Surapaneni KM. Research bias: a review for medical students. J Clin Diagnostic Res. 2010;4:2320–4. Krishna R, Maithreyi R, Surapaneni KM. Research bias: a review for medical students. J Clin Diagnostic Res. 2010;4:2320–4.
22.
go back to reference WHO. Infant and young child feeding. In Infant and young child feeding : model chapter for textbooks for medical students and allied health professionals. 2009:1–99. WHO. Infant and young child feeding. In Infant and young child feeding : model chapter for textbooks for medical students and allied health professionals. 2009:1–99.
24.
go back to reference Flannery V. Increasing breastfeeding rates: evidence-based strategies. Int J Childbirth Educ. 2014;29(4):59–63. Flannery V. Increasing breastfeeding rates: evidence-based strategies. Int J Childbirth Educ. 2014;29(4):59–63.
25.
go back to reference Maonga AR, Mahande MJ, Damian DJ, Msuya SE. Factors affecting exclusive breastfeeding among women in Muheza District Tanga Northeastern Tanzania: a mixed method community based study. Matern Child Health J. 2016;20:77–87.CrossRefPubMed Maonga AR, Mahande MJ, Damian DJ, Msuya SE. Factors affecting exclusive breastfeeding among women in Muheza District Tanga Northeastern Tanzania: a mixed method community based study. Matern Child Health J. 2016;20:77–87.CrossRefPubMed
26.
go back to reference Avery A, Zimmermann K, Underwood PW, Magnus JH. Confident commitment is a key factor for sustained breastfeeding. Birth. 2009;36:141–8.CrossRefPubMed Avery A, Zimmermann K, Underwood PW, Magnus JH. Confident commitment is a key factor for sustained breastfeeding. Birth. 2009;36:141–8.CrossRefPubMed
27.
go back to reference Brand E, Kothari C, Stark MA. Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum. J Perinat Educ. 2011;20(1):36–44. Brand E, Kothari C, Stark MA. Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum. J Perinat Educ. 2011;20(1):36–44.
28.
go back to reference Chalmers B, Levitt C, Heaman M, O’Brien B, Sauve R, Kaczorowski J. Breastfeeding rates and hospital breastfeeding practices in Canada: a national survey of women. Birth. 2009;36:122–32.CrossRefPubMed Chalmers B, Levitt C, Heaman M, O’Brien B, Sauve R, Kaczorowski J. Breastfeeding rates and hospital breastfeeding practices in Canada: a national survey of women. Birth. 2009;36:122–32.CrossRefPubMed
29.
go back to reference Goosen C, McLachlan M, Schübl C. Infant feeding practices during the first 6 months of life in a low-income area of the Western Cape Province. South African J Child Health. 2014;8:50–4.CrossRef Goosen C, McLachlan M, Schübl C. Infant feeding practices during the first 6 months of life in a low-income area of the Western Cape Province. South African J Child Health. 2014;8:50–4.CrossRef
30.
go back to reference Issaka AI, Agho KE, Page AN, Burns P, Stevens GJ, Dibley MJ. Determinants of early introduction of solid, semi-solid or soft foods among infants aged 3–5 months in four Anglophone West African countries. Nutrients. 2014;6:2602–18.CrossRefPubMedPubMedCentral Issaka AI, Agho KE, Page AN, Burns P, Stevens GJ, Dibley MJ. Determinants of early introduction of solid, semi-solid or soft foods among infants aged 3–5 months in four Anglophone West African countries. Nutrients. 2014;6:2602–18.CrossRefPubMedPubMedCentral
31.
go back to reference Kaufman L, Deenadayalan S, Karpati A. Breastfeeding ambivalence among low-income African American and Puerto Rican women in north and central Brooklyn. Matern Child Health J. 2010;14:696–704.CrossRefPubMed Kaufman L, Deenadayalan S, Karpati A. Breastfeeding ambivalence among low-income African American and Puerto Rican women in north and central Brooklyn. Matern Child Health J. 2010;14:696–704.CrossRefPubMed
32.
go back to reference Guendelman S, Kosa JL, Pearl M, Graham S, Goodman J, Kharrazi M. Juggling work and breastfeeding: effects of maternity leave and occupational characteristics. Pediatrics. 2009;123:e38–46.CrossRefPubMed Guendelman S, Kosa JL, Pearl M, Graham S, Goodman J, Kharrazi M. Juggling work and breastfeeding: effects of maternity leave and occupational characteristics. Pediatrics. 2009;123:e38–46.CrossRefPubMed
33.
go back to reference Rojjanasrirat W, Sousa VD. Perceptions of breastfeeding and planned return to work or school among low-income pregnant women in the USA. J Clin Nurs. 2010;19:2014–22.CrossRefPubMed Rojjanasrirat W, Sousa VD. Perceptions of breastfeeding and planned return to work or school among low-income pregnant women in the USA. J Clin Nurs. 2010;19:2014–22.CrossRefPubMed
34.
go back to reference de Toledo Vianna RP, Ferreira Rea M, Isoyama Venancio S, Escuder MM. Breastfeeding practices among paid working mothers in Paraíba State, Brazil: a cross-sectional study. Cad Saude Publica. 2007;23:2403–9.CrossRef de Toledo Vianna RP, Ferreira Rea M, Isoyama Venancio S, Escuder MM. Breastfeeding practices among paid working mothers in Paraíba State, Brazil: a cross-sectional study. Cad Saude Publica. 2007;23:2403–9.CrossRef
35.
go back to reference Osis MJD, Duarte GA, de Pádua KS, Hardy E, Sandoval LEM, Bento SF. Exclusive breastfeeding among working women with free daycare available at workplace. Rev Saude Publica. 2004;38:172–9.CrossRefPubMed Osis MJD, Duarte GA, de Pádua KS, Hardy E, Sandoval LEM, Bento SF. Exclusive breastfeeding among working women with free daycare available at workplace. Rev Saude Publica. 2004;38:172–9.CrossRefPubMed
36.
go back to reference Aryeetey RNO, Goh YE. Duration of exclusive breastfeeding and subsequent child feeding adequacy. Ghana Med J. 2013;47:24–9.PubMedPubMedCentral Aryeetey RNO, Goh YE. Duration of exclusive breastfeeding and subsequent child feeding adequacy. Ghana Med J. 2013;47:24–9.PubMedPubMedCentral
37.
38.
go back to reference Vaughn LM, Ireton C, Geraghty SR, Diers T, Niño V, Falciglia GA, Valenzuela J, Mosbaugh C. Sociocultural influences on the determinants of breast-feeding by Latina mothers in the Cincinnati area. Fam Community Health. 2010;33:318–28.CrossRefPubMed Vaughn LM, Ireton C, Geraghty SR, Diers T, Niño V, Falciglia GA, Valenzuela J, Mosbaugh C. Sociocultural influences on the determinants of breast-feeding by Latina mothers in the Cincinnati area. Fam Community Health. 2010;33:318–28.CrossRefPubMed
39.
go back to reference Ong G, Yap M, Li FL, Choo TB. Impact of working status on breastfeeding in Singapore: evidence from the National Breastfeeding Survey 2001. Eur J Public Health. 2005;15:424–30.CrossRefPubMed Ong G, Yap M, Li FL, Choo TB. Impact of working status on breastfeeding in Singapore: evidence from the National Breastfeeding Survey 2001. Eur J Public Health. 2005;15:424–30.CrossRefPubMed
40.
go back to reference Parada CMG de L, Carvalhaes MA de BL, Jamas MT. Complementary feeding practices to children during their first year of life. Revista Latino-Americana de Enfermagem. 2007:15(2):282–89. Parada CMG de L, Carvalhaes MA de BL, Jamas MT. Complementary feeding practices to children during their first year of life. Revista Latino-Americana de Enfermagem. 2007:15(2):282–89.
41.
go back to reference Datta J, Graham B, Wellings K. The role of fathers in breastfeeding: decision-making and support. Br J Midwifery. 2012;20:159–67.CrossRef Datta J, Graham B, Wellings K. The role of fathers in breastfeeding: decision-making and support. Br J Midwifery. 2012;20:159–67.CrossRef
42.
go back to reference Jedrychowski W, Perera F, Jankowski J, Butscher M, Mroz E, Flak E, Kaim I, Lisowska-Miszczyk I, Skarupa A, Sowa A. Effect of exclusive breastfeeding on the development of children’s cognitive function in the Krakow prospective birth cohort study. Eur J Pediatr. 2012;171:151–8.CrossRefPubMed Jedrychowski W, Perera F, Jankowski J, Butscher M, Mroz E, Flak E, Kaim I, Lisowska-Miszczyk I, Skarupa A, Sowa A. Effect of exclusive breastfeeding on the development of children’s cognitive function in the Krakow prospective birth cohort study. Eur J Pediatr. 2012;171:151–8.CrossRefPubMed
43.
go back to reference Koosha A, Hashemifesharaki R, Mousavinasab N. Breast-feeding patterns and factors determining exclusive breast-feeding. Singapore Med J. 2008;49:1002–6.PubMed Koosha A, Hashemifesharaki R, Mousavinasab N. Breast-feeding patterns and factors determining exclusive breast-feeding. Singapore Med J. 2008;49:1002–6.PubMed
Metadata
Title
Challenges and predictors of exclusive breastfeeding among mothers attending the child welfare clinic at a regional hospital in Ghana: a descriptive cross-sectional study
Authors
Abigail Kusi-Amponsah Diji
Victoria Bam
Ernest Asante
Alberta Yemotsoo Lomotey
Samuel Yeboah
Haim Acquah Owusu
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Breastfeeding Journal / Issue 1/2016
Electronic ISSN: 1746-4358
DOI
https://doi.org/10.1186/s13006-017-0104-2

Other articles of this Issue 1/2016

International Breastfeeding Journal 1/2016 Go to the issue