Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

“We give water or porridge, but we don’t really know what the child wants:” a qualitative study on women’s perceptions and practises regarding exclusive breastfeeding in Kilimanjaro region, Tanzania

Authors: Melina Mgongo, Tamara H. Hussein, Babill Stray-Pedersen, Siri Vangen, Sia E. Msuya, Margareta Wandel

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Login to get access

Abstract

Background

World Health Organization (WHO) recommends exclusive breastfeeding (EBF) as the optimal way to feed infants below 6 months of age. The benefits of EBF are well documented. However, in Tanzania, EBF is still rarely practised. This study explored the knowledge, attitudes and practises of EBF among mothers in Kilimanjaro region of northern Tanzania.

Methods

This is a qualitative research study. The three districts in Kilimanjaro region namely Same, Moshi Municipal Council and Rombo districts were selected. In each district, three focus group discussions (FGDs) with mothers of infants aged 0–12 months were conducted. A total of 78 mothers participated in the focus group discussion.

Results

The main result is that most of the mothers had a theoretical knowledge of the benefits of EBF but were not able to practise this knowledge for a range of reasons. The reasons for not practising EBF in real life included poor maternal nutrition, the pressure for women to return to work, inadequate knowledge about expressing breast milk, and perceived insufficiency of milk supply. Additionally, mothers received conflicting advice from a range of sources including close relatives, community members and health care providers, and they often choose the advice of their elders. Mothers also offered suggestions on ways to improve EBF including educating the community on the benefits of EBF.

Conclusion

The results show that the women need support from close relatives and employers to successfully practise EBF. This presents a need for involving close relatives in EBF interventions, as they are important sources of breastfeeding information in the community. Additionally, behavioural interventions that promote optimal breastfeeding practises might help to improve exclusive breastfeeding.
Literature
1.
2.
Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, Survival C. Child survival II how many child deaths can we prevent this year? Lancet. 2003;362:65–71.CrossRefPubMed
3.
UNICEF and WHO. Indicators for assessing infant and young child feeding practices. Part 1 Definitions. Geneva: WHO; 2008.
4.
Jackson KM, Nazar AM. Breastfeeding, the immune response and long –term health. Am Osteopath Assoc. 2006;106(4):203–7.
5.
Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding: a systematic review. AdvExp Med Biol. 2004;554:63–77.CrossRef
6.
Iliff PJ, Piwoz EG, Tavengwa NV, Zunguza CD, Marinda ET, Nathoo KJ, Moullton LH, Ward BJ, Humphrey JH. Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS. 2005;19(7):699–708.CrossRefPubMed
7.
Black RE, Alderman H, Bhutta ZA, Gillespie S, Haddad L, Horton S, Lartey A, Mannar V, Ruel M, Victora CG, et al. Maternal and child nutrition: Building momentum for impact. Lancet. 2013; 382:372–375.
8.
9.
Victora CG, Bahl R, Barros AJD, Franca GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.CrossRefPubMed
10.
11.
Yalcin SS, Berde AS, Yalcin S. Determinants of exclusive breastfeeding in sub Saharan Africa: a multilevel approach. Paediatr Perinat Epidemiol. 2016;30(5):439–49.CrossRefPubMed
12.
Ministry of Health and Social Welfare. The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania 2008–2015, Sharpened One Plan; Dares salaam, Tanzania, Ministry of health and social welfare, 2008.
13.
Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar] National Bureau of Statistics (NBS); Office of the Chief Government Statistician (OCGS), and ICF International. Tanzania and Demographic Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015–2016. Dar es Salaam and Rockville: (MoHCDGEC) USA: MoHSW, MoH, NBS, OCGS and ICF International; 2016.
14.
Mgongo M, Hashim TH, Uriyo JG, Damian DJ, Stray-Pedersen B, Msuya SE. Determinants of exclusive breastfeeding in Kilimanjaro region, Tanzania. Science J Public Health. 2014;2(6):631–5.
15.
Shirima R, Greiner T, Kylberg E, Gebre-Medhin M. Exclusive breast-feeding is rarely practiced in rural and urban Morogoro, Tanzania. Public Health Nutrition. 2000;4(02):147–54.
16.
Nkala TE, Msuya SE. 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
17.
Mgongo M, Mosha MV, Uriyo JG, Msuya SE, Straypedersen B. Prevalence and predictors of exclusive breastfeeding among women in Kilimanjaro region, northern Tanzania: a population based cross-sectional study. Int Breastfeed J. 2013;8(1):1–8.CrossRef
18.
Fjeld E, Siziya S, Katepa-Bwalya M, Kankasa C, Moland KM, Tylleskӓr T. ‘No sister the breast alone is not enough for my baby’ a qualitative assessment of potentials and barriers in the promotion of exclusive breastfeeding in southern Zambia. Int Breastfeed J. 2008;3:26.CrossRefPubMedPubMedCentral
19.
Hashim TH, Mgongo M, Katanga J, Uriyo JG, Damian DJ, Stray-Pedersen B, Wandel M, Msuya SE. Predictors of appropriate breastfeeding knowledge among pregnant women in Moshi Urban, Tanzania: a cross-sectional study. Int Breastfeed J. 2017;12:11.CrossRefPubMedPubMedCentral
20.
Leshabari SC, Blystad A, Moland KM. Difficult choices: Infant feeding experiences of HIV-positive mothers in northern Tanzania. SAHARA-J. 2007;4(1):544–55.CrossRefPubMed
21.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
22.
Lee HMH, Durham J, Booth J, Sychareun V. A qualitative study on the breastfeeding experiences of first time mothers in Vientiane, Lao PDR. BMC Pregnancy Childbirth. 2013;13:223.CrossRefPubMedPubMedCentral
23.
Wanjohi M, Griffiths P, Wekesah F, Muriuki P, Muhia N, Musoke RN, Fouts HN, Madise NJ, Kimani-Murage EW. Social cultural factors influencing breastfeeding practices in two slums in Nairobi Kenya. Int.breastfeed J. 2017;12:5.CrossRefPubMedPubMedCentral
24.
Osman H, El Zein L, Wick L. Cultural beliefs that may discourage breastfeeding among Lebanese women: a qualitative analysis. Int Breastfeed J. 2009;4:12.CrossRefPubMedPubMedCentral
25.
26.
Choo PJ, Ryan K. A qualitative study exploring first time mothers experiences of breastfeeding in Singapore. Proceedings of Singapore Healthcare. 2016;25(1):5–12.CrossRef
27.
Maonga AR, Mahande MJ, Msuya SE. Factors affecting exclusive breastfeeding among women in Muheza District Tanga north eastern Tanzania: a mixed method community based study. Matern Child Health J. 2016;20:77–87.CrossRefPubMed
28.
Chen A, Rogan WJ. Breastfeeding and risk of postneonatal deaths in the United States. Paediatrics. 2004;113(5):e435–9.CrossRef
29.
30.
WHO, UNICEF, USAID. Improving nutrition outcomes with better water, sanitation and hygiene: practical solutions for policies and programmers, WHO 2015.
31.
Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. The impact of water sanitation on childhood mortality in Nigeria: evidence from the demographic and health surveys 2003-2013. Inte J Environ Res Public Health. 2014;11:9256–76.CrossRef
32.
Me TM, Khaing EE, Diamond-Smith N, Sudhinaraset M, Oo S, Aung T. Barriers to exclusive breastfeeding in the Ayeyarwaddy Region in Myanmar: Qualitative findings from mothers, grandmothers and husbands. Appetite. 2016;96:62–9.CrossRef
33.
Frota MA, Mamede ALS, Vieira LJES, de Albuquerque CM, Martins MC. Culturalpractices about breastfeeding among families enrolled in a family health program. Rev Esc Enferm USP. 2009;43(4):890–6.CrossRef
34.
Thepha T, Marais D, Bell J, Muangpin S. Facilitators and barriers to exclusive breastfeeding in Thailand: a narrative review. J Comm Pub Health Nurs. 2017;3:1.CrossRef
35.
Ratnasari D, Paramashanti BA, Hadi H, Yugistyowati A, Astiti D, Nurhayati E. Family support and exclusive breastfeeding among Yogyakarta mothers in employment. Asia Pac J ClinNutr. 2017;26(suppl 1):S31–5.
36.
WHO. Evidence for the ten steps to successful breastfeeding. 1998.
37.
Amir LH, Donath SM. Maternal diet and breastfeeding: a case for rethinking physiological explanations for breastfeeding determinants. Early Hum Dev. 2012;88(7):467–71.CrossRefPubMed
Metadata
Title
“We give water or porridge, but we don’t really know what the child wants:” a qualitative study on women’s perceptions and practises regarding exclusive breastfeeding in Kilimanjaro region, Tanzania
Authors
Melina Mgongo
Tamara H. Hussein
Babill Stray-Pedersen
Siri Vangen
Sia E. Msuya
Margareta Wandel
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1962-3

Other articles of this Issue 1/2018

BMC Pregnancy and Childbirth 1/2018 Go to the issue

Study protocol

Effectiveness of an educational group intervention in primary healthcare for continued exclusive breast-feeding: PROLACT study

Study protocol

The Indigenous Birthing in an Urban Setting study: the IBUS study

Case report

Resolution of maternal Mirror syndrome after succesful fetal intrauterine therapy: a case series

Review

Pregnancy after bariatric surgery: a narrative literature review and discussion of impact on pregnancy management and outcome

Research article

Obstetric outcomes and effects on babies born to women treated for epilepsy during pregnancy in a resource limited setting: a comparative cohort study

Research article

Pregnancy risk factors associated with birthweight of infants born to Australian Aboriginal women in an urban setting - a retrospective cohort study