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Published in: International Breastfeeding Journal 1/2018

Open Access 01-12-2018 | Research

Knowledge of, and attitudes to giving expressed breastmilk to infants in rural coastal Kenya; focus group discussions of first time mothers and their advisers

Authors: Alison W. Talbert, Benjamin Tsofa, Edward Mumbo, James A. Berkley, Martha Mwangome

Published in: International Breastfeeding Journal | Issue 1/2018

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Abstract

Background

The World Health Organization (WHO)/UNICEF Baby-Friendly Hospital Initiative step number five of the “Ten steps to successful breastfeeding” states “Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants.” Urban mothers in Nairobi have low rates of exclusive breastfeeding after returning to work but there are no published data on rural Kenya mothers’ infant feeding practices when working or schooling away from home.

Methods

We explored knowledge of, and attitudes to, the practice of giving expressed breastmilk in a mixed methods observational study of breastfeeding in rural Kenyan mothers. Fifty mothers with newborns, identified by nurses and community health workers, were asked questions about their experiences of breastfeeding and who they had sought or received advice from on breastfeeding. Focus group discussions, one with community health workers, and four each with mothers and their named advisers were held. Recordings were analyzed using a thematic framework approach.

Results

The main themes were: the baby’s right to feed from the breast, lack of knowledge about expressing and giving breastmilk, negative attitudes towards expressed breastmilk, and traditional customs for disposing of expressed breast milk. Most participants did not have any experience of giving expressed breastmilk to infants. They described practices of expressing and discarding milk when the mother or baby was ill, to relieve discomfort from engorgement or after the baby had died.

Conclusions

Feeding expressed breastmilk to infants is a new concept in this context. Promotion of, and training in this practice would help mothers to maintain their milk supply when away from their babies and benefit the infants of working and schoolgirl mothers.
Literature
4.
go back to reference Marino DD. Water and food safety in the developing world: global implications for health and nutrition of infants and young children. J Am Diet Assoc. 2007;107(11):1930–4.CrossRefPubMed Marino DD. Water and food safety in the developing world: global implications for health and nutrition of infants and young children. J Am Diet Assoc. 2007;107(11):1930–4.CrossRefPubMed
5.
go back to reference Bahl R, Frost C, Kirkwood BR, Edmond K, Martines J, Bhandari N, et al. Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study. Bull World Health Organ. 2005;83(6):418–26.PubMedPubMedCentral Bahl R, Frost C, Kirkwood BR, Edmond K, Martines J, Bhandari N, et al. Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study. Bull World Health Organ. 2005;83(6):418–26.PubMedPubMedCentral
6.
go back to reference Kimani-Murage EW, Wekesah F, Wanjohi M, Kyobutungi C, Ezeh AC, Musoke RN, et al. Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in Kenya. Matern Child Nutr. 2015;11(3):314–32.CrossRefPubMed Kimani-Murage EW, Wekesah F, Wanjohi M, Kyobutungi C, Ezeh AC, Musoke RN, et al. Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in Kenya. Matern Child Nutr. 2015;11(3):314–32.CrossRefPubMed
7.
go back to reference Talbert AW, Ngari M, Tsofa B, Mramba L, Mumbo E, Berkley JA, et al. "when you give birth you will not be without your mother" a mixed methods study of advice on breastfeeding for first-time mothers in rural coastal Kenya. Int Breastfeed J. 2016;11:10.CrossRefPubMedPubMedCentral Talbert AW, Ngari M, Tsofa B, Mramba L, Mumbo E, Berkley JA, et al. "when you give birth you will not be without your mother" a mixed methods study of advice on breastfeeding for first-time mothers in rural coastal Kenya. Int Breastfeed J. 2016;11:10.CrossRefPubMedPubMedCentral
8.
go back to reference Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117.CrossRefPubMedPubMedCentral Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117.CrossRefPubMedPubMedCentral
9.
go back to reference Government of Kenya Ministry of Public Health and Sanitation. National school health policy. Nairobi 2009. Government of Kenya Ministry of Public Health and Sanitation. National school health policy. Nairobi 2009.
11.
go back to reference Chantry CJ, Wiedeman J, Buehring G, Peerson JM, Hayfron K, K'Aluoch O, et al. Effect of flash-heat treatment on antimicrobial activity of breastmilk. Breastfeed Med. 2011;6(3):111–6.CrossRefPubMedPubMedCentral Chantry CJ, Wiedeman J, Buehring G, Peerson JM, Hayfron K, K'Aluoch O, et al. Effect of flash-heat treatment on antimicrobial activity of breastmilk. Breastfeed Med. 2011;6(3):111–6.CrossRefPubMedPubMedCentral
13.
go back to reference Young S, Leshabari S, Arkfeld C, Singler J, Dantzer E, Israel-Ballard K, et al. Barriers and promoters of home-based pasteurization of breastmilk among HIV-infected mothers in greater Dar es salaam, Tanzania. Breastfeed Med. 2013;8(3):321–6.CrossRefPubMedPubMedCentral Young S, Leshabari S, Arkfeld C, Singler J, Dantzer E, Israel-Ballard K, et al. Barriers and promoters of home-based pasteurization of breastmilk among HIV-infected mothers in greater Dar es salaam, Tanzania. Breastfeed Med. 2013;8(3):321–6.CrossRefPubMedPubMedCentral
15.
go back to reference Tylleskar T, Jackson D, Meda N, Engebretsen IM, Chopra M, Diallo AH, et al. Exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa (PROMISE-EBF): a cluster-randomised trial. Lancet. 2011;378(9789):420–7.CrossRefPubMed Tylleskar T, Jackson D, Meda N, Engebretsen IM, Chopra M, Diallo AH, et al. Exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa (PROMISE-EBF): a cluster-randomised trial. Lancet. 2011;378(9789):420–7.CrossRefPubMed
16.
Metadata
Title
Knowledge of, and attitudes to giving expressed breastmilk to infants in rural coastal Kenya; focus group discussions of first time mothers and their advisers
Authors
Alison W. Talbert
Benjamin Tsofa
Edward Mumbo
James A. Berkley
Martha Mwangome
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Breastfeeding Journal / Issue 1/2018
Electronic ISSN: 1746-4358
DOI
https://doi.org/10.1186/s13006-018-0158-9

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