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Published in: BMC Pregnancy and Childbirth 1/2020

Open Access 01-12-2020 | Research article

“Once the child is delivered, he is no more your baby,” Exclusive Breastfeeding experiences of first-time mothers in Kassena-Nankana Municipality, Ghana - a qualitative study

Authors: Louisa Adda, Kwabena Opoku-Mensah, Phyllis Dako-Gyeke

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

Exclusive Breastfeeding (EBF), for the first 6 months of life, is globally accepted as the preferred method for infant feeding. In Ghana, an estimated 84% of children < 2 months old are exclusively breastfed.
But by age 4 to 5 months, only 49% continue to receive EBF. This situation continues to deteriorate. Thus, the need to explore perceptions, practices as well as factors that influence EBF in Ghana.

Methods

Using a qualitative design, four focus group discussions were conducted among first-time mothers and eight in-depth interviews with health workers and traditional birth attendants. The study was conducted in four communities in the Kassena-Nankana municipality of Ghana. Discussions and interviews were recorded and later transcribed verbatim to English language. The transcribed data was then coded with the aid of analysis computer software (Nvivo version 10.0) and later analyzed for the generation of themes.

Results

Exclusive breastfeeding is practiced among first-time mothers due to its perceived benefits; which include nutritional advantage, ability to enhance growth whilst boosting immunity and its economic value. However misconceptions as well as, certain cultural practices (e.g. giving herbal concoctions, breastmilk purification rites), and relational influences, may threaten a mother’s intention to exclusively breastfeed. Relational influences are mainly from mother in-laws, traditional birth attendants, grandmothers, herbalists and other older adults in the community.

Conclusions

Although first time mothers attempt EBF, external influences make it practically challenging. The availability and utilization of information on EBF was found to positively influence perceptions towards EBF, leading to change in attitude towards the act. Thus, the practice of community-based health services may be strengthened to provide support for first-time mothers as well as continuous education to the mother in laws, female elders and community leaders who influence decision making on breastfeeding of infants.
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Literature
1.
go back to reference Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding 1 Breastfeeding in the 21st century : epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.CrossRef Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding 1 Breastfeeding in the 21st century : epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.CrossRef
2.
go back to reference World Health Organization. The World Health Organization’s infant feeding recommendation. 2002;53:5–6. World Health Organization. The World Health Organization’s infant feeding recommendation. 2002;53:5–6.
3.
go back to reference UNICEF. From the first hour of life: making the case for improved infant and young child feeding everywhere. New York: UNICEF; 2016. p. 8. UNICEF. From the first hour of life: making the case for improved infant and young child feeding everywhere. New York: UNICEF; 2016. p. 8.
4.
go back to reference Soliman SM, Soliman AM, Bakr MS. Relationships between maternal nutritional status, quantity and composition of breast milk in Egypt. Afr J Ag Sci Technol. 2014;2:59–64. Soliman SM, Soliman AM, Bakr MS. Relationships between maternal nutritional status, quantity and composition of breast milk in Egypt. Afr J Ag Sci Technol. 2014;2:59–64.
5.
go back to reference Butte NF, Lopez-Alarcon MG, Garza C. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life; 2002. Butte NF, Lopez-Alarcon MG, Garza C. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life; 2002.
6.
go back to reference Rochat TJ, Houle B, Stein A, Coovadia H, Coutsoudis A, Desmond C, et al. Exclusive breastfeeding and cognition, executive function, and behavioural disorders in primary school-aged children in rural South Africa: a cohort analysis. PLoS Med. 2016;13(6):e1002044.CrossRef Rochat TJ, Houle B, Stein A, Coovadia H, Coutsoudis A, Desmond C, et al. Exclusive breastfeeding and cognition, executive function, and behavioural disorders in primary school-aged children in rural South Africa: a cohort analysis. PLoS Med. 2016;13(6):e1002044.CrossRef
7.
go back to reference Holloway H. Health benefits of breastfeeding for infants, leading to developmental differences between breast-fed and formula-fed infants; 2017. Holloway H. Health benefits of breastfeeding for infants, leading to developmental differences between breast-fed and formula-fed infants; 2017.
8.
go back to reference Bar S, Milanaik R, Adesman A. Long-term neurodevelopmental benefits of breastfeeding. Curr Opin Pediatr. 2016;28(4):559–66.CrossRef Bar S, Milanaik R, Adesman A. Long-term neurodevelopmental benefits of breastfeeding. Curr Opin Pediatr. 2016;28(4):559–66.CrossRef
9.
go back to reference Zivich P, Lapika B, Behets F, Yotebieng M. Implementation of steps 1–9 to successful breastfeeding reduces the frequency of mild and severe episodes of diarrhea and respiratory tract infection among 0–6 month infants in Democratic Republic of Congo. Matern Child Health J. 2018;22(5):762–71.CrossRef Zivich P, Lapika B, Behets F, Yotebieng M. Implementation of steps 1–9 to successful breastfeeding reduces the frequency of mild and severe episodes of diarrhea and respiratory tract infection among 0–6 month infants in Democratic Republic of Congo. Matern Child Health J. 2018;22(5):762–71.CrossRef
10.
go back to reference Banerjee N, Chakraborty A, Lahiri A, Biswas K. Exclusive breast feeding reduces diarrhoeal episodes among children: results from a cross-sectional study among the mothers of under-five children in Kolkata. Int J Community Med Public Heal. 2019;6(2):733–7.CrossRef Banerjee N, Chakraborty A, Lahiri A, Biswas K. Exclusive breast feeding reduces diarrhoeal episodes among children: results from a cross-sectional study among the mothers of under-five children in Kolkata. Int J Community Med Public Heal. 2019;6(2):733–7.CrossRef
11.
go back to reference Binns C, Lee M, Low WY. The long-term public health benefits of breastfeeding. Asia Pacific J Public Heal. 2016;28(1):7–14.CrossRef Binns C, Lee M, Low WY. The long-term public health benefits of breastfeeding. Asia Pacific J Public Heal. 2016;28(1):7–14.CrossRef
12.
go back to reference Fewtrell MS. The long-term benefits of having been breast-fed. Curr Paediatr. 2004;14(2):97–103.CrossRef Fewtrell MS. The long-term benefits of having been breast-fed. Curr Paediatr. 2004;14(2):97–103.CrossRef
13.
go back to reference Walker N, Tam Y, Friberg IK. Overview of the lives saved tool (LiST). BMC Public Health. 2013;13(Suppl 3). Walker N, Tam Y, Friberg IK. Overview of the lives saved tool (LiST). BMC Public Health. 2013;13(Suppl 3).
14.
go back to reference World Health Organization, UNICEF. Global nutrition targets 2025: breastfeeding policy brief. WHO; 2014. World Health Organization, UNICEF. Global nutrition targets 2025: breastfeeding policy brief. WHO; 2014.
15.
go back to reference GSS GHS, Macro ICF. Ghana demographic and health survey 2014. Ghana Stat Serv Ghana Heal Serv ICF Int 2015. GSS GHS, Macro ICF. Ghana demographic and health survey 2014. Ghana Stat Serv Ghana Heal Serv ICF Int 2015.
16.
go back to reference Labbok MH, Wardlaw T, Blanc A, Clark D, Terreri N. Trends in exclusive breastfeeding: findings from the 1990s. J Hum Lact. 2006;22(3):272–6.CrossRef Labbok MH, Wardlaw T, Blanc A, Clark D, Terreri N. Trends in exclusive breastfeeding: findings from the 1990s. J Hum Lact. 2006;22(3):272–6.CrossRef
17.
go back to reference Cai X, Wardlaw T, Brown DW. Global trends in exclusive breastfeeding. Int Breastfeed J. 2012;7(1):12.CrossRef Cai X, Wardlaw T, Brown DW. Global trends in exclusive breastfeeding. Int Breastfeed J. 2012;7(1):12.CrossRef
18.
go back to reference Lee HM, Durham J, Booth J, et al. A qualitative study on the breastfeeding experiences of first-time mothers in Vientiane, Lao PDR. BMC Pregnancy Childbirth. 2013;13:223.CrossRef Lee HM, Durham J, Booth J, et al. A qualitative study on the breastfeeding experiences of first-time mothers in Vientiane, Lao PDR. BMC Pregnancy Childbirth. 2013;13:223.CrossRef
19.
go back to reference Hussein TH, Mgongo M, Uriyo JG, Damian DJ, Stray-pedersen B, Msuya SE. Exclusive Breastfeeding Rates and Factors Associated with Exclusive Breastfeeding Practices in Northern Tanzania: Measurement using Two Different Methodologies — 24 Hours Recall and Recall Since Birth. Int J MCH AIDS. 2019;8(1):32–43. Hussein TH, Mgongo M, Uriyo JG, Damian DJ, Stray-pedersen B, Msuya SE. Exclusive Breastfeeding Rates and Factors Associated with Exclusive Breastfeeding Practices in Northern Tanzania: Measurement using Two Different Methodologies — 24 Hours Recall and Recall Since Birth. Int J MCH AIDS. 2019;8(1):32–43.
20.
go back to reference Alemayehu T, Haidar J, Habte D. Determinants of exclusive breastfeeding practices in Ethiopia; 2005. Alemayehu T, Haidar J, Habte D. Determinants of exclusive breastfeeding practices in Ethiopia; 2005.
21.
go back to reference Choo PJ, Ryan K. A qualitative study exploring first time mothers ’ experiences of breastfeeding in Singapore; 2016. Choo PJ, Ryan K. A qualitative study exploring first time mothers ’ experiences of breastfeeding in Singapore; 2016.
22.
go back to reference United Nations. Sustainable Development Goals. Sustain Dev Goals - 17 Goals To Transform Our World; 2015. p. 1–18. United Nations. Sustainable Development Goals. Sustain Dev Goals - 17 Goals To Transform Our World; 2015. p. 1–18.
23.
go back to reference World Health Organization. alth., UNICEF. Global nutrition targets 2025: breastfeeding policy brief. Geneva: WHO; 2014. World Health Organization. alth., UNICEF. Global nutrition targets 2025: breastfeeding policy brief. Geneva: WHO; 2014.
24.
go back to reference Adokiya MN. complementary feeding practices and nutrition status of young children 06–23 months of age in the Kassena-Nankana district, Upper East Region, ghana; 2010. Adokiya MN. complementary feeding practices and nutrition status of young children 06–23 months of age in the Kassena-Nankana district, Upper East Region, ghana; 2010.
25.
go back to reference Green J, Thorogood N. Qualitative methods for Health Research - Judith Green, Nicki Thorogood - Google books. Thousand Oaks: SAGE; 2018. Green J, Thorogood N. Qualitative methods for Health Research - Judith Green, Nicki Thorogood - Google books. Thousand Oaks: SAGE; 2018.
26.
go back to reference Oduro AR, Wak G, Azongo D, Debpuur C, Wontuo P, Kondayire F, et al. Profile of the Navrongo health and demographic surveillance system. Int J Epidemiol. 2012;41(4):968–76.CrossRef Oduro AR, Wak G, Azongo D, Debpuur C, Wontuo P, Kondayire F, et al. Profile of the Navrongo health and demographic surveillance system. Int J Epidemiol. 2012;41(4):968–76.CrossRef
27.
go back to reference Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. Res Des Qual Quant Mix methods approaches. 2009;3rd:260. Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. Res Des Qual Quant Mix methods approaches. 2009;3rd:260.
28.
go back to reference Creswell JW. Chapter 3: designing a qualitative study. Qual Inq Res Des Choos among five approaches; 2007. p. 35–41. Creswell JW. Chapter 3: designing a qualitative study. Qual Inq Res Des Choos among five approaches; 2007. p. 35–41.
29.
go back to reference World Health Organization. The optimal duration of exclusive breastfeeding: report of an expert consultation. 2002. Geneva: World Heal Organ; 2009. World Health Organization. The optimal duration of exclusive breastfeeding: report of an expert consultation. 2002. Geneva: World Heal Organ; 2009.
30.
go back to reference Hennink MM, Kaiser BN, Weber MB. What influences saturation? Estimating sample sizes in focus group research. Qual Health Res. 2019;29(10):1483–96.CrossRef Hennink MM, Kaiser BN, Weber MB. What influences saturation? Estimating sample sizes in focus group research. Qual Health Res. 2019;29(10):1483–96.CrossRef
31.
go back to reference Abasiattai AM, Etukumana EA, Nyong E, Eyo UE. Knowledge and practice of exclusive breastfeeding among antenatal attendees in Uyo. Southern Nigeria Gaziantep Med J. 2014;20(2):130–5.CrossRef Abasiattai AM, Etukumana EA, Nyong E, Eyo UE. Knowledge and practice of exclusive breastfeeding among antenatal attendees in Uyo. Southern Nigeria Gaziantep Med J. 2014;20(2):130–5.CrossRef
32.
go back to reference Heymann J, Raub A, Earle A. Breastfeeding policy: a globally comparative analysis. Bull World Health Organ. 2013;91:398–406.CrossRef Heymann J, Raub A, Earle A. Breastfeeding policy: a globally comparative analysis. Bull World Health Organ. 2013;91:398–406.CrossRef
33.
go back to reference Cripe ET. “You can’t bring your cat to work”: challenges mothers face combining breastfeeding and working. Qual Res Reports Commun. 2017;18(1):36–44.CrossRef Cripe ET. “You can’t bring your cat to work”: challenges mothers face combining breastfeeding and working. Qual Res Reports Commun. 2017;18(1):36–44.CrossRef
34.
go back to reference Sulaiman Z, Liamputtong P, Amir LH. The enablers and barriers to continue breast milk feeding in women returning to work. J Adv Nurs. 2016;72(4):825–35.CrossRef Sulaiman Z, Liamputtong P, Amir LH. The enablers and barriers to continue breast milk feeding in women returning to work. J Adv Nurs. 2016;72(4):825–35.CrossRef
35.
go back to reference Baum WM. Understanding behaviorism: behavior, culture, and evolution. Chichester: Wiley; 2017. Baum WM. Understanding behaviorism: behavior, culture, and evolution. Chichester: Wiley; 2017.
36.
go back to reference Hofstede G. The cultural relativity of organizational practices and theories. J Int Bus Stud. 1983;14(2):75–89.CrossRef Hofstede G. The cultural relativity of organizational practices and theories. J Int Bus Stud. 1983;14(2):75–89.CrossRef
37.
go back to reference Berhe H, Mekonnen B, Bayray A, Berhe H. Determinants of breast feeding practices among mothers attending public health facilities, Mekelle, northern Ethiopia; a cross sectional study. Int J Pharm Sci Res. 2013;4(2):650. Berhe H, Mekonnen B, Bayray A, Berhe H. Determinants of breast feeding practices among mothers attending public health facilities, Mekelle, northern Ethiopia; a cross sectional study. Int J Pharm Sci Res. 2013;4(2):650.
38.
go back to reference Triandis HC. Individualism and collectivism. New York: Routledge; 2018. Triandis HC. Individualism and collectivism. New York: Routledge; 2018.
39.
go back to reference Cox K, Giglia R, Zhao Y, Binns CW. Factors associated with exclusive breastfeeding at hospital discharge in rural Western Australia. J Hum Lact. 2014;30(4):488–97.CrossRef Cox K, Giglia R, Zhao Y, Binns CW. Factors associated with exclusive breastfeeding at hospital discharge in rural Western Australia. J Hum Lact. 2014;30(4):488–97.CrossRef
40.
go back to reference Aborigo RA, Moyer CA, Rominski S, Adongo P, Williams J, Logonia G, et al. Infant nutrition in the first seven days of life in rural northern Ghana. BMC Pregnancy Childbirth. 2012;12(1):76.CrossRef Aborigo RA, Moyer CA, Rominski S, Adongo P, Williams J, Logonia G, et al. Infant nutrition in the first seven days of life in rural northern Ghana. BMC Pregnancy Childbirth. 2012;12(1):76.CrossRef
Metadata
Title
“Once the child is delivered, he is no more your baby,” Exclusive Breastfeeding experiences of first-time mothers in Kassena-Nankana Municipality, Ghana - a qualitative study
Authors
Louisa Adda
Kwabena Opoku-Mensah
Phyllis Dako-Gyeke
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03272-5

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