1Online Postgraduate Education, University of Liverpool, Liverpool, UK.
2Department of Public Health and Policy, School of Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
Int Breastfeed J. 2019 Aug 20;14:38. doi: 10.1186/s13006-019-0231-z. eCollection 2019.
Suboptimal breastfeeding is responsible for 96% of deaths among children under 12 months of age in developing countries. However, the exclusive breastfeeding rate in Nigeria from birth to 6 months is just 23%. The study explored the sociocultural factors that influence exclusive breastfeeding among rural mothers.
The social constructionism-interpretivist epistemological approach underpinned this qualitative study. Semi-structured interviews were conducted with 20 mothers aged 18-39 years, purposefully sampled from two Local Government Areas in Katsina State, Nigeria. Thematic content approach was utilised for analysis.
Three major themes were developed from the analysis: (1) Breastfeeding initiation - the determinants of how soon a mother initiated breastfeeding included traditional new-born care practices, the birth attendant and place of delivery. (2) Exclusive breastfeeding - motivation to sustain exclusive breastfeeding was influenced by the conflict between the obligation to perform traditional rites, the mother's awareness and family support. (3) Decision-making about infant feeding - the husband, grandmother, traditional birth attendant and the health workers all influenced participants' decisions around infant feeding. Despite awareness of the benefits of exclusive breastfeeding among most mothers interviewed, they expressed concerns that they may not win their family's support if their views were contrary to those held by other family members.
While mothers have limited powers to make decisions, the key role that grandmothers and husbands have in decisions about breastfeeding demonstrates the need to engage the support of partners and relatives through community-driven policies and integrated interventions that address social and cultural barriers throughout the prenatal and postnatal period.
发展中国家 12 个月以下儿童死亡中，96%可归咎于母乳喂养不足。然而，尼日利亚从出生到 6 个月的纯母乳喂养率仅为 23%。本研究探讨了影响农村母亲纯母乳喂养的社会文化因素。
本定性研究采用社会建构主义-解释主义认识论方法。从尼日利亚 Katsina 州的两个地方政府区，按目的抽样法选取 20 名 18-39 岁的母亲进行半结构式访谈。采用主题内容分析法进行分析。
从分析中得出三个主要主题：（1）母乳喂养开始 - 母亲何时开始母乳喂养的决定因素包括传统的新生儿护理实践、分娩时的助产妇和分娩地点。（2）纯母乳喂养 - 持续纯母乳喂养的动机受到履行传统仪式义务、母亲意识和家庭支持之间冲突的影响。（3）婴儿喂养决策 - 丈夫、祖母、传统助产妇和卫生工作者都影响了参与者对婴儿喂养的决策。尽管大多数接受访谈的母亲都意识到纯母乳喂养的好处，但她们表示担心，如果她们的观点与其他家庭成员的观点相悖，她们可能无法获得家人的支持。
尽管母亲在决策方面的权力有限，但祖母和丈夫在母乳喂养决策中所扮演的关键角色表明，需要通过社区驱动的政策和综合干预措施，在产前和产后期间解决社会和文化障碍，争取伴侣和亲属的支持。
