Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), GPO Box 128, Dhaka, 1000, Bangladesh.
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, 0200, Australia.
J Health Popul Nutr. 2022 Aug 13;41(1):34. doi: 10.1186/s41043-022-00312-y.
Breastfeeding practice is still not optimum in Bangladesh. Understanding barriers to breastfeeding is needed to prevent harmful practices. This study aimed to understand barriers to breastfeeding among infants and young children in Bangladesh.
This qualitative study was conducted in five rural sub-districts and one urban slum in Bangladesh. We conceptualized that barriers to breastfeeding can be broadly grouped into individual, society, and system level barriers. We conducted in-depth interviews with 33 breastfeeding mothers and 13 grandmothers of breastfed children (total n = 46 interviews). We observed 23 of these infants and young children being breastfed. These data were supplemented by 3 focus group discussions held with the children's fathers. We managed the data using Atlas.ti software and analyzed the data thematically using an inductive approach.
Important individual-level barriers perceived to influence breastfeeding included misconceptions about the adverse effects of breastfeeding on maternal health, nutrition and physical appearance, and lack of awareness of the value of breastfeeding among family members. Perceived society-level barriers included sociocultural norms, beliefs, and practices such as mother obliged to give more attention on household chores than breastfeeding to become a good housewife and feeding formula milk perceived as a symbol of parents' financial solvency in the society. System-level barriers included attractive advertisements of breastmilk substitutes, and inadequate facilities and support processes in mothers' work environments.
A range of barriers at individual, society and system level have important implications for infant and young children's breastfeeding practices in Bangladesh. Development of interventions that address the range of barriers that many mothers face is essential to support breastfeeding practices. Potential interventions include strengthening information-giving during interaction between mothers and health workers on breastfeeding techniques, and engaging fathers and other "significant others" in counseling on breastfeeding.
母乳喂养实践在孟加拉国仍不尽如人意。了解母乳喂养的障碍对于防止有害做法至关重要。本研究旨在了解孟加拉国婴儿和幼儿母乳喂养的障碍。
本定性研究在孟加拉国的五个农村分区和一个城市贫民窟进行。我们认为母乳喂养的障碍可以大致分为个人、社会和系统层面的障碍。我们对 33 名母乳喂养的母亲和 13 名母乳喂养儿童的祖母（共 46 次访谈）进行了深入访谈。我们观察了其中 23 名婴儿和幼儿的母乳喂养过程。这些数据通过 3 次与孩子父亲举行的焦点小组讨论进行了补充。我们使用 Atlas.ti 软件管理数据，并采用归纳法对数据进行主题分析。
个人层面被认为会影响母乳喂养的重要障碍包括对母乳喂养对母亲健康、营养和外貌的负面影响的误解，以及家庭成员对母乳喂养价值的认识不足。社会层面的障碍包括社会文化规范、信念和习俗，例如母亲被认为有义务比母乳喂养更关注家务，以便成为一个好主妇，以及在社会中，配方奶粉被认为是父母经济能力的象征。系统层面的障碍包括母乳代用品的广告吸引力，以及母亲工作环境中设施和支持流程不足。
个人、社会和系统层面的一系列障碍对孟加拉国婴儿和幼儿的母乳喂养实践具有重要影响。制定干预措施来解决许多母亲面临的一系列障碍对于支持母乳喂养实践至关重要。潜在的干预措施包括在母亲与卫生工作者之间关于母乳喂养技巧的互动中加强信息传递，并让父亲和其他“重要他人”参与母乳喂养咨询。
