In-Depth Understanding of Exclusive Breastfeeding Barriers and Facilitators in Haryana, India Open Access
Muller, Gabriela (Spring 2022)
Abstract
Background: Exclusive breastfeeding is recommended for the first six months of an infant’s life. Although exclusive breastfeeding is vital to the health and development of a child, only 69% of children under six months of age exclusively breastfeed in Haryana, India (International Institute for Population Sciences (IIPS), 2021). To increase exclusive breastfeeding rates in Haryana, there is a need to gain further insight into key factors influencing breastfeeding practices.
Objective: The purpose was to examine lactating women’s breastfeeding experiences to identify key facilitators and barriers that affect breastfeeding behaviors.
Methods: The qualitative study consisted of 30 in-depth interviews with lactating mothers between the ages of 18 and 45 who had a child under seven months of age and were previously enrolled in a parent study that sought to examine lactation performance in the context of maternal nutritional status. Fourteen interviews were conducted with women from peri-urban communities, while the remaining 16 IDIs were conducted with women from rural communities in Haryana, India. Data was analyzed using a thematic analysis approach based on inductive and deductive themes generated a priori, as the semi-structured interview guide was developed and based on emic themes that arose over the course of data collection. Etic codes were included as they emerged from the literature. A codebook was developed and applied to relevant sections of transcripts. Using concepts from the Capability-Opportunity-Motivation (COM-B) framework, codes were categorized accordingly and identified as either facilitators or barriers for each breastfeeding behavior.
Results: Ten percent of the women in this study practiced exclusive breastfeeding. Key themes arose within the COM-B framework, showing barriers and facilitators. Within capability, key barriers and facilitators for exclusive breastfeeding behaviors included maternal knowledge of colostrum and complementary feeding, prior breastfeeding experience, misperceptions of water, perceived insufficient milk, and intentions to breastfeed. Maternal work and family support influenced women’s opportunity to breastfeed. Perceived benefits for the mother and child, negative impact on body image, maternal mental health, and lactation pain were key factors influencing maternal motivation.
Conclusion: The findings from this study provided an analysis of capability, opportunity, and motivation that can help identify areas of improvement and address potential issues that may influence exclusive breastfeeding rates. Additional training may help ensure that women and their families gain accurate information about breastfeeding recommendations, health benefits for both mother and child, and address common misperceptions. Effective engagement of family support systems can strengthen support and opportunity for women to meet breastfeeding goals. Evidence from this study can be used to help women in the region to improve breastfeeding rates and health outcomes.
Table of Contents
Chapter 1: Background 1
Introduction and Rationale 1
Problem Statement 4
Theoretical Framework Introduction 5
Purpose Statement 5
Significance Statement 6
Chapter 2: Literature Review 6
2.1 Exclusive Breastfeeding 6
2.2 Breastfeeding Statistics 8
2.2.1 Global Statistics 8
2.2.2 India Statistics 10
2.2.3 Haryana Statistics 11
2.3 Determinants of Breastfeeding 12
2.4 COM-B System 15
Chapter 3: Manuscript 18
Abstract 18
Introduction 19
Methods 20
Results 23
Descriptive Analysis 23
Capability 24
Opportunity 29
Motivation 31
Discussion 35
Strengths and Weaknesses 42
Chapter 4: Conclusions, Implications, and Recommendations 44
References 50
Appendix A: Code Book 54
Appendix B: In-Depth-Interview-Guide 63
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