Factors Hindering Compliance with Exclusive Breastfeeding Practices Among Mothers: A Narrative Review
Keywords:
factors, determinants, causes, barriers, hindering, influencing, exclusive breastfeeding
Abstract
Introduction: Commencing a child's developmental path with the unparalleled advantages of exclusive breastfeeding establishes the cornerstone for optimal health. Despite understanding the importance of exclusive breastfeeding (EBF), many mothers still face challenges in adhering to it. The objective of this review is to thoroughly delineate the barriers to exclusive breastfeeding.
Methods: Searches were conducted using PubMed, Google Scholar, and manually to retrieve studies from 2014-2024. Using our inclusion criteria, we selected studies that described barriers to exclusive breastfeeding. Qualitative and quantitative studies and survey reports published in English were considered. The descriptors used in this study were: factors, determinants, causes, barriers, hindering, influencing, and exclusive breastfeeding. Thirty-two studies from various countries were included.
Result: Out of the 244 articles identified, 32 met the inclusion criteria. Most of the included studies were cross-sectional and were published between 2014 and 2024. Evidence indicates that breastfeeding support is crucial for extending both the duration and exclusivity of breastfeeding. Factors such as physiological issues, health-related barriers, and limitations within the healthcare system significantly impact exclusive breastfeeding practices. Interventions addressing these factors are essential for improving exclusive breastfeeding rates and enhancing maternal and child health outcomes.
Conclusion: Despite being widely practiced, exclusive breastfeeding (EBF) rates remain low due to challenges faced by many mothers. Addressing these barriers through targeted interventions during antenatal and postnatal education can help improve and sustain EBF practices.
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References
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8. World Health Organization. Ghana launches National Breastfeeding Week [Internet]. 2021 [cited 2022 May 27]. Available from: https://www.afro.who. int/news/ghana-launches-national-breastfeeding-week
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10. Brown CRL, Dodds L, Legge A, Bryanton J, Semenic S. Factors influencing the reasons why mothers stop breastfeeding. Can J Public Health [Internet]. 2014;105(3):e179–85. Available from: http://dx.doi.org/10.17269/cjph.105.4244
11. Turke KC, Santos LRD, Matsumura LS, Sarni ROS. Risk factors for the lack of adherence to breastfeeding. Revista Da Associação Médica Brasileira [homepage on the Internet] 2021;67(1):107–114. Available from: https://doi.org/10.1590/1806-9282.67.01.20200510
12. Mekebo GG, Argawu AS, Likassa HT, et al. Factors influencing exclusive breastfeeding practice among under-six months infants in Ethiopia. BMC Pregnancy and Childbirth [homepage on the Internet] 2022;22(1). Available from: https://doi.org/10.1186/s12884-022-04955-x
13. Sociodemographic factors associated with uptake of exclusive breastfeeding practice in Brunei Darussalam June 2017Brunei International. Authors: Mohammed M Alhaji. 2017;13:12–9.
14. Bürger B, Schindler K, Tripolt T, et al. Factors Associated with (Exclusive) Breastfeeding Duration—Results of the SUKIE-Study. Nutrients [homepage on the Internet] 2022;14(9):1704. Available from: https://doi.org/10.3390/nu14091704
15. Nishimura H, Krupp K, Gowda S, Srinivas V, Arun A, Madhivanan P. Determinants of exclusive breastfeeding in rural South India. International Breastfeeding Journal [homepage on the Internet] 2018;13(1). Available from: https://doi.org/10.1186/s13006-018-0178-5
16. Gogoi I, Mahanta TG, Barua A. Prevalence of exclusive breastfeeding in slums of Dibrugarh Town and factors affecting the breastfeeding practice. Clinical Epidemiology and Global Health [homepage on the Internet] 2015;3:S58–S62. Available from: https://doi.org/10.1016/j.cegh.2015.10.009
17. Kumari S, Kshatriya GK. Breastfeeding practices among currently married women of selected tribes of Jharkhand, India. International Journal of Community Medicine and Public Health [homepage on the Internet] 2018;5(7):2959. Available from: https://doi.org/10.18203/2394-6040.ijcmph20182630
18. Nisman WA, Aryas D, Ratnasari E, et al. Infant Feeding Practices and Analysis Of Factors Affecting Exclusive Breastfeeding. Jurnal Keperawatan Soedirman [homepage on the Internet] 2021;16(3). Available from: https://doi.org/10.20884/1.jks.2021.16.3.1726
19. Bhanderi DJ, Pandya YP, Sharma DB. Barriers to exclusive breastfeeding in rural community of central Gujarat, India. J Family Med Prim Care. 2019 Jan;8(1):54-61. doi: 10.4103/jfmpc.jfmpc_329_18. PMID: 30911481; PMCID: PMC6396613.
20. Sankar TJ, Suryanarayana R, Kamath BTP, Sunil BN, Reddy MM. To determine the survival, prevalence and associated factors of exclusive breastfeeding practices in South India. Journal of Family Medicine and Primary Care [homepage on the Internet] 2023;12(1):36. Available from: https://doi.org/10.4103/jfmpc.jfmpc_784_22
21. Venkatachalapathi S, Mannu A, Subramaniyam K, Vasudevan J, Lala U. Uncovering the Barriers to Exclusive Breast Feeding for Mothers in a Rural Setting in Southern India. The Journal of Pediatric Research [homepage on the Internet] 2021;8(2):181–187. Available from: https://doi.org/10.4274/jpr.galenos.2020.20438
22. Ahmed KY, Page A, Arora A, Ogbo FA. Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016. International Breastfeeding Journal [homepage on the Internet] 2019;14(1). Available from: https://doi.org/10.1186/s13006-019-0234-9
23. Tampah-Naah AM, Kumi-Kyereme A, Amo-Adjei J. Maternal challenges of exclusive breastfeeding and complementary feeding in Ghana. PLoS ONE [homepage on the Internet] 2019;14(5):e0215285. Available from: https://doi.org/10.1371/journal.pone.0215285
24. Tangsuksan P, Ratinthorn A, Sindhu S, Spatz DL, Viwatwongkasem C. Factors Influencing Exclusive Breastfeeding among Urban Employed Mothers: A Case-Control Study. Pacific Rim International Journal of Nursing Research. 2020 Jan 1;24(1).
25. Ogbo FA, Dhami MV, Awosemo AO, Olusanya BO, Olusanya J, Osuagwu UL, et al. Correction to: Regional prevalence and determinants of exclusive breastfeeding in India. Int Breastfeed J [Internet]. 2019;14(1):22. Available from: http://dx.doi.org/10.1186/s13006-019-0220-2
26. Liu L, Wu Y, Xian X, Feng J, Mao Y, Balakrishnan S, Weber AM, Darmstadt GL, Chen Y, Sylvia S, Zhou H, Rozelle S. In-Hospital Formula Feeding Hindered Exclusive Breastfeeding: Breastfeeding Self-Efficacy as a Mediating Factor. Nutrients. 2023 Dec 12;15(24):5074. doi: 10.3390/nu15245074. PMID: 38140332; PMCID: PMC10746093.
27. Mohamed MJ, Ochola S, Owino VO. A Qualitative Exploration of the Determinants of Exclusive Breastfeeding (EBF) Practices in Wajir County, Kenya. International Breastfeeding Journal [homepage on the Internet] 2020;15(1). Available from: https://doi.org/10.1186/s13006-020-00284-x
28. Joseph FI, Earland J. A qualitative exploration of the sociocultural determinants of exclusive breastfeeding practices among rural mothers, North West Nigeria. Int Breastfeed J. 2019 Aug 20;14:38. doi: 10.1186/s13006-019-0231-z. PMID: 31452669; PMCID: PMC6701117.
29. Thepha T, Marais D, Bell J, Muangpin S. Perceptions of northeast Thai breastfeeding mothers regarding facilitators and barriers to six-month exclusive breastfeeding: focus group discussions. International Breastfeeding Journal [homepage on the Internet] 2018;13(1). Available from: https://doi.org/10.1186/s13006-018-0148-y
30. Kayode OO, Oyedeji AS, Alabi QK. Factors affecting exclusive breastfeeding practices among working class women in Osun State, Nigeria. Journal of Public Health in Africa [homepage on the Internet] 2023;Available from: https://doi.org/10.4081/jphia.2023.2191
31. Agyekum MW, Codjoe SNA, Dake F a. A, Abu M. Enablers and inhibitors of exclusive breastfeeding: perspectives from mothers and health workers in Accra, Ghana. International Breastfeeding Journal [homepage on the Internet] 2022;17(1). Available from: https://doi.org/10.1186/s13006-022-00462-z
32. Ndum Okwen GA, Karimuribo ED, Ngowi HA, Fombang EN. Exclusive breastfeeding and its determinants in Yaoundé, Cameroon: A retrospective survival analysis. J Pregnancy [Internet]. 2022;2022:8396586. Available from: http://dx.doi.org/10.1155/2022/8396586
33. Babakazo P, Bosonkie M, Mafuta E, Mvuama N, Mapatano MA. Common breastfeeding problems experienced by lactating mothers during the first six months in Kinshasa. PLoS One. 2022 Oct 12;17(10):e0275477. doi: 10.1371/journal.pone.0275477. PMID: 36223384; PMCID: PMC9555666.
34. Ed M, Ndep A, Akpan R. Factors Affecting Exclusive Breastfeeding Practice in Rural Communities of Cross River State, Nigeria. International Journal of Humanities Social Sciences and Education [homepage on the Internet] 2016;3(4). Available from: https://doi.org/10.20431/2349-0381.0304012
35. Knowledge B. Exclusive Breast-feeding Duration, and Perception of Insufcient Breast Milk Supply among Lactating Mothers in Ikwuano LGA of Abia State October 2022Nigerian. Journal of Nutritional Sciences. 2022;43(2):134–43.
36. Akter S, Tasnim S, Bhuiyan MMA, Hasan A. A Study on post partum breast problems of mothers attending at lactation management center (LMC). Bangladesh Medical Journal [homepage on the Internet] 2016;44(3):136–139. Available from: https://doi.org/10.3329/bmj.v44i3.27372
37. Zahra S, Monireh A, Easa M, Susan P. Successful breastfeeding mothers’ experiences of the difficulties of exclusive breastfeeding. Acta Medica Mediterranea.[Internet]. 2015 Jan 1:1479-87.
38. Martínez-Vázquez S, Hernández-Martínez A, Rodríguez-Almagro J, Peinado-Molina RA, Martínez-Galiano JM. Determinants and Factors Associated with the Maintenance of Exclusive Breastfeeding after Hospital Discharge after Birth. Healthcare [homepage on the Internet] 2022;10(4):733. Available from: https://doi.org/10.3390/healthcare10040733
39. Chhetri S, Rao AP, Guddattu V. Factors affecting exclusive breastfeeding (EBF) among working mothers in Udupi taluk, Karnataka. Clinical Epidemiology and Global Health [homepage on the Internet] 2018;6(4):216–219. Available from: https://doi.org/10.1016/j.cegh.2018.06.008
40. Amer S, Kateeb E. Mothers' Employment and Exclusive Breastfeeding Practices: A Brief Report from Jerusalem Governorate. Int J Environ Res Public Health. 2023 Jan 23;20(3):2066. doi: 10.3390/ijerph20032066. PMID: 36767434; PMCID: PMC9915241.
2. World Health Organization. Breastfeeding [Internet]. World Health Organization. World Health Organization: WHO; 2019. Available from: https://www.who.int/healthtopics/breastfeeding#tab=tab_1
3. Sankar MJ, Sinha B, Chowdhury R, Bhandari N, Taneja S, Martines J, et al. Optimal breastfeeding practices and infant and child mortality: a systematic review and metaanalysis. Acta Paediatr. 2015;104(467):3-13. https://doi.org/10.1111/apa.13147
4. Shamir R. The benefits of breast feeding. Nestle Nutr Inst Workshop Ser. 2016;86:67-https://doi.org/10.1159/000442724
5. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475- 90. https://doi.org/10.1016/S0140-6736(15)01024-7
6. Breastfeeding: The Best Possible Start in Life [Internet]. www.unicef.org. Available from: https://www.unicef.org/india/stories/breastfeeding-best-possible-start-life
7. Mohammed S, Yakubu I, Fuseini A-G, Abdulai A-M, Yakubu YH. Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health [Internet]. 2023;23(1):920. Available from: http://dx.doi.org/10.1186/s12889-023-15758-w
8. World Health Organization. Ghana launches National Breastfeeding Week [Internet]. 2021 [cited 2022 May 27]. Available from: https://www.afro.who. int/news/ghana-launches-national-breastfeeding-week
9. Khalid A, Aman S, Talreja W, et al. Factors Affecting Non Compliance with Exclusive Breastfeeding Among Mothers: A Survey at District Hospital Dadu. 2023;17(2):380–381. Available from: https://doi.org/10.53350/pjmhs2023172380 10
10. Brown CRL, Dodds L, Legge A, Bryanton J, Semenic S. Factors influencing the reasons why mothers stop breastfeeding. Can J Public Health [Internet]. 2014;105(3):e179–85. Available from: http://dx.doi.org/10.17269/cjph.105.4244
11. Turke KC, Santos LRD, Matsumura LS, Sarni ROS. Risk factors for the lack of adherence to breastfeeding. Revista Da Associação Médica Brasileira [homepage on the Internet] 2021;67(1):107–114. Available from: https://doi.org/10.1590/1806-9282.67.01.20200510
12. Mekebo GG, Argawu AS, Likassa HT, et al. Factors influencing exclusive breastfeeding practice among under-six months infants in Ethiopia. BMC Pregnancy and Childbirth [homepage on the Internet] 2022;22(1). Available from: https://doi.org/10.1186/s12884-022-04955-x
13. Sociodemographic factors associated with uptake of exclusive breastfeeding practice in Brunei Darussalam June 2017Brunei International. Authors: Mohammed M Alhaji. 2017;13:12–9.
14. Bürger B, Schindler K, Tripolt T, et al. Factors Associated with (Exclusive) Breastfeeding Duration—Results of the SUKIE-Study. Nutrients [homepage on the Internet] 2022;14(9):1704. Available from: https://doi.org/10.3390/nu14091704
15. Nishimura H, Krupp K, Gowda S, Srinivas V, Arun A, Madhivanan P. Determinants of exclusive breastfeeding in rural South India. International Breastfeeding Journal [homepage on the Internet] 2018;13(1). Available from: https://doi.org/10.1186/s13006-018-0178-5
16. Gogoi I, Mahanta TG, Barua A. Prevalence of exclusive breastfeeding in slums of Dibrugarh Town and factors affecting the breastfeeding practice. Clinical Epidemiology and Global Health [homepage on the Internet] 2015;3:S58–S62. Available from: https://doi.org/10.1016/j.cegh.2015.10.009
17. Kumari S, Kshatriya GK. Breastfeeding practices among currently married women of selected tribes of Jharkhand, India. International Journal of Community Medicine and Public Health [homepage on the Internet] 2018;5(7):2959. Available from: https://doi.org/10.18203/2394-6040.ijcmph20182630
18. Nisman WA, Aryas D, Ratnasari E, et al. Infant Feeding Practices and Analysis Of Factors Affecting Exclusive Breastfeeding. Jurnal Keperawatan Soedirman [homepage on the Internet] 2021;16(3). Available from: https://doi.org/10.20884/1.jks.2021.16.3.1726
19. Bhanderi DJ, Pandya YP, Sharma DB. Barriers to exclusive breastfeeding in rural community of central Gujarat, India. J Family Med Prim Care. 2019 Jan;8(1):54-61. doi: 10.4103/jfmpc.jfmpc_329_18. PMID: 30911481; PMCID: PMC6396613.
20. Sankar TJ, Suryanarayana R, Kamath BTP, Sunil BN, Reddy MM. To determine the survival, prevalence and associated factors of exclusive breastfeeding practices in South India. Journal of Family Medicine and Primary Care [homepage on the Internet] 2023;12(1):36. Available from: https://doi.org/10.4103/jfmpc.jfmpc_784_22
21. Venkatachalapathi S, Mannu A, Subramaniyam K, Vasudevan J, Lala U. Uncovering the Barriers to Exclusive Breast Feeding for Mothers in a Rural Setting in Southern India. The Journal of Pediatric Research [homepage on the Internet] 2021;8(2):181–187. Available from: https://doi.org/10.4274/jpr.galenos.2020.20438
22. Ahmed KY, Page A, Arora A, Ogbo FA. Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016. International Breastfeeding Journal [homepage on the Internet] 2019;14(1). Available from: https://doi.org/10.1186/s13006-019-0234-9
23. Tampah-Naah AM, Kumi-Kyereme A, Amo-Adjei J. Maternal challenges of exclusive breastfeeding and complementary feeding in Ghana. PLoS ONE [homepage on the Internet] 2019;14(5):e0215285. Available from: https://doi.org/10.1371/journal.pone.0215285
24. Tangsuksan P, Ratinthorn A, Sindhu S, Spatz DL, Viwatwongkasem C. Factors Influencing Exclusive Breastfeeding among Urban Employed Mothers: A Case-Control Study. Pacific Rim International Journal of Nursing Research. 2020 Jan 1;24(1).
25. Ogbo FA, Dhami MV, Awosemo AO, Olusanya BO, Olusanya J, Osuagwu UL, et al. Correction to: Regional prevalence and determinants of exclusive breastfeeding in India. Int Breastfeed J [Internet]. 2019;14(1):22. Available from: http://dx.doi.org/10.1186/s13006-019-0220-2
26. Liu L, Wu Y, Xian X, Feng J, Mao Y, Balakrishnan S, Weber AM, Darmstadt GL, Chen Y, Sylvia S, Zhou H, Rozelle S. In-Hospital Formula Feeding Hindered Exclusive Breastfeeding: Breastfeeding Self-Efficacy as a Mediating Factor. Nutrients. 2023 Dec 12;15(24):5074. doi: 10.3390/nu15245074. PMID: 38140332; PMCID: PMC10746093.
27. Mohamed MJ, Ochola S, Owino VO. A Qualitative Exploration of the Determinants of Exclusive Breastfeeding (EBF) Practices in Wajir County, Kenya. International Breastfeeding Journal [homepage on the Internet] 2020;15(1). Available from: https://doi.org/10.1186/s13006-020-00284-x
28. Joseph FI, Earland J. A qualitative exploration of the sociocultural determinants of exclusive breastfeeding practices among rural mothers, North West Nigeria. Int Breastfeed J. 2019 Aug 20;14:38. doi: 10.1186/s13006-019-0231-z. PMID: 31452669; PMCID: PMC6701117.
29. Thepha T, Marais D, Bell J, Muangpin S. Perceptions of northeast Thai breastfeeding mothers regarding facilitators and barriers to six-month exclusive breastfeeding: focus group discussions. International Breastfeeding Journal [homepage on the Internet] 2018;13(1). Available from: https://doi.org/10.1186/s13006-018-0148-y
30. Kayode OO, Oyedeji AS, Alabi QK. Factors affecting exclusive breastfeeding practices among working class women in Osun State, Nigeria. Journal of Public Health in Africa [homepage on the Internet] 2023;Available from: https://doi.org/10.4081/jphia.2023.2191
31. Agyekum MW, Codjoe SNA, Dake F a. A, Abu M. Enablers and inhibitors of exclusive breastfeeding: perspectives from mothers and health workers in Accra, Ghana. International Breastfeeding Journal [homepage on the Internet] 2022;17(1). Available from: https://doi.org/10.1186/s13006-022-00462-z
32. Ndum Okwen GA, Karimuribo ED, Ngowi HA, Fombang EN. Exclusive breastfeeding and its determinants in Yaoundé, Cameroon: A retrospective survival analysis. J Pregnancy [Internet]. 2022;2022:8396586. Available from: http://dx.doi.org/10.1155/2022/8396586
33. Babakazo P, Bosonkie M, Mafuta E, Mvuama N, Mapatano MA. Common breastfeeding problems experienced by lactating mothers during the first six months in Kinshasa. PLoS One. 2022 Oct 12;17(10):e0275477. doi: 10.1371/journal.pone.0275477. PMID: 36223384; PMCID: PMC9555666.
34. Ed M, Ndep A, Akpan R. Factors Affecting Exclusive Breastfeeding Practice in Rural Communities of Cross River State, Nigeria. International Journal of Humanities Social Sciences and Education [homepage on the Internet] 2016;3(4). Available from: https://doi.org/10.20431/2349-0381.0304012
35. Knowledge B. Exclusive Breast-feeding Duration, and Perception of Insufcient Breast Milk Supply among Lactating Mothers in Ikwuano LGA of Abia State October 2022Nigerian. Journal of Nutritional Sciences. 2022;43(2):134–43.
36. Akter S, Tasnim S, Bhuiyan MMA, Hasan A. A Study on post partum breast problems of mothers attending at lactation management center (LMC). Bangladesh Medical Journal [homepage on the Internet] 2016;44(3):136–139. Available from: https://doi.org/10.3329/bmj.v44i3.27372
37. Zahra S, Monireh A, Easa M, Susan P. Successful breastfeeding mothers’ experiences of the difficulties of exclusive breastfeeding. Acta Medica Mediterranea.[Internet]. 2015 Jan 1:1479-87.
38. Martínez-Vázquez S, Hernández-Martínez A, Rodríguez-Almagro J, Peinado-Molina RA, Martínez-Galiano JM. Determinants and Factors Associated with the Maintenance of Exclusive Breastfeeding after Hospital Discharge after Birth. Healthcare [homepage on the Internet] 2022;10(4):733. Available from: https://doi.org/10.3390/healthcare10040733
39. Chhetri S, Rao AP, Guddattu V. Factors affecting exclusive breastfeeding (EBF) among working mothers in Udupi taluk, Karnataka. Clinical Epidemiology and Global Health [homepage on the Internet] 2018;6(4):216–219. Available from: https://doi.org/10.1016/j.cegh.2018.06.008
40. Amer S, Kateeb E. Mothers' Employment and Exclusive Breastfeeding Practices: A Brief Report from Jerusalem Governorate. Int J Environ Res Public Health. 2023 Jan 23;20(3):2066. doi: 10.3390/ijerph20032066. PMID: 36767434; PMCID: PMC9915241.
How to Cite
Kadiyan, P., Verma, M., Shafqat, N., Anjali, A., & Vada, S. (2024). Factors Hindering Compliance with Exclusive Breastfeeding Practices Among Mothers: A Narrative Review. Pediatric Review: International Journal of Pediatric Research, 11(3), 49-57. Retrieved from https://pediatrics.medresearch.in/index.php/ijpr/article/view/773
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Review Article
Copyright (c) 2024 Author (s). Published by Siddharth Health Research and Social Welfare Society
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