Knowledge and barriers to exclusive breastfeeding among mothers in Gauteng province, South Africa
Résumé
The World Health Organization’s recommendation of exclusive breastfeeding (EBF) of babies within the first six months of life has been considered a milestone for enhancing the survival rate of the children and the well-being of the mothers. The adoption of EBF among South African mothers, however, remains a concern since it has not yet attained the recommended standards globally. This was a quantitative cross-sectional study undertaken among 399 mothers of children between the ages of 6 and 24 months who accessed immunization services at three clinics that were selected using a random sampling procedure. The study employed systematic sampling to get the subjects. Data collection used a structured questionnaire that focused on the level of knowledge, practices, and factors inhibiting the practice of EBF. There was a good level of maternal knowledge of EBF, with 98.2% having good knowledge, mostly attained through interaction with healthcare providers. All mothers practiced breastfeeding, but only 19.1% breastfed immediately after delivery. There was poor compliance with EBF, yet the majority (60%) introduced nothing but breast milk, although a large proportion (35.6%) introduced formula feeds and solid foods before the age of six months. There were no significant relations between knowledge and both socio-demographic and other factors (all p>0.05). The predominant factors that hindered the practice of EBF included reduced maternal autonomy (16.3%), fear of breasts sagging (6.8%), fear of low milk production (6.0%), maternal illness and preterm delivery, work constraints, and a lack of involvement of the father (35.6%). Despite high levels of maternal knowledge of EBF, there are a number of personal, cultural, and societal factors that exist that serve to impede the achievement of optimal practices. It is recommended that strategies be focused on the enhancement of supportive factors—principally paternal participation—fostered breastfeeding support at work, and concertedly addressed maternal counselling, targeted towards those experiencing difficulties related to maternal health and confidence.
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