Cultural barriers to exclusive breastfeeding among children aged 0-6 months in Tamale metropolitan area of Ghana

  • Habibu Issah Department of Global and International Health, School of Public Health, University for Development Studies, Ghana
  • Salifu Abukari Department of Behaviour Science, School of Public Health, University for Development Studies, Ghana
  • Yussif Hamdan Adam Department of Behaviour Science, School of Public Health, University for Development Studies, Ghana
Keywords: Exclusive breastfeeding, infant 0-6months, nutritional status, cultural factors, Tamale Metropolitan Area

Abstract

Background: The World Health Organization recommends exclusively breastfeeding (EBF) for 6-months commencing at birth, with early breastfeeding commencing within 30 minutes of delivery. Cultural factors have been discovered to influence women's choice to EBF. The research was to determine the cultural influences on EBF and its implications on the nutritional status of infants 0-6 months.
Methods: A descriptive cross-sectional study was conducted. The study included 300 women of reproductive age (18-45 years old) who had infants of 0-6 months and were accessing services at child welfare clinics in Tamale, Ghana. Data was collected using interviewer-administered questionnaire between mid-July to mid-August 2021.
Results: Most of the mothers (54%) had poor knowledge of exclusive breastfeeding. More than half (72%) did not practice exclusive breastfeeding. Most mothers (57%) did not offer colostrum to their newborns. Mothers-in-law influenced their daughters-in-laws breastfeeding behaviours. Over 50% of those who did not practice EBF said it was taboo to indulge in sex while EBF, to EBF when pregnant, to EBF when there was insufficient breast milk for infants signified by their frequent crying, and to EBF when mothers are likely to face challenges introducing complementary foods after 6 months. Most of the newborns had indications of underweight (69%), stunting (68%), and wasting (66%).
Conclusion: There are greater needs to develop health teaching, health education, and counselling strategies to change knowledge, attitude, and practices. Again, negative attitudes and behaviours of mothers and the community as whole regarding EBF could also be addressed using community based social marketing approach.

Annals of Medical Laboratory Science (2022) 2(1), 1 - 12

References

Adjei, E., & Schubert, J. (2003). Follow-up survey iii: a rapid appraisal of breastfeeding and complementary feeding knowledge and practices in Ghana. Retrieved from http://www.linkagesproject.org/media/static_pdfs/rap/ghanarap2003.pdf.

AArifeen, S., Black, R., Antelman, G., Baqui, A., Caulfield, L., & Becker, S. (2001). Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics., 108(4), e67.

Arts, M., Geelhoed, D., De Schacht, C., Prosser, W., Alons, C., & Pedro, A. (2011). Knowledge, beliefs, and practices regarding exclusive breastfeeding of infants younger than 6 months in Mozambique: a qualitative study. J Hum Lact., 27(1), 25–32.

Awumbila, M. (2003). Social Dynamics and Infant Feeding Practices in Northern Ghana. NS, 19 (2), 85–98.

Ayisi, R., & Wakoli, A. (2014). Exclusive breastfeeding practice: its implication on nutrition status, growth and morbidity pattern among infants aged 0-6 months. GJBAHS., 3(1), 254–258.

Bezner Kerr, R., Dakishoni, L., Shumba, L., Msachi, R., & Chirwa, M. (2008). ‘We grandmothers know plenty’: breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi. Soc Sci Med., 66(5), 1095–1105.

Boakye-yiadom, A., Yidana, A., Sam, N. B., Kolog, B., & Abotsi, A. (2016). Factors Associated with Exclusive Breastfeeding Practices among Women in the West Mamprusi District in Northern Ghana: A Cross-Sectional Study. Public Health Research, 6(3), 91–98. https://doi.org/10.5923/j.phr.20160603.03

Brown, K., Creed-Kanashiro, H., & Dewey, K. (1995). Optimal complementary feeding practices to prevent childhood malnutrition in developing countries. Food Nutr Bull., 16(4), 320–339.

Charan, J., & Biswas, T. (2013). How to Calculate Sample Size for Different Study Designs in Medical Research? Indian J Psychol Med, 35(2), 121–126. https://doi.org/10.4103/0253-7176.116232

Chudasama, R., Amin, C., & Parikh, N. (2009). Prevalence of exclusive breastfeeding and its determinants in first 6 months of life: a prospective study. Online J Health Allied Sci., 8(1), 3.

Darnton-Hill, I., Nishida, C., & James, W. (2004). A life course approach to diet , nutrition and the prevention of chronic diseases. Public Health Nutrition, 7(1A), 101–121. https://doi.org/10.1079/PHN2003584 FAO/FSAU. (2007). Infant and Young Child a Feeding and Health Seeking Practices. Somali Knowledge Attitude Practices Study (KAPS). Published by United Nations Food and Agricultural Organisation/Food Security Analysis Unit, PO Box 1230, Village Market, Nairobi, Kenya.

Fjeld, E., Siziya, S., Katepa-Bwalya, M., & et al. (2008). ‘No sister, the breast alone is not enough for my baby’ a qualitative assessment of potentials and barriers in the promotion of exclusive breastfeeding in southern Zambia. Int Breastfeed J., 3(1), 26.

Fuseini, I., Yaro, J. A., & Yiran, G. A. B. (2017). City profile: Tamale, Ghana. Cities, 60, 64–74. https://doi.org/10.1016/j.cities.2016.07.010 Ghana Statistical Service. (2014). 2010 Population
and Housing Census: District Analytical Report, Tamale metropolis. Retrieved from http://www.statsghana.gov.gh docfiles/2010_District_Report/Northern/ Tamale Metropolitan.pdf
Ghana Statistical Service (GSS) Ghana Health Service (GHS) ICF International. (2015). Ghana demographic and health survey 2014. Rockville.

Graf, J., Meierhofer, R., Wegelin, M., & Mosler, H.-J. (2008). Water disinfection and hygiene behaviour in an urban slum in Kenya: impact on childhood diarrhoea and influence of beliefs. Int J Environ Health Res., 18(5),335–355. International Breastfeeding Food Action Network: (2000). Ghana Law - Breastfeeding promotion regulation. Accra. Accra, Ghana.

Jefferson, T. (2016). Closing the gap: breastfeeding strategies and vulnerable population. West J Nurs Res., 38(5), 527–528.

Kakute, P., Ngum, J., Mitchell, P., & et al. (2005). Cultural barriers to exclusive breastfeeding by mothers in a rural area of Cameroon, Africa. J Midwifery Womens Health, 50(4), 324–328.

Khan, M. N., & Islam, M. M. (2017). Effect of exclusive breastfeeding on selected adverse health and nutritional outcomes: A nationally representative study. BMC Public Health, 17(1), 1–7. https://doi.org/10.1186/s12889-017- 4913-4

Legesse, M., Demena, M., Mesfin, F., & Haile, D. (2015). Factors associated with colostrum avoidance among mothers of children aged less than 24 Months in Raya Kobo district, North-eastern Ethiopia: Community-based cross-sectional study. Journal of Tropical Pediatrics, 61(5), 357–363. https://doi.org/10.1093/ tropej/fmv039

Lessen, R., & Kavanagh, K. (2015). Position of the academy of nutrition and dietetics: promoting and supporting breastfeeding. J Acad Nutr Diet. 2015;115:444–9., 115, 444–449.

Lucas, A. (1998). Programming by early nutrition: an experimental approach. J Nutr., 128(suppl 2), 401-6S.

Maonga, R., Mahande, J., Damian, J., & Msuya, E. (2016a). Factors affecting exclusive breastfeeding among women in Muheza District Tanga Northern-eastern Tanzania. A mixed method community based survey. Matern Child Health J., 20, 77–87.

Masarenhas, M., Singh, K., & Sukhwinder, S. (2006). Prevalence of Exclusive Breast Feeding and its determinants in the first 3 months of life in South of Brazil. Journal of Paediatrics, 82, 289–294.

Mekuria, G., & Edris, M. (2015). Exclusive breastfeeding and associated factors among mothers in Debre, Markos, Northwest Ethiopia. A cross sectional study. Int Breastfeeding J, 10(1), 1–7.
Nabulsi, M., Tamim, H., Shamsedine, L., Charafeddine, L., Yehya, N., KabakianKhasholian, T., & et al. (2019). A multi-component intervention to support breastfeeding in Lebanon: A randomized clinical trial. PLoS ONE, 14(6), e0218467

Northwest Center for Public Health Practice. (2017). Nutrition: Maternal and Child Health Strategies for Public Health. Washington DC. Otoo, G., Lartey, A., & Perez-Escamilla, R. (2009). Perceived incentives and barriers to exclusive breastfeeding among peri-urban Ghanaian women. J Hum Lact, 25(1), 34–41.

Otoo, G., Lartey, A., & Pérez-Escamilla, R. (2009). Perceived incentives and barriers to exclusive breastfeeding among periurban Ghanian women. J Hum Lact., 25(1), 34–41.

Pereira, T. A. de M., Freirea, A. K. G., & Gonçalves, V. S. S. (2021). Exclusive breastfeeding and underweight in children under six months old monitored in primary health care in Brazil, 2017. Rev Paul Pediatr., 39(e2019293), 1–10. https://doi.org/10.1590/1984- 0462/2021/39/2019293

Quigley, M., Kelly, Y., & Sacker, A. (2007). Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom millennium cohort study. Pediatrics. 2007;119(4):E837–42., 119(4), e837-42.

Reinsma, K., Bolima, N., Fonteh, F., Okwen, P., Yota, D., & Montgomery, S. (2012). Incorporating cultural beliefs in promoting exclusive breastfeeding. Afr J Midwifery Womens Health, 6(2), 65–70. https://doi.org/10.12968ajmw.2012.6.2.65.Incorporating

Rogers, N., Abdi, J., & Moore, D, et al. (2011). Colostrum avoidance, prelacteal feeding and late breast-feeding initiation in rural Northern Ethiopia. Public Health Nutr 14:2029–36.

Saaka, M., & Iddrisu, M. (2013). Patterns and Determinants of Essential Newborn Care Practices in Rural Areas of Northern Ghana. International Journal of Population Research, 2014,1–10.

Seidu, I. (2013). Exclusive breastfeeding and family influences in rural Ghana: A qualitative study. Malmö University Health.

Sholeye, O., Abosede, A., & Salako, A. (2015). Exclusive breastfeeding and its associated factors among mothers in Sagamu, Southwest Nigeria. J Health Sci., 5(2), 25–31.

Sika-Bright, S., & Oduro, G. (2013). Exclusive breastfeeding practices of mothers in Duakor, a traditional migrant community in Cape Coast, Ghana. J Glob Init Policy Pedagogy Perspect, 8(1), 87–102.

Sutherland, T., Pierce, C., Blomquist, J., & Handa, V. (2012). Breastfeeding practices among first-time mothers and across multiple pregnancies. Matern Child Health J. 2012;16 (8):1665–71., 16(8), 1665–1671.

Tadele, N., Habta, F., Akmel, D., & Deges, E. (2016). Knowledge, attitude and practice towards exclusive breastfeeding among lactating mothers in Mizan Aman towm, Southern west Ethiopia. Descriptive cross-sectional survey. Int Breastfeeding J. 11(3):1–7.

Tamiru, D., Belachew, T., & Loha, E, et al. (2012). Sub-optimal breastfeeding of infants during the first six months and associated factors in rural communities of Jimma Arjo Woreda, Southwest Ethiopia. BMC Public Health, 12, 363.

Tampah-naah, A. M., & Kumi-kyereme, A. (2013). Determinants of exclusive breastfeeding among mothers in Ghana: a cross-sectional study. International Breastfeeding Journal, 8(13), 1. https://doi.org/10.1186/1746-4358-8-13

Tan, K. (2011). Factors associated with exclusive breastfeeding among infants under six months of age in peninsular Malaysia. Int J Breastfeeding, 6(2), 1–7.

Thet, M., Khaing, E., Diamond-Smith, N Sudhinaraset, M., & Aung, T. (2016). Barriers to exclusive breastfeeding in the Ayeyarwaddy Region in Myanmar. Qualitative findings from the mothers, grandmothers, and husbands. Appetite, 96(62–69).

United Nation Children’s Fund. (2015). Nutrition: improving breastfeeding, complementary foods and feeding practices. New York.

Victora, C., Bahl, R., Barros, A., Franca, G., Horton, S., & Krasevec, J. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet, 387(10017), 475–490.

WHO. (2006a). Infant and young child nutrition, Quadrennial secretariat report, World health assembly. 9th ed. Geneva.

WHO. (2006b). WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development.
https://doi.org/10.1111/ j.14698749.2009.03503.x

WHO UNICEF. (2003). Global strategy for infant and young child feeding. Geneva, New York. World Health Organization. (2007). Indicators for assessing infant and young child feeding practice: part I. Definitions. Conclusions of a consensus meeting held 6–8 November 2007. Washington DC.

Yeboah, J. Y., Forkuor, D., & Duah, W. A. (2019). Exclusive breastfeeding practices and associated factors among lactating mothers of infants aged 6–24 months in the Kumasi Metropolis, Ghana. BMC Research Notes, 12 (689), 12–17. https://doi.org/10.1186/s13104 -019-4723-0
Published
2022-04-16
How to Cite
Issah, H., Abukari, S., & Adam, Y. H. (2022). Cultural barriers to exclusive breastfeeding among children aged 0-6 months in Tamale metropolitan area of Ghana. Annals of Medical Laboratory Science, 2(1), 1-12. https://doi.org/10.51374/annalsmls.2022.2.1.0053
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Articles