Barriers to breastfeeding are shaped by sociocultural context: an exploratory qualitative study in Bangladesh

Md Fakhar Uddin; Ishrat Jabeen; Mohammad Ashraful Islam; Mahfuzur Rahman; Mohammod Jobayer Chisti; Tahmeed Ahmed; Haribondhu Sarma

doi:10.1186/s41043-022-00312-y

Barriers to breastfeeding are shaped by sociocultural context: an exploratory qualitative study in Bangladesh

J Health Popul Nutr. 2022 Aug 13;41(1):34. doi: 10.1186/s41043-022-00312-y.

Authors

Md Fakhar Uddin¹, Ishrat Jabeen², Mohammad Ashraful Islam², Mahfuzur Rahman², Mohammod Jobayer Chisti², Tahmeed Ahmed², Haribondhu Sarma³

Affiliations

¹ Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), GPO Box 128, Dhaka, 1000, Bangladesh. fakhar.uddin@icddrb.org.
² Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), GPO Box 128, Dhaka, 1000, Bangladesh.
³ National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, 0200, Australia.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Bangladesh; Barriers; Breastfeeding practices; Sociocultural context.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bangladesh
Breast Feeding* / psychology
Child
Child, Preschool
Female
Health Knowledge, Attitudes, Practice*
Humans
Infant
Mothers / psychology
Qualitative Research