Introduction
Breastfeeding, also known as baby nursing, is when a mother feeds her baby with breast milk directly from her breast. Many world organizations such as WHO and UNICEF highly recommend breastfeeding newly born babies. Moreover, medical experts around the globe also support the breastfeeding of newborn babies. According to WHO (2022), mothers should breastfeed their young ones immediately, some hours after delivery and recommend breastfeeding exclusively for six months. Although the child is exposed to foreign foods after six months, mothers are advised to continue breastfeeding their young ones until two years. Breast milk is the ideal nutrition for newly born babies. Research has shown that breast milk contains vitamins, proteins, and other nutrients that aid an infant’s growth and development compared to alternative infant formula. Moreover, breast milk contains antibodies helping the baby’s body fight pathogens like bacteria and viruses. According to WHO (2022), breastfeeding alleviates babies’ chances of having asthma, allergies, ear infections, respiratory illness, and commonly repeated diarrhea. Moreover, appropriately breastfed mothers also reduce their ovarian and breast cancer chances.
Children who are not appropriately breastfed by their mothers show some development inferiority, including being prone to diseases, lower IQ, obesity, and stunted growth. Children deserve to be breastfed since it aids their physical and cognitive development. For these detrimental effects of inappropriately breastfeeding, healthcare officials and other concerned bodies such as WHO and UNICEF recommend that babies be breastfed appropriately for children’s well-being. However, many children today are not adequately breastfed as they should be. As doctors and concerned bodies recommend, several barriers hinder mothers from breastfeeding their young ones. Therefore, this article presents the literature behind why mothers today do not breastfeed their young ones but prefer infant formula. Moreover, this article discusses some barriers to breastfeeding, as identified in the previous research.
In exploring barriers that exist to breastfeeding, secondary qualitative data were analyzed. These sources of data include publications on previous studies on challenges to breastfeeding. This is the most straightforward and flexible data collection and analysis since online secondary sources are plenty, unlimited and timeless. For example, this search aims to find and understand the barriers responsible for inappropriate breastfeeding in the world. Therefore, analyzing previous records found in research journals and other publications is the best to explore the topic. Secondary data sources were chosen because it takes a short time, cheaper than primary data collection. Moreover, secondary data are easier to analyze and compare (Tam et al., 2019). Therefore, the entire search took the following steps to explore barriers to breastfeeding among women.
The first step was locating the secondary data from the relevant databases. For this case, several nursing journals databases such as PubMed, Medline, and Cochrane were visited to access the previous research on barriers to breastfeeding. The keywords for this search were ‘barriers to breastfeeding,’ ‘breastfeeding,’ and ‘challenges to appropriate breastfeeding.’ The search yielded several peer-reviewed journals and articles concerning barriers to breastfeeding. Moreover, WHO and UNICEF websites also provided relevant data about the benefits and effects of the inappropriate breastfeeding process. The second step entailed thematic analysis of the searched journals by identifying standard vital terms, themes, and ideas in the articles. The third step was further research on the identified themes to ascertain the journal’s main issues. The final step in this methodology was verifying and validating the identified themes. Verification involves further research on the themes to compare what other researchers have found regarding the topic at hand. Despite its advantages, the secondary methodology has setbacks, such as biased opinions and emotions among the authors (Tam et al., 2019). The other challenge experienced during the search was obtaining the exact data that fit the search needs.
However, five research journals on barriers to breastfeeding were identified and analyzed. The first research journal relevant to this topic was Hernández-Cordero et al., published in 2021, regarding hurdles and enablers to breastfeeding during immediate and one-month postpartum periods. Another journal polished in 2020 by Shobo et al. was also relevant for this study. Shobo et al. (2020) investigated factors influencing the early initiation of breastfeeding in public primary healthcare facilities. The third journal that was insightful as breastfeeding is concerned was Bookhart et al., published in 2021, which investigated factors hindering breastfeeding. Moreover, an article by Orr et al. in 2018 was also relevant as it studied the relationship between household foods and mothers’ breastfeeding behavior. Furthermore, two more pieces that investigated overcoming breastfeeding barriers were also insightful and helped in building this literatures review on barriers to breastfeeding are concerned.
Critical Literature
Overweight and Obese Mothers
Overweight and obese mothers believe that they have less milk than normal-weight mothers. The mindset for over decades has been a barrier as breastfeeding babies is concerned. Many overweight mothers discontinue breastfeeding their young ones at four months and adopt the available infant formula. Kair and Colaizy (2016) investigated if overweight and obese mothers have less breast milk production than normal-weight mothers, as believed by the victims. This study aimed to examine the breastfeeding hurdle among obese and overweight mothers.
This study utilized data retrieved from the Centers for Disease Control and Prevention (CDC) Prevention Risk Assessment Monitoring Systems (PRAMS) to identify barriers for overweight and obese mothers who initiated breastfeeding after delivery. This study was conducted on 6467 women who had delivered and started immediate breastfeeding but stopped after some months. Kair and Colaizy (2016) found that there is a high probability of discontinued breastfeeding among overweight and obsessed mothers. The study revealed that overweight and obese mothers hold that their babies were not contented and pleased with breast milk alone and hence supplemented breast milk with other solid foods or adopted infant formula.
Throughout this research, milk inadequacy among obese mothers was significantly cited as the hurdle to breastfeeding among overweight and obese mothers. According to Kair and Colaizy (2016), there is a belief that obese mothers produce less milk than average weighted women; as such, obese mothers reside to another feeding formula to supplement breast milk. Previous research has shown that obese mothers introduce solid foods to their babies at barely four months (Kair & Colaizy, 2016). The overweight mother adopted the feeding formula because they believed that breast milk alone was insufficient to satisfy their babies’ nutritional needs. Moreover, the study reports that some obese mothers experience difficulties with breastfeeding and thus discontinue the practice. Although obese mothers experienced less nipple pain, which the previous research identified as the main threat to breastfeeding, they still stopped breastfeeding their babies for personal reasons. Further, Kair and Colaizy (2016) also found that obese mothers were likely to cite cases of jaundice among infants as the reason to discontinue breastfeeding their young ones. This is because; increasing maternal body mass index (BMI) is associated with cases of neonatal jaundice.
Household Food Insecurity and Breastfeeding
Food abundance and insecurities dictate children’s feeding habits and adults’ eating behavior. People living in an environment with an adequate food supply tend to eat more than those experiencing food shortages. Orr et al. (2018) carried out research to determine how food insecurity affects infants feeding practices. The study specifically aimed to define the relationship between food insecurity and breastfeeding initiation and cessation among women living under adverse poverty. This study was conducted on 10,450 women who had completed maternal experiences in the Canadian Community between 2005-and 2014 (Orr et al., 2018). Orr et al. (2018) define household food insecurity as inadequate or insecure access to food due to scarcity of financial constraints. This is a public health problem because it seriously affects households with babies who depend on mothers’ breast milk. According to Orr et al. (2018), food insecurity adversely affects children’s breastfeeding as most mothers have higher odds of supplementing breast milk with the available infant formula and solid foods. This research study was formulated and conducted to investigate if women struggling with food shortages could follow WHO breastfeeding recommendations.
Although adherence to breastfeeding procedures is unclear, food shortage contributes to the early cessation of breastfeeding among vulnerable women with inadequate food access. According to Orr et al. (2018), food insecurities and poverty affects many families in Canada, and they are forced to stop their young ones from breastfeeding. Furthermore, the research found that between 1998 and 2002, breastfeeding for four months was a nightmare for women struggling with financial constraints. Breastfeeding cessation is attributed to several psychological disturbances such as stress and depression. This study found that 17 percent of the population examined lived under food insecurity; a considerable portion lived under marginal, moderate, and severe food insecurity. It was found that households with sufficient food supply registered a higher percentage of breastfeeding initiation than those with food insecurities. In summary, the findings of this study indicated that most women initiated breastfeeding regardless of food constraints. The research also acknowledged that food insecurity has a negative impact on the duration of exclusive breastfeeding practice. Therefore, household food insecurity is a barrier as initiation and continued breastfeeding in babies are concerned.
Cultural Narratives
Today, the world is experiencing the effect of cultural narratives spread about breastfeeding. Although modern societies parrot the importance of breastfeeding, few take the knowledge they already have into practice. The world is intoxicated by the notion that breastfeeding is more problematic than infant formula. Many women reside in infant formula and other solid foods before their babies reach six months. According to Tomori (2022), the Western communities in the world possess cultural stigmatization of breastfeeding young ones are concerned. Moreover, this research holds that cultural barriers are today rooted in most parts of the world as the practice is regarded as discomfort to women’s bodies. Most communities believe that formula feeding among babies is cheap and easy. This notion has spread from generation to generation and thus, influences the recommended exclusive breastfeeding practice, as WHO says.
Moreover, one of the pervasive narratives that have intoxicated the world is the notion that the human body cannot produce enough milk to cater to babies’ nutritional needs. Tomori (2022) found that many women and society generally prefer another infant formula before their babies reach six months. This is worrying because inappropriate breastfeeding has detrimental effects on children as physical and mental health is concerned. Tomori (2022) has reviewed the history of breastfeeding in the United States and has found that cultural beliefs are the number one enemy of appropriate breastfeeding. Moreover, the research also attributed women’s breastfeeding failure to many infant formula companies who advertise their alternative feedings to the public. This is unethical because children have the right to get exclusively breastfed until they are six months. However, this study has identified some of the interventions that can be put in place to improve breastfeeding in the United States. Maternal care, postpartum care, and education on the importance of breastfeeding are some of the intervention plans recommended by this study. In summary, cultural narrative and alternative infant formula are barriers to appropriate breastfeeding practice.
Hospital Practices
Hospital practices also, to some extent, determine and influences the feeding behaviors that a maternal mother exhibits. According to Hernández-Cordero et al. (2020), deficient hospital practices and sociocultural alongside community factors have a negative impact on children’s breastfeeding practice. For example, Hernández-Cordero et al. (2020) found that providing infant formula to women in the healthcare units nurtures an intermittent breastfeeding culture. Moreover, the research also positively found that the separation of babies from their mother promote the use of alternative feeding practices that are assumed to be an equivalent surrogate for breast milk. Inadequate perinatal care and supports significantly influence breastfeeding characteristics. According to Hernández-Cordero et al. (2020), mothers who get access to proper perinatal care, support, and advice show concern for their babies, initiate breastfeeding and maintain practices as WHO recommends. Previous qualitative research has proved that psychosocial, multiple physical, and emotional factors significantly control the type of feeding programs women adopts. Moreover, health inequalities, social norms and beliefs, and public policies administered in healthcare facilities during maternal care also have a share in controlling breastfeeding among children are concerned.
This research study successfully investigated the influence of hospital practices on the feeding programs adopted by Mexican women. Out of the 224 women tested, about 15 percent reported that they were briefed on the importance of breastfeeding, were concerned about their babies’ physical and mental health, and, as such, stuck to the breastfeeding procedures. Moreover, 65 percent also acknowledged the work of hospital support groups and further reinforced their knowledge and attitudes as breastfeeding is concerned. According to this study, breastfeeding characteristics solely depended on the received information and support mothers were put through during prenatal and postpartum care. Moreover, Hernández-Cordero et al. (2020) found that babies born by cesarean had high odds of receiving late breastfeeding initiation after birth. In addition, the research found that children born at private hospitals are most likely to be subjected to infant formula supplements than those delivered in public hospitals. Hospital practices, thus, influence and could be a barrier to breastfeeding young babies.
Breastfeeding Support
Finally, breastfeeding support, just like other discussed barriers, plays a significant role as women breastfeeding culture is concerned. Bookhart et al. (2021) conducted research based on the importance of maternity care and women’s perception that human milk is unsuitable or inadequate for babies’ growth. This is a notion that many communities have held on to and is affecting the breastfeeding habits and patterns that women have developed in feeding their babies. Besides, the research further indemnifies other barriers to the complete adoption of the recommended breastfeeding programs among women. According to Bookhart et al. (2021), level of education is also another factor that significantly influences women understanding of the issue of breastfeeding. The study presented that those women with a higher level of education show higher odds of initiating and continuing with exclusively breastfeeding their babies up to the recommended six months. Population disparities also are a massive barrier to exclusive breastfeeding practice. According to Bookhart et al. (2021), the research found that disparities in subpopulation groups such as the non-Hispanic population hinder exclusive breastfeeding in the United States. Therefore, this is a serious issue that must be dealt with to enhance breastfeeding among the subpopulation.
Although the research holds on to the lack of education and support as the leading cause of less initiation and cessation of breastfeeding among women, the study also agrees that factors across the social-ecological model also had a significant effect on exclusive breastfeeding. The key determinants in this model included the perception of inadequate mother’s milk, personal and customized breastfeeding therapy, and provision of prenatal and postpartum women’s education on the importance of breastfeeding. This research, therefore, calls for a multilevel approach to backing in Hospital exclusive breastfeeding practices among most women in the world to save dying children globally. In summary, the research found that breastfeeding is primarily influenced and affected by intrapersonal, interpersonal, institutional, and Community based factors, including relationships between organizations.
Conclusion
In summary, breastfeeding is the feeding of newborn babies and those children below the age of two years. The discussion in this paper has proved that breastfeeding should be mandatory because inappropriate breastfeeding has many detrimental effects on children’s physical and mental health. Poorly breastfed children show lower IQ levels, prone to disease, ear infections other serious illnesses. On the contrary, mothers who stick to the WHO breastfeeding plans do save not only their babies but also reduce their risk of ovarian and breast cancer. Furthermore, inappropriate breastfeeding in some cases leads to death among young children. Although the world now knows the benefits of breastfeeding, not all mothers stuck to the WHO-recommended breastfeeding plan. This is because the world experiences many breastfeeding barriers that influence mothers’ feeding habits for their babies.
By analyzing five previous empirical studies concerning barriers to breastfeeding, this critical literature has identified some of the obstacles that exist as children breastfeeding is concerned. The first barrier that the previous studies identified is the issue of overweight and obese mothers as a barrier to breastfeeding. It states that these mothers have high odds of discontinuing breastfeeding their young ones barely at four months. Food insecurity also affects and is a barrier to breastfeeding. This influences the mother’s feeding habits, depression, and stress leading to low milk production. On the list are also cultural narratives that the community hold as breastfeeding is concerned. Cultural narratives and beliefs that breastfeeding is problematic have immensely changed the babies feeding style. Other barriers to breastfeeding identified include hospital practices and the availability of support groups in healthcare facilities.
References
Bookhart, L., Joyner, A., Lee, K., Worrell, N., Jamieson, D., & Young, M. (2021). Moving beyond breastfeeding initiation: A qualitative study unpacking factors influencing infant feeding at hospital discharge among urban, socioeconomically disadvantaged women.Journal Of The Academy Of Nutrition And Dietetics, 121(9), 1704-1720. Web.
Hernández-Cordero, S., Lozada-Tequeanes, A., Fernández-Gaxiola, A., Shamah-Levy, T., Sachse, M., Veliz, P., & Cosío-Barroso, I. (2020). Barriers and facilitators to breastfeeding during the immediate and one-month postpartum periods, among Mexican women: a mixed-methods approach.International Breastfeeding Journal, 15(1). Web.
Kair, L., & Colaizy, T. (2016). When breast milk alone is not enough.Journal Of Human Lactation, 32(2), 250-257. Web.
Orr, S., Dachner, N., Frank, L., & Tarasuk, V. (2018). Relation between household food insecurity and breastfeeding in Canada.Canadian Medical Association Journal, 190(11), 312-319. Web.
Shobo, O., Umar, N., Gana, A., Longtoe, P., Idogho, O., & Anyanti, J. (2020). Factors influencing the early initiation of breastfeeding in public primary healthcare facilities in Northeast Nigeria: A mixed-method study.BMJ Open, 10(4), e032835. Web.
Tam, V., Patel, N., Turcotte, M., Bossé, Y., Paré, G., & Meyre, D. (2019). Benefits and limitations of genome-wide association studies.Nature Reviews Genetics, 20(8), 467-484. Web.
Tomori, C. (2022). Overcoming barriers to breastfeeding.Best Practice & Research Clinical Obstetrics & Gynaecology. Web.
WHO. (2022). Breastfeeding. Who.int. Web.