Exclusive breastfeeding promotion : a summary of EPB [expanded promotion of breastfeeding] qualitative research on infant feeding

Findings, based on focus group discussions, interviews with key informants, 24-hour recall observations, and behavioral trials, revealed that successful breastfeeding is impeded by the following practices: separation of mother and infant at birth; giving water or prelacteal feeds; delayed initiation of the first breastfeeding; discarding colostrum as harmful to infant health; scheduled rather than on-demand feeding; insufficient frequency and duration of feedings; perceived "insufficient milk," leading to early supplementation; and abrupt cessation of breastfeeding. These findings tend to confirm existing beliefs in Western medicine about optimal breastfeeding practices. The study recommends that social marketing and training of health workers is essential to promote breastfeeding. Another recommendation is to develop culturally acceptable social marketing messages designed to overcome specific feeding problems. For example, in response to perceived milk insufficiency (an almost universal concern), women need to be reassured that more breastfeeding produces more milk, not less.