Exclusive breastfeeding promotion : a summary of findings from EPB's applied research program (1992-1996)

(1) Focus on the first week and month postpartum; if women exclusively or fully breastfed beyond this critical period, they are likely to continue. (2) Focus on specific messages that target key behaviors. General messages such as breast is best' are less effective than messages that target key behaviors that impede optimal infant feeding, such as use of medicinal water and sugar and salt solutions in response to infant crying or stomach discomforts, the use of water to prevent dehydration, or the early introduction of complementary foods to get infants accustomed to it. (3) Focus on families and communities. In all the countries and settings where research was conducted, exclusive breastfeeding is not a cultural norm. Thus -- to varying degrees -- social support, social networks, and the health system are negative influences that must be countered. (4) Focus on low birthweight (LBW) infants. LBW is a significant risk factor for not breastfeeding. (5) Focus on employed women. Although the effect of maternal employment on breastfeeding has been mixed, the effect on exclusive breastfeeding has been consistently negative. (6) Focus on women's nutrition. Nutrition is a concern to breastfeeding women; exclusive breastfeeding is believed to be harmful to maternal nutrition. (7) Focus on integrating breastfeeding promotion into existing health systems. Health systems are in a unique position to take advantage of frequent contacts with women with young infants.