State of breastfeeding in the Dominican Republic : practices and promotion -- final report

Results show that most mothers (90-98%) initiate breastfeeding, but only a few (10%) breastfeed exclusively during the first 3 months, and virtually none breastfeed exclusively during months 4-6. Mothers are well informed about the health advantages of breastfeeding but the gap between knowledge and practice is wide. One-third stop breastfeeding by 3 months. Dominican mothers have many beliefs about when breastfeeding must be stopped or at least supplemented (e.g., when mothers have fever, anemia, or are hot and sweaty, or when babies have diarrhea or vomit). There is no difference in initiation rates between women who work outside the home and those who do not, although those who work outside the home stop breastfeeding earlier, generally because they lack support for continuing. Ironically, Dominican law is supportive of breastfeeding -- it assures 12 weeks of paid maternity leave, three 25-minute breastfeeding breaks for 8 months, and nurseries at workplaces with more than 30 employees. In reality, only maternity leave is granted, and few Dominicans are aware of the other provisions. Medical personnel receive little, if any, in-depth training in breastfeeding. In the public sector, there is a breastfeeding policy, although with the exceptions of hospitals, it is not applied; physicians and nurses are apt to recommend formula under any unusual circumstance. In private hospitals breastfeeding is the norm. Auxiliary health workers, especially promoters from NGO"s, have received some training. Most current activities to promote breastfeeding are based with private organizations, often with USAID funding. Recommendations for further USAID assistance are included. (Author abstract, modified)