| Popis: |
Background Sri Lanka was named as the first-ever 'Green' breastfeeding (BF) nation status by the World Breastfeeding Trends Initiative (WBTi) in January 2020. However, capacity exists for improvement. This study aims to identify barriers and facilitators for early initiation of breastfeeding (EI) and exclusive BF (EBF) for 6 months in rural Sri Lanka. Methods We conducted in-depth interviews with 16 mothers with infants, who had been unable to practice EI and/or EBF, in six child-welfare clinics in Anuradhapura, Sri Lanka. Three focus group discussions were held with public health midwives (PHMs). Initial thematic analysis that built upon force field and social learning theories was performed. Results Main barriers for EBF were clustered at three time periods; during the first 2-3 days, 2-3rd week, and 4-5 months post-partum. Early barriers included cesarean section pain, poor latch, maternal exhaustion, Suboptimal maternity ward environment, lack of support for BF led to maternal stress. Around 2-3 weeks postpartum mothers introduced water or infant formula due to social norms and poor support. On-demand feeding was poorly practiced. Around 4 and 5 months EBF ended due to return to work. PHMs reported heavy workload impede support for BF. Conclusion Interruption of EBF are due to specific barriers corresponding to specific periods within first six months. Sri Lanka should focus on strengthening policies for reducing the excessive rates of cesarean section, better postnatal ward facilities, demand feeding, support for working mothers and reducing the work load of PHMs in order to optimize EBF. |
