Objective 1: Barriers to promoting breastfeeding in communities

Barriers Household level Community level Community norms, e.g. Cultural practices need to educate families (men, in laws – mothers in law) CHW visit important, but in conflict with the seclusion practice. Men- influence on breastfeeding, educate them to be able to support their partners Grannies’ influence Community level Must start at antenatal care Alcohol use – may influence women to rush to stop breastfeeding Cultural beliefs- e.g. If you are pregnant and have a breastfeeding baby MYTH: baby could have a psycho logical problems

Barriers Conflict between breastfeeding and demand for child maintenance Lack of Feeding places Sekgalaka- sore in the breast then elders say stop breastfeeding Sekgalaka should not stop breastfeeding as can still b/f with the other breast Is treatable! Ditantanyane- baby fed with mixture of root ‘tea’ Impact and influence of imported culture through media influence & peer group pressure,etc.

Barriers HCW- don’t give proper information to the mother due to high workload Post C/S moms- practice that baby needs to suckle within the first hr not possible as mom and baby are separate Doctors are influential and often choose the ‘easier’ option of formula feeding. Problems identified at ANC not addressed and become a problem post-delivery

Barriers Teenagers and working moms- not always practical to continue b/f AFASS Private sector- sometimes contradicts public health policy

What needs to be done? Community leadership- advocate for promotion of breastfeeding Involve men in health care practice & support to partners in breast feeding Capacity building & in service training for HCWs & CHWs Regulate the formula Feed industry Fast track code of marketing

Should speak in one voice promote the use of health facilities for information and support for motherrs How do we support our leaders to support breastfeeding?- Capacity building