1. Objective 1: Barriers to promoting breastfeeding in communities

2. 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

3. 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.

4. 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

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

6. 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

7. 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