Abstract
To explore why women in Ghana initiate breast-feeding early or late, who gives advice about initiation and what foods or fluids are given to babies when breast-feeding initiation is late. Qualitative data were collected through 52 semistructured interviews with recent mothers, 8 focus group discussions with women of child-bearing age and 13 semistructured interviews with health workers, policy makers and implementers. The major reasons for delaying initiation of breast-feeding were the perception of a lack of breast milk, performing postbirth activities such as bathing, perception that the mother and the baby need rest after birth and the baby not crying for milk. Facilitating factors for early initiation included delivery in a health facility, where the staff encouraged early breast-feeding, and the belief in some ethnic groups that putting the baby to the breast encourages the milk. Policy makers tended to focus on exclusive breast-feeding rather than early initiation. Most activities for the promotion of early initiation of breast-feeding were focused on health facilities with very few community activities. It is important to raise awareness about early initiation of breast-feeding in communities and in the policy arena. Interventions should focus on addressing barriers to early initiation and should include a community component.
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Zelee Hill has received consultancy fees from the Gates Foundation. Betty R Kirkwood has received grant support from DFID, USAID, Saving Newborn Lives and WHO. Betty R Kirkwood has also participated in the Vikram Patel Welcome Trust Senior Clinical Research Fellowship in Tropical Medicine and the Dominique Behague Welcome Trust Research Development Fellowship. The remaining authors have declared no financial interests.
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Tawiah-Agyemang, C., Kirkwood, B., Edmond, K. et al. Early initiation of breast-feeding in Ghana: barriers and facilitators. J Perinatol 28 (Suppl 2), S46–S52 (2008). https://doi.org/10.1038/jp.2008.173
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DOI: https://doi.org/10.1038/jp.2008.173
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