Breast milk, which has numerous benefits, is the most natural and healthy diet for the baby. Certain personal and environmental factors that influence the mother’s decision to feed her baby in this way may have characteristics that expose her or enable her to benefit more from this food source. In addition, the number of publications and studies supporting breastfeeding in baby nutrition by the World Health Organization is increasing day by day. However, having information about these social determinants allows for a more conscious breastfeeding process. This article contains information about the social factors that affect the mother’s breastfeeding decision.
As stated in the study, the correlations of breastfeeding initiation and duration include maternal status, vaginal birth, previous live birth, multiple live births (multiple), smoking and drinking habits, prenatal care in the first trimester, interview with a healthcare provider about breastfeeding, and delivery factors such as intentionality. Additional factors associated with breastfeeding behavior include maternal age, race and ethnicity, education level, employment status, annual household income, and Body Mass Index (BMI). Adolescent mothers, particularly those who had a cesarean section, experienced postpartum depression, or perceived an insufficient supply of breast milk, were reported to be exclusively breastfed for a shorter period of time.
The ethnicity of the mothers also has a significant relationship to the duration of exclusive breastfeeding, which may be related to the traditions of various ethnic origins, in addition to religious advice and views. For example, in the US, black women have the lowest breastfeeding and duration rates of all ethnicities. The racial breastfeeding disparity among black women in the US continues due to some cultural misperceptions. For example, a common cultural belief prevalent in the black community is that adding cereal to a baby’s bottle will help a baby sleep longer.
Moreover, pre-existing health problems of a mother such as obesity, multiple pregnancy complications, or giving birth to a premature child were also associated with shorter duration of special breastfeeding. A mother’s lack of knowledge about breastfeeding, limited guidance on breastfeeding, poor family and social support are also associated with the absence or shorter duration of exclusive breastfeeding.
In contrast, mothers who have a high school diploma, are married, and are older at birth are more likely to breastfeed. Married mothers are more likely to breastfeed because they are more likely to receive spousal support, which helps to overcome breastfeeding difficulties. Other factors that significantly increase the duration of only breastfeeding include single pregnancy, the opportunity to give birth suitable for breastfeeding, natural vaginal delivery, appropriate weight gain of babies while breastfeeding, and the calmness of the baby.
Man is a social being and most of his actions are influenced by the social environment in which he lives. Breastfeeding is a condition that is affected by the community where the mother lives. Common misperceptions and attitudes towards breastfeeding are real quotes from various members of the global communities that demonstrate common misconceptions about breastfeeding. Cultural attitudes, non-acceptance by society, and social norms that sexualize breasts can deter women from breastfeeding in society. Interventions that promote breastfeeding behavior change should focus on eliminating poor cultural beliefs and practices that result in poor breastfeeding practices. Infant feeding practices are strongly influenced by family members and partners who do not know enough about optimal breastfeeding practices.
In some communities, breastfeeding in the community is perceived as culturally unacceptable practice. Therefore, the propagation of specific communication messages that address common misperceptions based on the positive aspects of breastfeeding while involving partners and other family members is critical to changing negative perceptions about breastfeeding.
Pediatricians, obstetricians and other healthcare professionals are often the most reliable and trusted source for infant health and nutrition. The nursing practices of maternity hospitals and the recommendations of healthcare professionals contribute to the mother’s decision to breastfeed. New mothers may not have confidence or relevant knowledge about breastfeeding, and healthcare professionals can play an important role in guiding breastfeeding and helping to resolve difficulties.
Breastfeeding problems that may arise can be addressed through breastfeeding support and counseling. Therefore, healthcare professionals must be adequately trained to support breastfeeding and help mothers manage common breastfeeding barriers and difficulties. The support of healthcare providers ensures that women have the confidence and skills to breastfeed successfully and best.
However, when healthcare professionals provide baby food promotional materials to pregnant or new mothers, they inadvertently reduce the likelihood of breastfeeding. Studies show that mothers who receive discharge packs containing ingredients useful for breastfeeding are more likely to breastfeed than mothers who receive discharge packs containing free formula samples and coupons. The sooner a mother stops breastfeeding, the more food is purchased, creating an incentive for formulators to market infant formula to women before they give birth; This is usually when the prenatal intention for breast milk or formula is established.
The practices of maternity hospitals regarding breastfeeding and the attitudes and knowledge of healthcare professionals towards infant feeding have a great influence on infant feeding behaviors. Providing information about the benefits of breastfeeding and also providing useful breastfeeding resources, healthcare providers and maternity facilities have the potential to significantly increase breastfeeding prevalence.
In 1991, WHO and UNICEF launched the Baby Friendly Hospital Initiative to improve maternity facilities to better support and promote breastfeeding. In order for a facility to be designated as a “Baby friendly” facility, it must follow the “Ten Steps to Successful Breastfeeding”.
Policies that protect and support breastfeeding are necessary to enable a mother’s decision to initiate and continue breastfeeding. Most of the approximately 1 million full-time women worldwide do not benefit from supportive workplace policies regarding breastfeeding. The prevalence and increase of women working outside the home is often cited with low breastfeeding rates, which indicates the need for workplace policies to support working mothers.
A woman needs to have the time, space, privacy and place to express milk in the workplace and in public places. Legislation supporting women’s breastfeeding choice can help overcome employment barriers and help make the return of breastfeeding become the societal norm and standard nutritional practice.
The absence of legal regulation in the workplace is an important determinant of the shorter duration of exclusive breastfeeding. Key workplace barriers include the lack of flexibility for milk expression in the work schedule, lack of accommodation such as a nursing room equipped to allow mothers to pump or store breast milk, and concerns about employer or colleague support.
Additionally, workplace barriers include the perception that breastfeeding can interfere with the mother’s job performance, the lack of privacy in breastfeeding or breastfeeding, and the inability to find a childcare facility near the workplace, the high cost of day care, insurance regulations, employer building codes and other rules that may restrict babies and children in the workplace. Studies show that supportive workplace environments that provide a dedicated place to express milk and access to a quality breast pump help women continue to breastfeed when they return to work.
Workplace policies, such as paid breaks to express milk, provision of nursing rooms, and public awareness of breastfeeding policies, have the ability to improve mothers’ ability to continue breastfeeding while working. Using data from 182 countries, Atabay et al. (2015) found that in countries with guaranteed paid breastfeeding breaks, the prevalence of exclusive breastfeeding was approximately 9 percentage points higher among babies 6 months and younger than those without paid breaks.
In another study conducted in 2014, 136 out of 176 countries, or about 71% of the world, gave mothers the right to take paid breaks during the working day to provide breast milk for up to 6 months after birth, while four countries allowed shorter leave. (or unpaid breastfeeding breaks). However, 51 countries, which make up the remaining 29% of the world, do not have policies protecting mothers’ right to breastfeed.
In addition, studies show that long-term maternity leave is associated with higher prevalence of exclusive breastfeeding because women can continue to breastfeed without choosing between providing breastmilk to their child or employment. A report from the International Labor Organization found that in most developed countries, 75-100% of the salary is guaranteed for maternity leave of up to 16 weeks. In more than 70 countries, employers are paid through social security systems to reduce their cost burden.
The United States does not have a universal policy that guarantees paid maternity leave, and it also has one of the lowest breastfeeding rates and one of the highest infant mortality rates among developed countries. A study examining 16 countries found that maternity leave policies increased the prevalence of breastfeeding and prevented one to two neonatal deaths per 2000 live births.
In Norway, mothers can receive up to 42 weeks of maternity leave at full pay or 80% for 52 weeks. More than 97% of Norwegian women start breastfeeding and 80% continue breastfeeding for at least 3 months; this is drastically different from 79% of American women who started breastfeeding and 41% who only breastfed at 3 months. Other interventions implemented in Norway to promote breastfeeding include finding information on breastfeeding, educating healthcare professionals to help mothers have positive breastfeeding experiences, and establishing support groups where the mother can share her breastfeeding experiences collectively.
Working Norwegian mothers are entitled to 60 to 90 minutes of breaks per day and can even leave their babies to breastfeed or bring their babies to work. Supportive workplace policies are needed to improve breastfeeding rates and gain the maximum benefit breastfeeding can offer.
Author: Ozlem Guvenc Agaoglu