Cultural practices in exclusive breastfeeding (Part 1: A case study?)

Hi.

Source:

Kakute, P. N., Ngum, J., Mitchell, P., Kroll, K. A., Forgwei, G. W., Ngwang, L. K., & Meyer, D. J. (2005). Cultural barriers to exclusive breastfeeding by mothers in a rural area of Cameroon, Africa. Journal of Midwifery & Women’s Health, 50(4), 324-328.

A previous blog of mine served as an introduction to exclusive breastfeeding. While doing further research on the topic, I found quite a few article that discuss barriers to exclusive breastfeeding in very specific cultures (read: not U.K. or U.S. populations). In more remote areas, we can expect to see different expectations for breastfeeding and baby raising. One article, the citation provided above, interviewed women in tribal groups living in the Nde area of North West Province of Cameroon. The women identified several cultural beliefs that served as barriers to exclusive breastfeeding. These barriers persist in the face of Knowledge provided by local medical providers. Remember that the WHO and UNICEF recommend exclusive breastfeeding for the first 6 months of the babies life, with supplementary food being added alongside breastfeeding for the 6 months to 2 years period. They also recommend breastfeeding within the first hour of the child's life. The mothers interviewed practiced mixed feeding where they would combine breastfeeding with water, tea, or other foods.


The cultural beliefs listed are (with discussion to follow):

1) Mixed feeding is a traditional practice encouraged by village elders. This is an issue because NOT supplementing breastfeeding could lead to issues with husbands, mothers-in-law, or women village elders.

2) Breastfeed is though to be an incomplete food source that only serves to satisfies a baby's thirst but does not help with the babies weight. A babies cry is a demand for MORE than breast milk

3) Mother's work to produce enough food to feed their family. If the food is for the family, it should go toward the family.

4) Sexual contact is prohibited during the breastfeeding period-- sexual intercourse is believed to spoil both the milk and child. 

The initiation of breastfeeding, including the provision of the colostrum, is also influenced by cultural beliefs. Colostrum is:

the milky fluid that comes from the breasts of humans, cows, and other mammals the first few days after giving birth, before true milk appears. It contains proteins, carbohydrates, fats, vitamins, minerals, and proteins (antibodies) that fight disease-causing agents such as bacteria and viruses. Antibody levels in colostrums can be 100 times higher than levels in regular cow’s milk.

Colostrum also helps encourage a babies first stool. Colostrum, as discussed in class, would be extremely lucrative if able to be produced on mass. The Fulani women prefer giving cow's milk and viindi (local substance) rather than colostrum, which they believe to have no nutrients. Other issues with colostrum include the color being seen as "bad". The Fulani women also waited more than 2 days to breastfeed their babies. Again, the WHO recommendation is breastfeed within the first hour of life.

Their are other considerations at play with the Fulani women-- they work in the field and on farms. They may have to travel long distances to the field, which necessitates leaving the baby with grandparents or other caregivers. Without pumping or refrigeration, it is close to impossible to provide enough daily milk to take care of the baby through exclusive breastfeeding. The women also are aware of the relationship between supplemental feeding and diarrhea, but recognize that they have to return to the fields for work. Analysis to begin in Part 2! The adventure continues...