Cultural practices in exclusive breastfeeding (Part 2: The Analysis)

My previous blog post discussed cultural practices and beliefs that have been identified as barriers to exclusive breastfeeding in the Faluni women of the Ndu area of North West Province of Cameroon. The barriers identified were:

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.

Other barriers include the need to return to working in the fields, which may be a long distance away and where they cannot bring the infant. Without pumping or a way to keep the breastmilk, exclusive breastfeeding may be close to impossible.

The point of this case or blog post is not to criticize these cultural beliefs or practices, but to illustrate where we face extreme difficulties in encouraging exclusive breastfeeding for the first 6 months of the child's life. It also illustrates some limits to introducing Western best practices into indigenous populations. The authors did find a difference in compliance when comparing the rate exclusive breastfeeding between the educate and illiterate. While not significant, it did appear that those with at least a primary school education more frequently attempted to comply with medical advice than illiterate women.

In class, Dr. Acharya discussed how we can begin to do work in populations where we are outsiders. It probably requires dropping our expert status, being vulnerable, and really listening. BUT! I am not certain that this population would identify any issues with how feeding is conducted in their society. Where I see a loss of agency in decision making (mixed feeding is an "old" practice encouraged by elders and group processes are in effect which may shame or ostracize women that do not comply), how is this any different than Western norms? We eat and shake with our left hands-- this would be inappropriate in other populations. What practices do we perpetuate through group pressures?