Barriers to Breastfeeding Study

Suboptimal infant feeding contributes to 800,000 child deaths per year globally. Barriers to Breastfeeding was a focused ethnographic study of first time mothers in a rural coastal community in Kilifi County, Kenya that set out to determine the factors leading to this distressing statistic.

Conducted between 2016-18 — the study followed twenty mothers from late pregnancy until their babies were six months old, focusing on the challenges encountered in following nutrition advice to breastfeed only. Through visiting mothers in their homes and observing their interaction with other family members, Dr Alison Talbert developed an in-depth understanding of the drivers and barriers related to exclusive breastfeeding.

‘Exclusive breastfeeding up to 6 months of age is recommended by the World Health Organization as the optimal mode of infant feeding, providing adequate nutrition for the baby and protection against infectious diseases. Breastfeeding can be adversely affected by individual, cultural and socio-economic factors. The study aimed to explore barriers of exclusive breastfeeding in the first six months of life among first-time mothers in rural Kenya.’

sankalpa funded the research costs of the two year study, support which enabled Alison to undertake a detailed holistic examination of young mothers’ autonomy and choices in infant feeding in Kilifi County. The study has provided an additional body of knowledge in relation to young people’s daily lives in sub-Saharan Africa and the gathered data is being used to raise awareness of the lack of breastfeeding support for mothers at a local level in Kenya. 

The first paper of the findings has been published in the International Breastfeeding Journal and a further paper is being prepared for publication. The findings have also been presented at a workshop at Liverpool School of Tropical Medicine, and at a seminar at The KEMRI Wellcome Trust Research Programme.

Although community feedback has been delayed due to the impact of Covid-19, as of June 2020 the research has been shared in a number of other ways. In addition to visiting 80 households to talk with both mothers and grandmothers, Alison has shared the results with the sub-county health management team, community leaders and representatives. Alison has also worked with the local health facility — enabling them to show instructional videos on breastfeeding during mother and child clinics. Post Covid, the clinic plans to hold regular open days with the community where correct breastfeeding positioning and attachment will be demonstrated.

Today Alison is still attached to The KEMRI Wellcome Trust Research Programme in Kilifi. Her work involves developing interventions to prevent malnutrition in infants under six months, alongside community management of uncomplicated severe acute malnutrition (in children of the same age) and nutritionally vulnerable mothers.