Ruchika Chugh Sachdeva1, Jayashree Mondkar2, Sunita Shanbhag3, Minu Manuhar3, Aisha Khan2,3, Rajib Dasgupta4, Kiersten Israel-Ballard1,5. 1. 1 Department of Maternal, Newborn, Child Health and Nutrition, PATH, New Delhi, India. 2. 2 Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, India. 3. 3 Department of Neonatology, MBFI+ project, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, India. 4. 4 Community Health, Jawaharlal Nehru University, New Delhi, India. 5. 5 Department of Maternal, Newborn, Child Health and Nutrition, PATH, Seattle, Washington.
Abstract
BACKGROUND: Known interventions like breastfeeding and kangaroo mother care (KMC) can avert a large share of infant deaths. Mother Baby Friendly Initiative Plus (MBFI+) is an integrated approach to ensure exclusive human milk diet through promotion of breastfeeding, KMC, and provision of donor human milk (DHM) to vulnerable neonates lacking mothers' own milk. MATERIALS AND METHODS: Qualitative research was conducted among 56 service recipients including mothers and key influencers and 9 service providers to understand their knowledge, perceptions, and practices on breastfeeding, KMC, DHM, and human milk banks (HMBs) in 2 facilities in India, one with and another without an operational HMB. This article presents the findings on breastfeeding and KMC. RESULTS: Nearly all mothers mentioned that antenatal visits lacked information on breastfeeding. Most were unaware of the recommended duration of exclusive breastfeeding. Most parents knew about the benefits of breast milk and colostrum. Limited staff and privacy in facilities resulted in inadequate breastfeeding and milk expression support to mothers, who found feeding of preterm and low-birth-weight babies challenging. Mothers shared challenges in breastfeeding at home, such as low family support and privacy and burden of household chores. Only those mothers who practiced KMC were aware of its benefits. Few service providers and recipients were comfortable with the practice of wet nursing in the absence of breastfeeding. CONCLUSIONS: MBFI+ is a promising approach to strengthen breastfeeding and KMC. Quality counseling on breastfeeding and milk expression from antenatal period, increasing awareness and training on KMC for mothers, improving infrastructure, addressing staff shortage, and building capacities of hospital staff on MBFI+ are needed.
BACKGROUND: Known interventions like breastfeeding and kangaroo mother care (KMC) can avert a large share of infantdeaths. Mother Baby Friendly Initiative Plus (MBFI+) is an integrated approach to ensure exclusive human milk diet through promotion of breastfeeding, KMC, and provision of donorhuman milk (DHM) to vulnerable neonates lacking mothers' own milk. MATERIALS AND METHODS: Qualitative research was conducted among 56 service recipients including mothers and key influencers and 9 service providers to understand their knowledge, perceptions, and practices on breastfeeding, KMC, DHM, and human milk banks (HMBs) in 2 facilities in India, one with and another without an operational HMB. This article presents the findings on breastfeeding and KMC. RESULTS: Nearly all mothers mentioned that antenatal visits lacked information on breastfeeding. Most were unaware of the recommended duration of exclusive breastfeeding. Most parents knew about the benefits of breast milk and colostrum. Limited staff and privacy in facilities resulted in inadequate breastfeeding and milk expression support to mothers, who found feeding of preterm and low-birth-weight babies challenging. Mothers shared challenges in breastfeeding at home, such as low family support and privacy and burden of household chores. Only those mothers who practiced KMC were aware of its benefits. Few service providers and recipients were comfortable with the practice of wet nursing in the absence of breastfeeding. CONCLUSIONS: MBFI+ is a promising approach to strengthen breastfeeding and KMC. Quality counseling on breastfeeding and milk expression from antenatal period, increasing awareness and training on KMC for mothers, improving infrastructure, addressing staff shortage, and building capacities of hospital staff on MBFI+ are needed.
Authors: Tony Ma; Katie Chang; Amal Alyusuf; Elina Bajracharya; Yukiko Washio; Patricia J Kelly; Roopa M Bellad; Niranjana S Mahantashetti; Umesh Charantimath; Vanessa L Short; Parth Lalakia; Frances Jaeger; Shivaprasad Goudar; Richard Derman Journal: JMIR Form Res Date: 2022-09-08