New mothers in poor urban communities may feel the necessity to work and have a measure of food security rather than trying to find the time and ability for exclusive breastfeeding, research in Haiti finds.
“Poor women and their families in the Petite Anse area of Cap Haitien, Haiti, face serious challenges due to poverty,” says lead author Carolyn Lesorogol, professor and associate dean for global strategy and programs at the Brown School at Washington University in St. Louis.
As reported in Maternal & Child Nutrition, Lesorogol and coauthors found that food insecurity, women’s time, and employment all had negative implications for exclusive breast feeding (EBF).
“When a woman has a baby, she often faces a stark choice between staying home with the baby in order to exclusively breastfeed but forgoing income from employment, or leaving the baby at home while she works and forgoing exclusive breast feeding,” Lesorogol says.
“In either case, household income may be so low that food insecurity persists, triggering perceptions of breast milk insufficiency leading to abandonment of EBF, or continuation of last-resort EBF that might put mother and child at risk of undernutrition.”
The study used mixed methods to show the relationships among urban context, poverty factors, and breastfeeding practices. The research suggests that policies and programs addressing these constraints may increase EBF with positive implications for maternal and child health.
“Breastfeeding is important in Haiti and elsewhere for the health effects on children,” Lesorogol says. “EBF confers many benefits for infants in terms of nutrition, immunity to disease, and also protection from harmful pathogens in the environment that they are exposed to if they are fed other foods or liquids too early.”
Thus, she says, the international recommendation is for six months of exclusive breastfeeding.
“In our research, we found that women valued EBF and wanted to do it, but the barriers that we discussed in the article were preventing them from optimal breastfeeding,” Lesorogol says.
“Also, ‘last-resort’ breastfeeding presents a challenge since it means that women are adhering to breastfeeding guidelines, but out of necessity rather than by choice, and given the high level of food insecurity that drives them to ‘last-resort’ EBF, they and their babies may actually be at greater risk for undernutrition.
“The upshot is that women and infants need more and better supports to enable them to practice optimal breastfeeding behaviors.”
Coauthors are from the Brown School, Indiana University, and Universite Publique du Nord au Cap Haitien.