Barriers to exclusive breastfeeding in the Ayeyarwaddy Region in Myanmar: Qualitative findings from mothers, grandmothers, and husbands.
BACKGROUND
Myanmar has low rates of exclusive breastfeeding despite many decades of efforts to increase this practice. The purpose of this study is to examine the barriers to exclusive breastfeeding and how different household members participate in decision-making.


METHODS
We conducted semi-structured interviews with mothers with an infant 6-12 months (24), and a subset of their husbands (10) and their mothers/mothers-in-laws (grandmothers) (10) in rural and urban areas of Laputta, Myanmar.


RESULTS
Respondents had high levels of knowledge about exclusive breastfeeding, but low adherence. One of the primary barriers to exclusive breastfeeding was that mothers, husbands, and grandmothers believed that exclusive breastfeeding was not sufficient for babies and solid foods and water were necessary. Water and mashed up rice were commonly introduced before 6 months of age. Mothers also faced barriers to exclusive breastfeeding due to the need to return to work outside the home and health related problems. Other family members provide support for mothers in their breastfeeding, however, most respondents stated that decisions about breastfeeding and child feeding were made by the mother herself.


CONCLUSIONS
Mothers in this part of Myanmar know about exclusive breastfeeding, but need more knowledge about its importance and benefits to encourage them to practice it. More information for other family members could improve adherence to exclusive breastfeeding, as family members often provide food to children and support to breastfeeding mothers. Support for mothers to be able to continue breastfeeding once they return to work and in the face of health problems is also important. Finally, additional information about the types of foods that infants need once they cease breastfeeding could improve infant and child health.
Population Services International, No.16, Shwe Gon Taing Street 4, Yangon, Myanmar.
May Me
MM
Thet
Population Services International, No.16, Shwe Gon Taing Street 4, Yangon, Myanmar.
Ei Ei
EE
Khaing
Global Health Group/UCSF Global Health Sciences, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158, USA. Electronic address: nadia.diamond-smith@ucsf.edu.
Nadia
N
Diamond-Smith
Global Health Group/UCSF Global Health Sciences, University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA 94158, USA.
May
M
Sudhinaraset
Population Services International, No.16, Shwe Gon Taing Street 4, Yangon, Myanmar.
Sandar
S
Oo
Population Services International, No.16, Shwe Gon Taing Street 4, Yangon, Myanmar.
Tin
T
Aung
D000328:Adult; D000368:Aged; D001942:Breast Feeding / Q000523:psychology*; D003657:Decision Making; D005260:Female; D000066502:Grandparents / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D002052:Myanmar; D036301:Qualitative Research; D012424:Rural Population; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult
Child feeding; Decision-making; Exclusive breastfeeding; Myanmar