Uncovering the barriers to exclusive breast feeding for mothers in a rural set up of southern India

INTRODUCTION: Exclusive breast feeding (EBF) is of paramount importance for a child’s growth and development. The aim of this study was to determine the prevalence of EBF practices, examine factors associated with such practices, and uncover the barriers to EBF practices in the community.
METHODS: A cross-sectional study with structured questionnaires was conducted among 252 mothers with children aged 6 - 9 months in the community covering southern Chennai and adjoining districts of Chengalpet and Kanchipuram from October 2018 to October 2019. Multiple logistic regression was used to determine factors associated with EBF.
RESULTS: Seventy three percent (184/252) of mothers had followed EBF practices till child completed 6 months of age. About 58% of mothers initiated breastfeeding within 1 h of birth, with 32.53% reporting to have fed colostrums to the child. Mothers (19.80%) reported prelacteal feed administration. Perceived milk insufficiency (58.82%) was the commonest problem reported by mother that led to EBF discontinuation. Children of mothers who were working (OR 3.32; 95% CI 1.13, 9.70), residing in urban (OR; 6.67 95% CI 1.12, 39.66) and semi-urban areas (OR; 12.47 95% CI 2.05, 75.90) were less likely to be exclusively breastfed as evident from multivariate regression analysis. No association was found with sex of baby, birth order, lactation counseling, and administering prelacteal feed.
DISCUSSION AND CONCLUSION: Working mothers and those residing in urban areas were at higher risk of not adhering to EBF. The national impact of increasing urbanization and the impact on EBF practices should be studied in greater depth.