Breastfeeding problems and associated factors: a cross-sectional study after the 2023 Türkiye earthquake

Breastfeeding offers critical benefits in disasters but faces significant barriers. In this study, we aimed to determine the association between experiencing the 2023 Türkiye earthquake and breastfeeding problems.

This cross-sectional descriptive study was conducted in pediatric clinics in eight different provinces of Türkiye, three earthquake-affected provinces and five earthquake-unaffected provinces, between April and July 2023. Breastfeeding mothers and their 0-23 month infants were included in the study. A structured questionnaire was applied to mothers face-to-face. Multivariate logistic regression analysis was performed to determine independent parameters associated with breastfeeding problems.

A total of 761 mother-child pairs participated in the study. Among these mothers, 49% (n = 373) were living in the earthquake-affected region, and 51% (n = 388) were not. Breastfeeding problems were more common in the earthquake-affected mother-child pairs (48.8%) compared to unaffected pairs (28.6%). Perceived insufficient milk supply was the most common breastfeeding problem, reported by 33.0% in earthquake-affected regions and 11.1% in unaffected region. Breastfeeding problems were 2.01 times more common in mothers from earthquake-affected region (95% CI: 1.45, 2.77) and 1.66 times more common in those who bottle-fed their infants (95% CI: 1.45, 2.37). Perceived insufficient milk supply was 4.12 times more prevalent in earthquake-affected regions (95% CI: 2.73, 6.22) and 1.78 times higher in bottle-feeding mothers (95% CI: 1.23, 2.57). The likelihood of perceived insufficient milk supply was lower in mothers receiving mental health support (AOR: 0.53, 95% CI: 0.33, 0.84) and nutritional support (AOR: 0.49, 95% CI: 0.27, 0.89).

Perceived insufficient milk supply is the most common breastfeeding challenge reported by mothers affected by earthquakes, occurring more frequently than among mothers who were not affected. This issue is associated with increased bottle feeding, limited mental health support, and inadequate nutritional support. Addressing this issue through adherence to the International Code of Marketing of Breast-milk Substitutes, controlling donation and distribution of commercial milk formula to discourage bottle feeding, alongside ensuring nutritional and mental health support for mothers, could significantly mitigate breastfeeding difficulties during disasters.