Psychosocial and context factors associated with breastfeeding and complementary feeding changes in Belize: a mixed
Jurgita Slekiene1,2, Anna Elisabeth Gamma3, Paulette Wade4
1Anthropometrics & Historical Epidemiology Group, Institute of Evolutionary Medicine, Faculty of Medicine, University of Zurich, Zürich, Switzerland. jurgita.slekiene@uzh.ch.
Insights
Breastfeeding rates are improving in Belize, but exclusive breastfeeding and early initiation remain challenges. Maternal mental health is linked to socioeconomic factors, not directly to breastfeeding practices.
Area of Science:
- Public Health
- Maternal and Child Health
- Nutrition
Background:
- UNICEF's mission includes reducing child mortality and improving health through optimal infant feeding practices.
- Breastfeeding and complementary feeding are key interventions for child survival and development.
- This study investigates breastfeeding practices in Belize, considering factors like the Baby-Friendly Hospital Initiative and maternal mental health.
Purpose of the Study:
- To analyze breastfeeding and complementary feeding practices in Belize using historical and current data.
- To explore barriers and psychosocial factors, including maternal mental health, influencing these practices.
- To assess breastfeeding within the first hour, exclusive breastfeeding for six months, and continued breastfeeding.
Main Methods:
- Mixed-methods approach combining quantitative data from Multi Indicator Cluster Studies (2006, 2011, 2015-16) and qualitative data from 2022.
- Qualitative data included 45 interviews with caregivers, Key Informant Interviews, and Focus Group Discussions.
- Maternal mental health was assessed using the Self-Reporting Questionnaire (SRQ-20).
Main Results:
- Two-thirds of children were not exclusively breastfed for the first six months.
- 82% of interviewed mothers practiced exclusive breastfeeding, and 78% initiated breastfeeding within one hour.
- Half of the mothers reported mental health issues; no direct association with breastfeeding, but correlations with socioeconomic factors were observed.
Conclusions:
- Despite improving breastfeeding rates, psychosocial vulnerabilities and structural disadvantages persist.
- Indirect links between maternal mental health and socioeconomic status highlight the need for integrated interventions.
- Addressing breastfeeding barriers and child nutrition requires equity-focused public health strategies.
Background:
UNICEF advocates for children's rights by ensuring their basic needs are met and their potential maximized. Reducing child mortality and improving health are central to this mission, particularly through breastfeeding and complementary feeding. This study aims to analyse these practices in Belize using data from three past Multi Indicator Cluster Studies (MICS) and conducted a research study that explores barriers and factors influencing breastfeeding, including the Baby-Friendly Hospital Initiative, with a focus on maternal mental health. The study examines breastfeeding within the first hour after birth, exclusive breastfeeding for the first six months (EBF), and continued breastfeeding for up to two years and beyond.
Methods:
A mixed-methods design was used, combining quantitative MICS data (2006, 2011, 2015-16), desk reviews, and qualitative data collected in Belize in August-September 2022, to assess the context and psychosocial factors, including maternal mental health, that influence breastfeeding and complementary feeding practices among caregivers. Data collection involved 45 face-to-face interviews mainly with female caretakers of children under two, Key Informant Interviews, and Focus Group Discussions with caretakers and healthcare staff. Maternal mental health was assessed using the Self-Reporting Questionnaire (SRQ-20).
Results:
The findings indicate that two out of three children were not exclusively breastfed for the first six months. Among the 45 interviewed caretakers, 93% reported overall breastfeeding (exclusive, non-exclusive, or complementary), 82% practiced EBF during the first six months, and 78% breastfed within one hour after birth. While general breastfeeding was common, EBF showed increasing trends, and early initiation was less frequent. Half of the woman interviewed were at risk of common mental health disorders. There was no significant direct association between mental health and breastfeeding. Correlation analysis showed that mothers with poorer mental health had more children, less education, lower socioeconomic status, and greater awareness of breastfeeding barriers.
Conclusions:
While breastfeeding rates in Belize are improving, psychosocial vulnerabilities persist. Indirect links between maternal mental health and structural disadvantage, as well as the identified barriers to breastfeeding highlight the need for integrated, equity-focused public health interventions to enhance breastfeeding outcomes and address broader child nutrition challenges.
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