Support or Interference: Relational Influences on Mother's Exclusive Breastfeeding Practices in Ghana

Breastfeeding (BF) is a crucial step in the path to improving a child's health. Exclusive breastfeeding (EBF) is recognized as the best practice to improve a child's physical growth and cognitive development in the first months of life. The World Health Organization (WHO) recommends EBF for 6 months. Family support is an important element to help mothers' adhere to breastfeeding recommendations in Ghana. This study aimed to: (a) understand, at the interpersonal level, the relational influences of fathers, grandmothers, and other family members on the adherence of the mother-child dyad to recommended EBF practices and (b) document community and societal influences on EBF. This study took place in the Central Region of Ghana. We used a qualitative design to analyze semi-structured in-depth interviews with mothers (n = 24; 12 adults and 12 teens), fathers (n = 16; 12 adults and 4 teens), and other caregivers (n = 12) of children younger than 1-year-old. Findings showed that family relational influences on a mother's EBF practices did not occur in isolation, given that the family members' EBF knowledge and behaviors were influenced mainly by nurses, community and church peers, and societal and environmental characteristics. Fathers' presence had a protective effect on the mother-child dyad. Fathers built their knowledge on nurses' recommendations. Grandmothers were vital in sharing household and child-caring chores. Cultural and social norms and community peers influenced family member beliefs about EBF. Fathers' and grandmothers' support was essential to mothers' adherence to the practice of EBF; thus, including these family members in prenatal and postnatal care should be encouraged.