Assessing Maternal Breastfeeding Plans and Perceived Barriers to Optimal Breastfeeding in Kumasi, Ghana

Despite overwhelming evidence of the benefits of breastfeeding (BF) and its potential to decrease infant mortality, BF rates are low in many low- and middle-income countries like Ghana. We sought to assess Ghanaian mothers' BF plans and their rationale for these plans.

We conducted a mixed method study via face-to-face interviews administered in 2019. We included pregnant or recently delivered maternity ward patients at a tertiary care center in Kumasi, Ghana. Semi-structured interviews were conducted to collect sociodemographic information, BF plans, and reasons for BF preferences. In accordance with World Health Organization recommendations, optimal BF was defined as 6 months of feeding an infant with breastmilk only (exclusive BF) followed by at least 18 months of feeding an infant the combination of breast milk and supplementary liquids and/or solid foods (complementary BF). Demographic characteristics of the cohort were compared by maternal BF plan using Pearson's chi-squared and t-test. Simple thematic analysis was performed to identify reasons for BF preferences.

During the study period, 126 participants were enrolled. Forty-two (33.3%) participants planned to practice optimal BF. Participants who were married were more likely to have optimal BF plans than unmarried participants (OR 0.17; 95% CI 0.04, 0.53). There was no association between optimal BF plans and age, education, religion, and pre- or post-delivery status. Reasons for not practicing optimal BF included concern about the nutritional sufficiency and infants' enjoyment of breastmilk, logistical challenges of optimal BF, milk underproduction, and medical concerns for mother or baby.

Only one-third of our cohort planned to practice optimal BF. Strengthening family support systems and improving patient education may increase optimal BF rates in Ghana.