Barriers to Early Initiation of Breastfeeding: A Hospital-Based Qualitative Study

Breastfeeding is a key intervention to improve global targets on nutrition, health and survival. The World Health Organization recommends initiating breastfeeding within the first hour of birth to prevent infections, strengthen neonatal-maternal bonding, maintain thermoregulation and promote long term breastfeeding success. Global prevalence of early initiation of breastfeeding is 46% while in Tanzania it is 70%. The target set by the Baby Friendly Hospital Initiative guidelines for hospital deliveries is at least 80%.

This study aimed to explore barriers to early initiation of breastfeeding in a hospital setting using a descriptive qualitative approach.

Semi-structured individual interviews were conducted to explore barriers to early initiation of breastfeeding from the perspective of midwives and post-partum mothers. Data was analysed using Systematic Text Condensation as described by Malterud.

Participants perceived that inadequate and sometimes conflicting information during antenatal period, especially on ideal time to start breastfeeding contributed to delayed initiation. Post-delivery practices such as perineal tear repair, along with environmental factors, including perceptions of unclean labour rooms and the presence of male personnel in the delivery room further hindered timely initiation. Overall, barriers were linked to gaps in knowledge, non-conducive postpartum environments and restrictive hospital practices.

Improving early initiation of breastfeeding requires policies and programs aimed at strengthening the provision of breastfeeding related education to mothers during antenatal visits and enhancing the knowledge of midwives. At the health facility level, creating a supportive post-partum environment with individualised care, and implementing evidence-based practices are essential for promoting timely initiation.