Background: Effective promotion of exclusive breast-feeding (EBF) is needed to improve child nutrition and survival. Objective: We explored barriers and facilitators to EBF in rural Tanzania and assessed parents’ willingness and ability to try specific recommended EBF practices plus strategies for men to support breast-feeding. Methods: We conducted Trials of Improved Practices in 36 households with infants <6 months. Fathers participated in focus group discussions on ways to support breast-feeding. Fathers and mothers were individually interviewed 2 and 3 times, respectively, about their willingness to try and experience with selected new practices. We analyzed data thematically. Results: Common barriers to EBF were (1) use of gripe water and traditional medicines for perceived symptoms of infantile distress; (2) mothers’ workloads and time away from infants, limiting availability for EBF; and (3) water given for perceived thirst. Although several mothers expressed concerns about breast-milk insufficiency, few were giving other foods. After counseling, most mothers reported breast-feeding more optimally. Some reported improved breast-milk supply. Fathers saw their roles as providing food to mothers to ensure sufficient breast-milk and encouraging new practices. Dominant gender roles and work away from home were barriers even if fathers were willing to help with household chores. Fathers mostly provided emotional support or encouraged others to help with chores. Conclusion: Exclusive breast-feeding promotion needs to address concerns about infantile distress and help parents develop effective soothing techniques while avoiding nonprescribed medicines. Engaging men in EBF interventions could help change social norms and facilitate men’s involvement in improving breast-feeding practices.

中文翻译：

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坦桑尼亚改善纯母乳喂养实践的障碍和机遇：与母亲和父亲的家庭试验

背景：需要有效促进纯母乳喂养 (EBF)，以改善儿童营养和存活率。目标：我们探索了坦桑尼亚农村 EBF 的障碍和促进因素，并评估了父母尝试特定推荐的 EBF 做法以及男性支持母乳喂养策略的意愿和能力。方法：我们在 36 个有 6 个月以下婴儿的家庭中进行了改进实践试验。父亲们参加了关于如何支持母乳喂养的焦点小组讨论。父亲和母亲分别接受了 2 次和 3 次单独访谈，询问他们是否愿意尝试和体验选定的新做法。我们按主题分析了数据。结果：EBF 的常见障碍是 (1) 使用抱怨水和传统药物治疗婴儿痛苦的感知症状；(2) 母亲的工作量和远离婴儿的时间，限制了 EBF 的可用性；(3) 为感觉到口渴而给予的水。尽管有几位母亲表达了对母乳不足的担忧，但很少有人给予其他食物。咨询后，大多数母亲报告说母乳喂养效果更好。一些报告称母乳供应有所改善。父亲认为自己的角色是为母亲提供食物以确保充足的母乳并鼓励新的做法。即使父亲愿意帮助做家务，主导性别角色和离家工作也是障碍。父亲大多提供情感支持或鼓励他人帮助做家务。结论：纯母乳喂养推广需要解决对婴儿痛苦的担忧，帮助父母开发有效的安抚技巧，同时避免非处方药。