Exclusive breastfeeding up to 6 months of age is recommended by the World Health Organization as the optimal mode of infant feeding, providing adequate nutrition for the baby and protection against infectious diseases. Breastfeeding can be adversely affected by individual, cultural and socio-economic factors. The study aimed to explore barriers of exclusive breastfeeding in the first 6 months of life among first-time mothers in rural Kenya. An observational longitudinal design aimed to provide rich data on breastfeeding behaviour. Twenty pregnant first-time mothers were recruited through antenatal clinics and snowballing. Mothers were visited nine times at home from late pregnancy, at 1 week and 2 weeks post-delivery, then monthly until the baby was aged 6 months. Visits were conducted between November 2016 and April 2018. At the first visit, participants were asked about breastfeeding intentions and infant feeding education received. At each postnatal visit, direct observation of breastfeeding, a recorded semi-structured interview on feeding, mother’s and baby’s health was performed. Interviews were transcribed, checked, content was grouped into categories and analyzed using a qualitative descriptive approach. Most participants were adolescent (75%) and unmarried (65%). All 20 mothers intended to and did breastfeed, however additional fluids and semi-solids were commonly given. Only two mothers exclusively breastfed from birth up to 6 months of age. Prelacteal feeds, home remedies and traditional medicine were given by over a third of mothers in the first week of life. Concern over babies’ bowel habits and persistent crying perceived as abdominal colic led to several mothers receiving advice to give gripe water and traditional remedies. Early introduction of maize porridge from 3 months of age because of perceived hunger of the child was recommended by other family members. Breastfeeding observation showed persistent problems with positioning and attachment of infants. Exclusive breastfeeding from birth to 6 months was uncommon. Prioritization of capacity to detect mothers with breastfeeding problems and provide breastfeeding education and support is necessary, particularly during the antenatal and early postnatal period. It is important to engage with other women resident in the household who may offer conflicting feeding advice.

中文翻译：

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肯尼亚农村首次母亲的纯母乳喂养：生命前六个月喂养模式的纵向观察研究。


世界卫生组织推荐6个月以下纯母乳喂养为最佳婴儿喂养方式，可以为婴儿提供充足的营养并预防传染病。母乳喂养可能会受到个人、文化和社会经济因素的不利影响。该研究旨在探讨肯尼亚农村地区初次当妈妈的人在出生后前 6 个月内进行纯母乳喂养的障碍。观察性纵向设计旨在提供有关母乳喂养行为的丰富数据。通过产前诊所和滚雪球的方式招募了 20 名首次怀孕的母亲。从怀孕后期、产后 1 周和 2 周开始，母亲们会在家中接受 9 次探访，然后每月一次，直到婴儿 6 个月大。访问于2016年11月至2018年4月期间进行。在第一次访问时，参与者被询问母乳喂养意愿和接受的婴儿喂养教育。每次产后访视时，都会直接观察母乳喂养情况，并进行有关喂养、母亲和婴儿健康的半结构化访谈记录。采访内容被转录、检查，内容被分组并使用定性描述方法进行分析。大多数参与者是青少年（75%）和未婚（65%）。所有 20 名母亲都打算母乳喂养并且确实进行了母乳喂养，但通常会给予额外的液体和半固体食物。只有两名母亲从出生到 6 个月龄期间纯母乳喂养。超过三分之一的母亲在出生第一周就接受了哺乳前喂养、家庭疗法和传统药物。对婴儿排便习惯的担忧以及被认为是腹部绞痛的持续哭闹导致一些母亲收到建议，建议给予腹泻水和传统疗法。 其他家庭成员建议，由于孩子感到饥饿，因此从 3 个月大开始就尽早添加玉米粥。母乳喂养观察显示婴儿的定位和依恋持续存在问题。从出生到 6 个月的纯母乳喂养并不常见。有必要优先考虑发现有母乳喂养问题的母亲并提供母乳喂养教育和支持的能力，特别是在产前和产后早期。与家中其他可能提供相互矛盾的喂养建议的女性居民交流非常重要。