BACKGROUND The World Health Organization recommends exclusive breastfeeding for the first six months of life. A qualitative study was conducted to assess the factors that influence the practice of exclusive breastfeeding amongst mothers attending Wajir County Hospital, Kenya. METHOD This study was part of a cross-sectional study to compare the exclusive breastfeeding rates amongst primiparous and multiparous mothers with infants under 6 months old attending Wajir County Hospital. Focus group discussions and key informant interviews were conducted to collect information on exclusive breastfeeding and related factors. Four focus group discussions were conducted with mothers who exclusively breastfed and the same number with mothers who did not exclusively breastfeed their babies. Key informant interviews were conducted with nine healthcare providers. The data were transcribed, and a content analysis identified common themes and inferences. RESULTS The exclusive breastfeeding rate among the mothers in the larger study was 45.5%. There was no disparity between the practice of exclusive breastfeeding between primiparous and multiparous mothers. Despite the high knowledge and positive attitudes towards exclusive breastfeeding of most mothers, the practice of exclusive breastfeeding was unsatisfactory. The major hindrances identified were cultural barriers propagated by mothers-in-law and traditional birth attendants; the belief that babies cannot live without water; and a few unsupportive health workers. The uptake of exclusive breastfeeding was enhanced by Islamic teaching on breastfeeding, education from a few supportive healthcare providers; support from husbands; and positive deviance among some lactating mothers who practiced exclusive breastfeeding. CONCLUSIONS Deeply rooted cultural factors were the major hindrance to the practice of exclusive breastfeeding. Most of the mothers did not practice exclusive breastfeeding, despite the majority being knowledgeable and having positive attitudes towards the practice. The influence of mother-in-law's and traditional birth assistants were major barriers. Strengthening the Community Health Strategy through training traditional birth attendants on Infant Young Child Nutrition practices, designing mechanisms linking traditional birth assistants to existing health facilities for support, and capacity building and monitoring is critical in promoting exclusive breastfeeding. Behavior change and communication through multiple channels within the community should be utilized to maximize promotion of exclusive breastfeeding among all stakeholders.

中文翻译：

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对肯尼亚瓦吉尔县纯母乳喂养（EBF）行为决定因素的定性探索。

背景世界卫生组织建议在生命的头六个月内纯母乳喂养。进行了定性研究，以评估影响肯尼亚瓦吉尔县医院就诊母亲的纯母乳喂养习惯的影响因素。方法本研究是一项横断面研究的一部分，该研究比较了在瓦吉尔县医院就诊的初产和复产婴儿以及6个月以下婴儿的纯母乳喂养率。进行了焦点小组讨论和主要知情人访谈，以收集有关纯母乳喂养和相关因素的信息。与仅母乳喂养的母亲进行了四次焦点小组讨论，与非母乳喂养婴儿的母亲进行了相同数量的讨论。与9位医疗保健提供者进行了关键信息提供者访谈。数据被转录，内容分析确定了共同的主题和推论。结果在较大的研究中，母亲的纯母乳喂养率为45.5％。初产和多产母亲之间的纯母乳喂养习惯之间没有差异。尽管大多数母亲对纯母乳喂养有很高的知识和积极态度，但纯母乳喂养的做法仍不能令人满意。确定的主要障碍是岳母和传统接生员传播的文化障碍；相信婴儿离不开水；以及一些无助的卫生工作者。伊斯兰教关于母乳喂养的教义进一步促进了纯母乳喂养的接受，来自一些支持性医疗保健提供者的教育；丈夫的支持；和一些纯母乳喂养的哺乳期母亲出现积极偏差。结论根深蒂固的文化因素是纯母乳喂养实践的主要障碍。尽管大多数母亲知识渊博，并对这种做法持积极态度，但大多数母亲并未实行纯母乳喂养。婆婆和传统助产士的影响是主要障碍。通过对传统接生员进行婴儿幼儿营养做法方面的培训，设计将传统接生员与现有卫生设施联系起来以提供支持的机制以及能力建设和监测的机制，对促进纯母乳喂养至关重要。