Exclusive breastfeeding experiences among mothers in Bangkok, Thailand : findings from a mixed-methods study

Abstract

The purpose of this mixed-methods study was to investigate knowledge, attitude and exclusive breastfeeding practice, as well as, facilitators and barriers to exclusive breastfeeding in Bangkok. This cross-sectional study of 208 postpartum mothers used a quantitative questionnaire to assess knowledge, attitude and practice, as well as facilitators and barriers to exclusive breastfeeding practices. Qualitative analyses were based on in-depth interviews of 7 postpartum mothers and 2 breastfeeding experts. Data were analyzed using descriptive statistics, Chi square and multivariable analyses. In the quantitative analyses, 14% of Thai women in Bangkok did exclusive breastfeeding for some duration of time, with 10.1% exclusively breastfeeding for 6 months. Income level, knowledge of breastfeeding, number of times breastfeeding was discussed during antenatal visits and caesarean deliveries were positively associated with exclusive breastfeeding, with number of times breastfeeding discussed being the most highly associated facilitator (two times: OR 3.798, 95% CI: 1.039, 13.879; 3 or more times: OR 3.374, 95% CI: 1.034, 11.016). Qualitative data showed low milk supply, working outside the home, supplemental feedings (especially water) and perceived lack of supports as barriers and parents, hospital staff and knowledge as strong facilitators to an exclusive breastfeeding practice. Increased knowledge regarding an infant’s ability to thrive on breast milk alone for 6 months and enhanced discussions during antenatal care are important to increase exclusive breastfeeding.