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Factors affecting actualization of the WHO breastfeeding recommendations in urban poor settings in Kenya

By Elizabeth W. Kimani-Murage, Frederick Wekesah, Milka Wanjohi, Catherine Kyobutungi, Alex C. Ezeh, Rachel N. Musoke, Shane A. Norris, Nyovani J. Madise and Paula L. Griffiths


This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Poor breastfeeding practices are widely documented in Kenya, where only a third of children are exclusively\ud breastfed for 6 months and only 2% in urban poor settings.This study aimed to better understand the factors that\ud contribute to poor breastfeeding practices in two urban slums in Nairobi, Kenya. In-depth interviews (IDIs),\ud focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with women of childbear-\ud ing age, community health workers, village elders and community leaders and other knowledgeable people in the\ud community. A total of 19 IDIs, 10 FGDs and 11 KIIs were conducted, and were recorded and transcribed\ud verbatim. Data were coded in NVIVO and analysed thematically. We found that there was general awareness\ud regarding optimal breastfeeding practices, but the knowledge was not translated into practice, leading to\ud suboptimal breastfeeding practices. A number of social and structural barriers to optimal breastfeeding were\ud identified: (1) poverty, livelihood and living arrangements; (2) early and single motherhood; (3) poor social and\ud professional support; (4) poor knowledge, myths and misconceptions; (5) HIV; and (6) unintended pregnancies.\ud The most salient of the factors emerged as livelihoods, whereby women have to resume work shortly after\ud delivery and work for long hours, leaving them unable to breastfeed optimally. Women in urban poor settings\ud face an extremely complex situation with regard to breastfeeding due to multiple challenges and risk behaviours\ud often dictated to them by their circumstances. Macro-level policies and interventions that consider the ecological\ud setting are needed

Topics: Exclusive breastfeeding, Infant feeding behaviour, Breastfeeding duration, Breastfeeding knowledge, Child nutrition, Urban slums
Publisher: John Wiley & Sons Ltd. (© 2014 The Authors)
Year: 2015
DOI identifier: 10.1111/mcn.12161
OAI identifier:

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