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Pregnancy and breastfeeding Growth & Development Nutrition Health & Wellness

It’s well established that breastfeeding is the preferred method for infant nutrition, with the World Health Organisation (WHO) recognising it as one of the most effective ways to ensure child health and survival. Despite global awareness efforts from the WHO and its specialist facilities across Africa, there has been little progress over the past two decades. On a global scale, only approximately 44% of infants are Exclusively Breastfed (EBF) for the recommended 6 months. In Africa, this percentage is about 37% and in South Africa, 32%.

National-level analyses have shown that most African countries will not meet the WHO’s Global Nutrition Target of 50% EBF prevalence by 2025. There is a clear disconnect between the recommendations of organisations, such as the WHO and UNICEF, and breastfeeding practices across the world.

In a recent study on new mothers in Uttar, Pradesh, India, Early Initiation of Breastfeeding (EIBF) was associated with maternal knowledge, counselling during pregnancy / delivery, and vaginal delivery. EBF additionally included positively associated factors such as mothers’ beliefs and self-efficacy, parity, and socio-economic status. Yet, high maternal stress and domestic violence had the opposite effect on Exclusive Breastfeeding (EBF).

When identifying breastfeeding experiences and support for overweight / obese mothers, a mixed methods systematic review indicated a set of maternal physical barriers influencing EBF These included larger breasts, difficulties of positioning to breastfeed, delayed onset of lactation, perceived insufficient supply of breastmilk and impact of caesarean birth. Maternal psychological barriers identified included low confidence in ability to breastfeed, negative body image, embarrassment at breastfeeding in public and experiences of obesity stigma. Yet, support from health care professionals and family members influenced positive EBF behaviours.

Mothers are turning to online message boards, listservs and/or social media for advice and information on breastfeeding, with over 140 000 users found on forums such as the Breastfeeding Support and Help community on

Future breastfeeding interventions can turn to studies and resources as mentioned above, to offer more tailored, evidence-based support for mothers, with individual-, partner- and community-based focused advice and recommendations.