Organizations worldwide have noted that the influence of society and cultural norms as well as lack of family and community support is a major factor that influences breastfeeding rates.

Factors involving the community and health care system include lack of attention and preparation of the mother to help her commit to exclusive breast feeding for the first six months of the baby’s life.

Fear of not being able to continue breastfeeding once the mother rejoins work and lack of support at the working place and employers is another major hurdle.

Many mothers are not counselled adequately that they could breast feed exclusively for at least 6 to 12 weeks before they join work. In addition there are several ways by which they can continue breastfeeding.

The benefits of breastfeeding for the baby as well as for the mother need to be adequately stressed.

One major role played in breastfeeding is receiving adequate support from the partner and from the family.

Problems at the family and immediate community level

Problems at the family and immediate community level often interact with each other.

Some of these include:-

• Negative attitudes of partner, mother and friends.

• Lack of social support provided by partner, family and friends.

• Lack of collective knowledge about experiences of breastfeeding in the community leading to low confidence building in the mother.

• Lack of the mother being breastfed herself.

• Perceived difficulty and unacceptability of breastfeeding in public within and outside homes especially for teenage and young mothers.

• Difficulty in involving the partner or spouse in feeding rituals.

• Anxiety about total dependence of the baby on the mother making joining work difficult.

“Insufficient milk”

Another major fear is “insufficient milk”. This is reinforced by family, friends and grandmothers. This affected the mother’s self esteem and hampers the process further.

This is compounded by the lack of support, living in a culture where feeding of formula milk is more acceptable and considered normal.

Fears regarding adequate feeding of the baby by the care giver (a family member or grandparent) who must look after the baby after the mother rejoins work is also a major factor that affects breastfeeding.

Jealous partner

Partners who are well prepared in advance regarding the mother’s choice to breastfeed and the rigorous routine of feeding that will be involved in the early days of the baby’s life usually do not suffer from jealousy.

This said, there should be adequate support and time for the partner as well. He should not feel left out of the whole process of baby-rearing in the early days.

The health benefits and cost effectiveness of the process needs to be discussed well in advance. The father can be involved by changing and burping the baby, sharing chores around the house and should be allowed to share the feeding time to experience the bonding between the mother and the baby.

If the baby is fed expressed breast milk, the partner can help by feeding the baby himself.

Sex life whilst breastfeeding

Sex life usually suffers the initial few weeks after childbirth as the mother recovers. However, this does not mean couples cannot indulge in gentle foreplay and sexual intercourse during this time. If there is vaginal dryness, water based lubricants may be used.

Sexual intercourse after feeding will mean less leaking from the breasts and breasts will feel more comfortable as well.

Breastfeeding usually delays the return of the periods after childbirth. This can protect from a second pregnancy to some extent. However, this is not foolproof and some method of contraception like condoms, diaphragms or Intrauterine devices may be used after consultation with the doctor.

Combined hormonal contraceptive pills are usually not recommended during breastfeeding.