Table 3 Select quotes from LIFE study sites*
Practices and beliefs | Facilitators | Barriers | |
|---|---|---|---|
Direct breast- feeding | “We tell [mothers] the benefits of exclusive breastfeeding because the breast milk has benefits but it reduces when mixed with other things…we insist the mothers to exclusively breastfeed the baby for the first 6 months because the mother’s breast milk is everything to the baby” -Tanzania, HCP | “Doctors told us to exclusively breastfeed for 6 months. Whenever you exclusive breastfeed but see that the baby is not gaining weight, you as a mother should try to get good nutrition, porridge, soya porridge, pumpkin seeds, eat a lot of fruits, get fresh cow milk not diluted with water so that your breast milk can be thick and satisfy the baby and grow well without feeding her anything else.” -Tanzania, Mother with preterm infant 0–3 months | “In most cases, low birth weight babies are not able to breastfeed because they become tired of feeding and their jaws are not strong enough to keep sucking the breast. They generally stop breastfeeding.” -Malawi, HCP |
Expressed breast milk | “I have never seen anyone [EBM] as a matter of fact, they were shocked by me because there was a time when I had to pump milk for my baby since he was so small and couldn’t feed on his own. So they were surprised ‘we have never seen anyone doing this’ they said.” -Tanzania, Mother with preterm infant 4–7 months | “We have a special room allocated for mothers to express their milk and feed their babies…I see no problem [with privacy] since that special room only accommodates lactating mothers.” -Tanzania, HCP | “Moms may not know the technique and some have never heard of expressing and this would be their first time. They at times feel shy to do and fail to express.” -Malawi, HCP |
Donor human milk | “In terms of donating the milk, that is a challenge because people have the social concept that ‘my milk is for my child’. They think about who is receiving the milk and how it is going to be helpful to them…so it is about the social concepts which we have, about expressing our milk and giving it to someone else.” -Malawi, DHM subject/practice expert | “We will first counsel them because not all mothers will be okay to feed their babies from another woman. Some will think about hygiene, diseases and other things and that is why we will first give out education on how this milk is cleaned and the state of the donors. So we will give a mother assurance as in informed consent then she will make a decision for herself. But we will counsel mothers to agree with the plan by giving them the benefits and risks of a baby lacking milk.” -Tanzania, HCP | “I won’t trust the person who conducted a test. You know he can overlook [during testing], I won’t be sure with how sterile the storage equipment was. [Those who will test the milk] are human beings, they cannot be correct in everything. I won’t trust the milk. I will have trust in my own breast milk.” -Tanzania, Mother with preterm infant 0–3 months |
Infant formula | “I also learnt that formula milk causes baby diarrhea, vomiting and developmental issues.” -Tanzania, Mother with preterm infant 4–7 months | “We provide [LBW infants with formula]. Our facility is supplied with formula…we nurses prepare it.” -Tanzania, HCP | “Some women in the communities may not know how to prepare the formula because they can hardly read the instructions on the tin due to their illiteracy levels.” -Malawi, HCP |