Table 7 Reasons for low prevalence of exclusive breastfeeding and preference of infant formula mentioned by mothers in the Focus Group Discussions (n = 21)

Knowledge about EBF

• “Many mothers never heard about exclusive breastfeeding.”

Amount of breast milk is not enough

• “We know breast milk is the best, but we were afraid that the amount is not enough. We don’t know when the baby is full.”

• “Because sometimes, if the breast milk is not enough, the baby will cry, so we give him infant formula in addition.”

• “I am afraid that my breast milk is not enough and consequently my baby will not grow/develop properly.”

• “I have no idea. I want to breastfeed exclusively, but the amount of my breast milk is not enough.”

• “Many of my friends in my generation didn’t have breast milk after childbirth at all.”

• “In fact, most of the mothers are willing to breastfeed their babies because breast milk is the best. But there is no way to breastfeed exclusively, because their breast milk is not enough.”

Breast milk is not nutritious enough (influence of advertising)

• “Probably the nutrient content in my milk is not enough, therefore I use infant formula as supplement.”

• “Because infant formula has many advantages, it is rich in some nutrients like DHA (docosahexaenoic acid), taurine that are good for baby’s development. But the content of these nutrients is low in mothers’ milk.”

• “Infant formula preference is often influenced by advertising for it everywhere.”

Necessary to add water

• “Someone with experience told us water is necessary besides breast milk.”

Parents’ concerns

• “As we only have one child, all parents cherish their babies and worry too much that their baby may get hungry.”

• “Everyone treasures the baby so much and thinks that with infant formula the baby will develop better. Many mothers believe that ‘infant formula is necessary in addition to breast milk.’”

• “The feeling that “all the other babies are fed with infant formula” makes mothers think it is wrong if they don’t give infant formula to their own babies. Mothers are afraid of the development of their babies falling behind others.”

Mother’s figure

• “Mothers choose infant formula instead of breastfeeding for the shape of their breasts; it’s a common problem. Anyway,I don’t care about my figure, I will insist on breastfeeding.”

• “At present, mothers have different perceptions. Some mothers do not want to breastfeed, just like my friend who believes breastfeeding is harmful for her figure.”

Convenience

• “Some mothers are using infant formula for convenience.”

• “The babies fed with infant formula will not be hungry easily. Their mothers do not need to wake up and feed the babies so frequently in the night. It’s more convenient.”

Wound pain after C/S

• “It’s painful after Caesarean section. It may influence exclusive breastfeeding (hard to hold the baby).”