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Table 1 Major themes and sub-themes of barriers to EBF practice

From: A systematic review of qualitative research on barriers and facilitators to exclusive breastfeeding practice in sub-Saharan African countries

Themes

Sub-themes

Codes

Studies

1.Maternal-infant factors

1.1 Maternal factors

1.1.1. Mother’s formal (employment) and informal work schedules

[26,27,28,29,30,31,32,33]

  

1.1.2 Perceived breast milk insufficiency

[26,27,28, 31,32,33,34,35,36,37,38]

  

1.1.3 Concerns of effects on mother’s appearance

[28, 31, 38, 39]

  

1.1.4 Poor understanding/lack of awareness of EBF benefits

[32, 34, 35, 40]

  

1.1.5 Being HIV positive or fear of transmitting HIV infection to the child

[31, 32, 34, 36]

  

1.1.6 Schooling or resuming school or work

[29, 33, 36, 37, 41]

  

1.1.7 Poor maternal nutrition

[29, 32,33,34, 41]

  

1.1.8 Maternal perceived discomfort and embarrassment

[26, 28, 29, 31, 33, 39]

  

1.1.9 Reluctance to breastfeed in public/disapproval of public breastfeeding

[29, 31, 33, 37]

  

1.1.10 Refusal of mothers to breastfeed for several other reasons

[31,32,33,34, 41, 42]

 

1.2 Infant factors

1.2.1 Crying baby

[31, 32, 37, 41, 42]

  

1.2.2 Infant’s difficulty in latching or positioning or refusal to breastfeed

[31, 33, 37]

  

1.2.3 Infant other issues

[30,31,32]

 

1.3 Breast-related factors

1.3.1 Some breast conditions (cracked, painful or sore nipples)

[27, 28, 30, 32, 33, 42]

  

1.3.2 Breast milk lightness and lousy odour

[39]

2. Support structures related factors

2.1 Family influence

2.1.1 Influence of husband

[26, 28, 29, 31, 33, 35, 37, 39]

  

2.1.2 Influence of mother/mother-in-law/grandmother

[27, 29, 31, 33, 37,38,39, 41]

  

2.1.3 Influence of other family members and important others

[27, 28, 31,32,33,34,35,36,37, 41, 43]

 

2.2 Influence of health systems

2.2.1 Influence of advice or messages shared by HCWs

[28, 30, 33, 36, 37, 41]

  

2.2.2 Inadequate breastfeeding education, counselling, and support by HCW

[28, 33, 38]

 

2.3 Influence of workplace

2.3.1 Lack of workplace support

[28, 29, 40]

  

2.3.2 Short and/or unpaid maternity leave

[28, 40, 41]

3. Influence of traditional and sociocultural beliefs

3.1 Use of herbal concoctions for medicinal purposes

3.1.1 Use of traditional herbal concoctions as medicine

[26, 32, 34, 39]

 

3.2 Norms and beliefs

3.2.1 Traditional / cultural practices, myths, and misconceptions about EBF

[29,30,31,32,33,34,35, 39, 42,43,44]