Table 5 Themes and illustrative quotations related to breastfeeding determinants

HCWs’ influence mothers’ feeding decisions

“It was the nurse [who influenced me regarding the way I fed my baby].” (Mother, Pujehun, 23 years)

“After two weeks she was just crying, I wanted to give her [powder] milk but the nurse advised me [not to].” (Mother, Sahn Malen, 26 years).

“The nurses [had me feed my baby this way.]” (Mother, Pujehun, 33 years)

Husbands’ involvement with child feeding practices

“The father of the baby is supporting me because he gives me enough food. He encourages me.” (Mother, Sahn Malen,22 years)

“My husband supports me, for example by providing food for me.” (Mother, FGD, Bandajuma)

“We fathers should support lactating mothers by giving them enough food so that they can feed our babies well. Encouragement is also important, because without encouragement the woman will find it difficult to breastfeed her baby.” (Father, Pujehun)

“Yes, if you are a farmer, businessman or carpenter, just work hard to provide food for your wife. If not, she will not breastfeed your baby exclusively and she will go out for food. When your wife is without food, she will disobey you.” (Father, Bandajuma)

“Most people used to say that a newborn given exclusive breastfeeding will feel hungry, and sometimes they feed babies hot water, but now I have realized that is not true, that the best food

for a baby is breastmilk. In fact, giving hot water to baby will result to cough.” (Father, Pujehun)

“It was his father who decided to give the baby hot water, because her stomach kept drying, so he told me to give her hot water one morning and after that the child has passed stool.” (Mother, Zimmi, 26 years)

“Most women also refused to breastfeed their babies because of lack of encouragement from their husbands. Today most young husbands do not take care of their wife, they will neglect them for another woman because they are lactating mothers” (Mother FGD, Bandajuma)

Issues of sex and breastfeeding

“[No sex] For the simple reason that it will affect the breastmilk, and if you feed your baby with such breastmilk the baby will end up malnourished. Also, just having sex could lead to another pregnancy, which would mean there is not enough time to care for the baby properly. For me, whenever my wife is breastfeeding, I go out.” (Father Pujehun)

“I heard a mother went to have sex with someone else to get food and then her child became ill.” (Father Bandajuma)

Mothers’ reasons for feeding items alongside breastmilk before the child reaches 6 months of age

“When he was 3 weeks old [I started giving him other food]. That is because my breast was not having enough breast milk.” (Mother Pujehun, 20 years)

“Because there are times that the breast milk was not enough for him.” (Mother, Bandajuma, 23 years)

“Her stomach was dry; it kept drying. She could not pass stools.” (Mother, Zimmi,26 years)

“Because the baby is always crying, I give it hot water.” (Mother, Bandajuma, 20 years)

“Lack of enough food for the mother; if the mother is not satisfied, she can hardly feed her baby.” (Mother, Pujehun FGD)

“Except if I am hungry. If I am hungry, I will not be able to breastfeed my child because my head will start to spin.’ (Mother, Gbondapi, 40 years).