Table 4 Breastfeeding barriers according to HCWs’ observations

Not feeling well physically or mentally after delivery

75 (8.6)

Breast milk insufficiency or breastfeeding problems

326 (37.2)

 • Mother’s postpartum fatigue and pain

42 (4.8)

 • Insufficient breast milk production

244 (27.9)

 • Mother’s mental illness

33 (3.8)

 • Insufficient weight gain of the child

34 (3.9)

 • Nipple pain

2 (0.2)

 • Frequent crying / not getting enough of the baby

33 (3.8)

Lack of experience or education

46 (5.3)

 • Believing that breast milk is not enough

32 (3.7)

 • Mothers do not know how to breastfeed and are inexperienced

41 (4.7)

 • Breast problems

16 (1.8)

 • Unable to attach baby to breast

6 (0.7)

 • Breast rejection

7 (0.8)

The belief of there is not enough breast milk

29 (3.3)

 • Artificial feeding

5 (0.6)

 • Failure of milk to reach the breast

32 (3.7)

 • Twin birth

4 (0.5)

 • Baby’s crying or not getting enough

1 (0.1)

Factors related to maternal health

181(20.7)

Illness of the mother or baby

26 (3.0)

 • Maternal poor health/drug use

107 (12.2)

Delivery type

19 (2.2)

 • Maternal malnutrition

79 (9.0)

 • Cesarean delivery

16 (1.8)

 • Mother’s mental illness

15 (1.7)

 • General anesthesia given during delivery*

6 (0.7)

 • Aesthetic concerns

5 (0.6)

Cultural misconception

13 (1.5)

 • Desire to gain weight

3 (0.3)

Deficiencies in Baby-Friendly Hospital Initiative implementation

3 (0.3)

 • Absence of mother

2 (0.2)

 • Uneducated health professionals

1 (0.1)

Lack of experience or education

90 (10.3)

 • The impact of formula companies in the hospital

1 (0.1)

 • Not knowing the importance of breast milk, no education

77 (8.8)

 • Doctors recommend formula

1 (0.1)

 • Mother’s inexperience

13 (1.5)

 • Lack of health care

6 (0.7)

Frequent pregnancy plan

88 (10)

Mother’s working conditions-economic problems

41 (4.7)

 • Mother’s work

27 (3.1)

 • Economic problems

15 (1.7)

Culture-social environment

29 (3.3)

Illness of children

28 (3.2)