Factors affecting Exclusive breastfeeding in the first six months of birth: An Exploratory-Descriptive Study

Background & aim: Considering the important role of exclusive breastfeeding in the first six months of birth and its relation with sociocultural beliefs, this study was conducted to explore the factors affecting exclusive breastfeeding in the first six months of birth in women residing in Neyshabour, Iran. Methods: This qualitative study was based on an exploratory-descriptive design, which was conducted using focus group interviewing based on the PEN-3 model. Thirty-seven women from four groups (i.e., mothers with an infant under six months of age, grandmothers with an infant grandchild, pregnant women in the third trimester of pregnancy, as well as health care providers and health volunteers) participated in group discussions. The interviews were recorded and transcribed. A framework was used to analyze the data including five stages of identifying a thematic framework, indexing, drawing a table, mapping, and interpreting. Also, for better data management, MAXQDA software was employed.. Results: Factors affecting exclusive breastfeeding were categorized in three dimensions of the PEN-3 model, namely cultural identity, relationships and expectations, and cultural empowerment and the six main factors of individual factors (factors related to the mother and the child), family, neighborhood, nurturers (influential people), enablers (socially influential), and cultural beliefs. Relaxation and lack of stress, adequate knowledge of the mother and her relatives, adequate lactation skills, desirable growth, lack of crying and restlessness of the child, and support of others were the most important affect successful exclusive breastfeeding. Conclusion: We recommend social and political support of authorities, continuous support for employed mothers during lactation, and the implementation of 10 Steps to Baby-Friendly hospitals. Developing and implementing of educational programs during pregnancy and postpartum period is also suggested for the promotion of exclusive breastfeeding.  Monitoring of the breastfeeding process as well as encouraging nursing during the night can also help to maintain exclusive breastfeeding.