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Table 2 Key quotations of study participants related to barriers to breastfeeding practices

From: Barriers to breastfeeding are shaped by sociocultural context: an exploratory qualitative study in Bangladesh

Broad theme

Sub-themes

Verbatims of study respondents

Individual-level barriers

Misperceptions about breastfeeding

“I did not provide colostrums to my child as I thought, feeding colostrums might cause loose motion as it is very thick, and the newborn infants are unable to digest it. Therefore, I gave honey to my child.” [140429M01_IDI_MO_Stk_Ctg_rural]

“My grandson was born at a delivery centre and immediately after the birth, I provided sugar-mixed water to the newborn child concealing the view of the nurse. I thought that the child was crying because of his appetite when the mother was unable to produce breastmilk.” [140530M01_IDI_GM_Bgb_Dha_urban]

“I provided honey to my grandson immediately after the birth as I thought that feeding honey first will facilitate to behave well at his adult age.” [140429M01_IDI_GM_Stk_Ctg_rural]

“I thought that water should be provided to the child immediately after birth as the child becomes thirsty as he/she comes from one earth to another earth.” [140509M01_FGD_FAT_Gfg_rural]

“I have forbidden my wife to provide breastmilk more often as I thought that excessive breastfeeding might be harmful to teeth of the child (can be affected by insect).” [140429M01_FGD_FAT_Stk_Ctg_rural]

“I became pregnant recently, and I thought that at this moment if I continue breastfeeding, my baby in the womb will get less nutrition.”

[040429M01_IDI_MOT_Stk_Ctg_rural]

Lack of knowledge and skills among family members and mothers

“I was supposed to provide sugar-mixed water to my newborn baby as per the instructions from my mother-in-law, but I did not know the benefits of giving this.” [140506M01_IDI_MOT_Gfg_rural]

“A mother breastfed her child immediately after feeding complementary food when she lies down on the bed and talking to the father of the child. In this condition, the child discontinued taking breastmilk after feeding 2–3 min, then the child started crying and the mother gave chocolate to the child to stop crying.” [140326M01_OBS_Blg_Syl_rural]

Society-level barriers

Sociocultural norms, beliefs, and practices hinder breastfeeding

“My mother-in-law instructed me to provide formula milk to my child when I became busy for cooking meals for other household members. My mother-in-law thought if I breastfeed my child, he/she could take much time, resulting in disruption of cooking meals in time. Therefore, to satisfy her I provided formula milk to my child.” [140429M01_IDI_MOT_Stk_Ctg_rural]

“The mother of my grandson often provides semolina instead of breastfeeding because of her lack time. She is mainly responsible for doing household chores as she is the young energetic woman in the family.” [140429M01_IDI_GM_Stk_Ctg_rural]

“I gave instruction to the mother of my grandson to limit breastfeeding more often as I knew from elders that excessive breastfeeding is responsible for becoming fool at his adult age.”[ 140429M01_IDI_GM_Stk_Ctg_rural]

“I purchased formula milk for my child as most children in our community feed formula milk. It might be beneficial for the health of the child.” [140509M01_FGD_FAT_Gfg_rural]

“I provided my child (age 4 months) sweet food received from the mosque as I considered it a blessed food, which might be beneficial to the health of the child.” [140429M01_FGD_FAT_Stk_Ctg_rural]

System-level barriers

Adverse effects of cesarean delivery on breastfeeding

“I had been suffering for the last few days from an infection in my surgical incision mark immediately after my cesarean delivery in a low-cost facility. At that time, I had no appetite for food due to taking a high-power antibiotic for a long time. So, I was unable to produce breastmilk sufficiently, and I initiated formula milk as a substitute for breastmilk. However, after the improvement of my illness, I was still unable to breastfeed sufficiently. In the meantime, the child was habituated to formula milk.” [140530M01_IDI_MOT_Blg_Dhk_rural]

“My child was crying much when I became senseless immediately after my cesarean delivery at the hospital. Then, my sister fed formula milk to my child to stop the child’s crying as per the physician’s instruction of the hospital.” [140506M01_IDI_MOT_Gaf_Mym_rural]

Attractive media advertisements to initiate breastmilk substitutes

“Since I thought that I was unable to produce sufficient breastmilk to feed my child, I went to a physician and requested him to write the name of formula milk. I learned about feeding formula milk from watching television, but I was unaware which one is best for child health. Then, the physician prescribed a name of formula milk; thus, I started feeding formula milk at 4 months of child age.”

[140507M01_IDI_MOT_Tithi_Gfg_rural]

“I went to a physician when my child was 4 months to receive treatment for the problem of production of insufficient breastmilk. Instead of giving treatment to improve the production of breastmilk, the physician suggested and prescribed a name of formula milk as an alternative of breastmilk.” [140530M01_MOT_Bgb_Dhk_urban]

Inadequate facilities and support process in mothers’ work environment

“I live in a nuclear family where no one is available to look after my child. In this situation, I am not allowed to work as a maid-servant in others’ households if I want to carry and keep my child with me. Meanwhile, I have lost a few job opportunities because of the situation, but I desperately needed a job to survive.” [140530M01_IDI_MOTi_Bgb_Dhk_urban]

“Most women in my community are garment workers. A mother cannot bring and keep her child in the garment factory as the factory owner does not allow as he was concerned about the loss of work time due to breastfeeding of any child, which will reduce the overall productivity of the factory.”

[140530M01_FGD_FAT_Bgb_Dhk_urban]