Poor breastfeeding practices can put children at increased risk of morbidity and mortality
particularly due to diarrheal and respiratory diseases and impaired physical and mental
development. It is therefore important to understand the determinants of exclusive breastfeeding,
particularly among residents in refugee settlements who may not have access to key resources
and health education. The purpose of this study was to explore if acculturation influenced
exclusive breastfeeding practices among Liberian refugees living in the Buduburam refugee
settlement. A cross-sectional survey was administered between July - August 2008 to Ghanaian
and Liberian women, with at least one biological child between 6 months and five years of age,
who lived at Buduburam Refugee Settlement in Ghana. The sample (n=480) consisted of 120
Liberians living in zones 1-10, 119 Liberians living in zones 11-12, 121 Ghanaians living in zone
11-12, and 120 Ghanaians living in urban, Awutu villages 5 kilometers from Buduburam.
Liberian mothers who lived in Ghana at least eight years were significantly more likely to
exclusively breastfeed (OR: 2.13, 95% CI: 1.25, 3.61) compared to Ghanaian mothers living in
Awutu (outside the camp). After adjustment for confounders, Liberian mothers who lived in
Ghana for at least 8 years were still more likely to exclusively breastfeed (OR: 1.78, 95% CI:
1.02, 3.09), compared to Ghanaian mothers who lived in Awutu. These findings suggest that
increased time in the Ghanaian context of Buduburam improved the chances of relative success
with EBF. Further research to understand the “mechanisms” explaining exclusive breastfeeding
differences will be crucial for improving breastfeeding in refugee settlements and host
communities in low income countries.