Introduction: Ever increasing institutional deliveries in India has
shifted the responsibility of timely initiation and continuation of
breastfeeding from peripheral health workers and families to the
nursing care providers of health facilities where the births take
place. While institutional deliveries have increased to 72.6%,
only 44.6% of the newborns enjoy early breastfeeding in India.
Aim: To study the barriers to early initiation of breastfeeding in
institutional delivery.
Materials and Methods: A total 34 nursing care providers were
selected randomly and five Focus Group Discussions (FGDs)
were carried out. This Qualitative Study was conducted through
FGDs among the nursing care providers of a tertiary care
institute in the Indian State of Haryana, India.
Statistical Analysis: The analyses continued throughout the
group discussions as the newly emerged themes were tested in
the subsequent discussion. FGDs transcripts were analysed to
enhance the robustness of the emerged domain.
Results: Major barriers to initiation of breast feeding identified
included: lack of awareness regarding proper technique of
breastfeeding and benefits of colostrum; breast abnormality like
inverted/retracted nipples; obstetric/neonatal complications
requiring specialised care; and cultural practices like giving prelacteals
and gender discrimination. It was further reported that
the manpower has not been rationalised with ever increasing
number of institutional deliveries. The respondents though willing
to promote early initiation and continuation of breastfeeding felt
excessive workload as one of the major barriers due to multitasking
nature of their job.
Conclusion: The new challenges to the early initiation and
continuation of breastfeeding are emerging due to change in
the place of delivery which needs to be addressed at the policy
level.