Research in Kinshasa, Democratic Republic of Congo, has shone a light on the social pressures on first-time mothers not to breastfeed exclusively for six months, but instead to include water for the baby during that period. Fourteen focus groups were organised involving 85 first-time mothers, 42 ‘male partners’, and 35 mothers/mothers-in-law.
The research revealed that social influences are the deciding factor in providing water to the newborn. First-time mothers are likely to follow the advice of their mother and friends because of the superior experience of these women. First-time mothers desire to please family and friends by doing what they are told by them and because they trust them. Some mothers fear the possible negative consequences of going against social pressure, such as mockery, name-calling and being accused of stubbornness. The pressure is applied consistently, not only within the circle of family and friends, but in wider social circles, such as churches.
This research corroborates similar findings in Uganda, Rwanda, Asia, Latin America and the Caribbean.
The researchers suggest two kinds of interventions to counter this social pressure.
- For the mothers: increase their knowledge of breastfeeding, for example through trusted health professionals, and set up peer groups of breastfeeding mothers.
- For the community: target social norms and cultural beliefs through community health promotion programs.
What about engaging fathers?
The researchers refer to “male partners” as part of the social pressure and recommend that they be educated too, as part of community health promotion. The researchers, however, report significant differences between fathers and others, differences that are not then explored in the discussion or conclusions.
- The social pressures reported are from other women, not fathers. “The reference groups for decisions pertaining to exclusive breastfeeding included health care workers, friends, mothers, and mothers-in-law….” This list does not include fathers.
- Fathers are more neutral and more amenable to advice from health professionals. “Some participants, mainly male partners, were neutral because they felt that the mother of the baby would need to consult a health provider prior to making the decision.”
The researchers say there is a need for more research on engaging fathers. There is, in fact, already a strong body of research into breastfeeding interventions, including in Africa, that shows substantial increases in rates of breastfeeding when fathers are specifically engaged. (A collection of research reports is at FamilyIncluded.com/category/breastfeeding.)
The key to these approaches is to see, as was apparent in the findings from Kinshasa, that fathers are not just an equal part of the social surround along with friends, family and community. They are not just “male partners”, but are parents of the baby, “fathers”, with distinct interests and concerns that may make them more amenable to information and advice from health professionals.
Wood FE, Gage AJ & Bidashimwa D (2020), Insights on exclusive breastfeeding norms in Kinshasa: findings from a qualitative study, BMC Pregnancy and Childbirth 20
Header photo: H6 Partners. Creative Commons.