Breastfeeding among rural Panamanian women: initiation and duration factors

Alexandra F. Hayes

Breastfeeding is an integral part of Panamanian culture and important for mitigating the high rates of infant morbidity caused by diarrhea; yet, according to recent reports, only 25% of babies are exclusively breastfed at six months of age, while only 38% receive any breastmilk at nine months of age. This study identified the factors that affect breastfeeding initiation and duration to provide Panamanian public health agencies the data necessary to develop culturally appropriate breastfeeding campaigns aimed at increasing support for and rates of breastfeeding among Panamanian families. Ethnographic data was collected in rural communities in Panama from August 2007 until March 2009. This data comes from participant-observation within the community and informal interviews (N=150) with community members on breastfeeding experiences and factors that affected infant feeding decisions. Observations and informal interviews were augmented by detailed, open-ended, semi-structured interviews with ten key female informants, aged 18-36, with at least one child under the age of 5. Higher levels of prenatal education associated with increased knowledge regarding breastfeeding benefits for infants. Participants reported heavily relying on informal sources of support, such as mothers and male partners, when making infant feeding decisions. Women who delivered in hospitals that did not supply formula, encouraged breastfeeding on demand, and permitted "rooming-in" , where the mother and infant remain in the same room for the duration of the hospital stay, reported longer breastfeeding durations. Informants reported positive attitudes toward breastfeeding as a result of their perceived widespread acceptance and practice of breastfeeding. To increase breastfeeding duration rates, prenatal education should include discussions of alternative feeding methods, such as breast milk pumping, and the conditions that precipitate their use, such as employment outside the home, as well as the importance of exclusive breastfeeding during the first six months. Because mothers rely heavily upon informal sources of support, including their mother and male partners, breastfeeding campaigns should include audio-visual messages that focus on infant feeding as a family decision with special emphasis on paternal influence and involvement. Public health agencies and hospitals should collaborate to develop a national breastfeeding policy to improve efforts to achieve Baby-Friendly Hospital status.

Breastfeeding among rural Panamanian women: initiation and duration factors

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