Exclusive Breastfeeding in Lesotho: Influences, Barriers, and The Role of Informal Networks

Abstract: This research investigated maternal and infant care in Lesotho, with an emphasis on exclusive breastfeeding practices during the first year of life. A quantitative, descriptive survey included 97 mothers attending healthcare facilities. The findings highlighted a prevalent preference for exclusive breastfeeding in the initial three months, which decreases during the following 3 months. Yet around 7% introduced complementary foods or fluids early on and many did not breastfeed exclusively until the 6-month recommended period. The majority began breastfeeding within the recommended one-hour post-delivery window. Distinct decision-making dynamics emerged: nearly half of the mothers made autonomous feeding decisions, around a quarter collaborated with the child’s father or partner, and 11.3% involved extended family in these choices. Colostrum's recognized value as a newborn's first nutrient source aligned with global health recommendations. However, the early introduction of other foods indicates a need to explore mothers’ beliefs and knowledge about feeding practices further. Common breastfeeding challenges encompassed issues like sore nipples and perceived milk insufficiency, underlining the importance of educational support. Healthcare professionals, especially nurses, played a key role in offering guidance and support on breastfeeding. The frequent practice of immediate skin-to-skin contact post-birth emphasized the trend toward promoting early bonding and breastfeeding initiation. Furthermore, the community’s positive reception to public breastfeeding signaled societal acceptance. In conclusion, this study illuminates the nuances of breastfeeding practices and decision-making in Lesotho, providing insights into interventions and policies to enhance maternal and child health in the country. Keywords: Decision-making, Exclusive Breastfeeding, Parental Autonomy, Support Systems