FACTORS ASSOCIATED WITH EXCLUSIVE BREASTFEEDING
IN THE INFORMAL SETTLEMENTS.
1.1 Maternal factors
1.1.1 Maternal occupation
A review article on barriers to EBF in low- and middle-income countries revealed a negative
relationship between maternal occupation and EBF practices (Kavle et al., 2017). Women
working in the informal sector often face structural barriers such as lack of maternity leave
because the sector is not subject to government legislation which may hinder EBF (U.N. women
2016). Another article by the International Labour Organization further strengthens these
findings that women comprise a large proportion of the poor working population in most
developing countries. Further, lack of safeguard strategies to shield new mothers in the informal
setup reduces their capability to practice exclusive breastfeeding. These mothers are already
facing high economic risks. Due to the instability of their employment, they often feel obliged to
continue or resume economic activities earlier, leaving no time to practice EBF (ILO, 2003).
A systematic review of barriers to EBF by USAID in 25 priority countries, in a campaign to end
preventable child and maternal deaths findings show that maternal employment, especially that
which involves manual labor or those without workplace safeguards, such as breaks for
breastfeeding, was a barrier to EBF (Justine A. et al., 2017). In this study maternal occupation
was found to have both positive and negative influence. Those in informal and formal
employment had a higher likelihood of practicing mixed feeding than those in business due to
flexibility of work.
1.1.2 Time constraints
A study carried out in India and South Africa among mothers working in the informal sector
found they were knowledgeable about EBF and its benefits. However, they could not sustain it
due to family economic needs requiring them to return to work almost immediately. This double
burden put most women at a crossroads in deciding whether to return to work or stay home and
take care of the child. The non-conducive work environment where a baby cannot be taken to the
, workplace due to safety and hygiene and the lack of support from colleagues also discourage the
mothers from bringing their babies to work, limiting mother-child interaction time. Findings also
revealed that the nature of informal work of having no formal maternity protection such as
maternity leave or kitty to cushion them during the period further impeded their ability to
continue exclusive breastfeeding. In contrast, the study found that informal work offered some
mothers the independence and flexibility to practice exclusive breastfeeding in some cases.
(Antara R.C. & Aditi S. 2018).
In another study carried out in India among 120 mothers working in three informal occupations,
i.e., domestic workers, street vendors, and waste pickers, almost half (47%) of the mothers
resumed working within three months after delivery, while 21 % returned three months
following. The proportion of those who could sustain breastfeeding during working hours was
27%, with the rest opting to complement with other feeds. (Chowdhury A, Surie A, 2018).
In a study in Thailand among mothers working in the informal economy, they reported that long
working hours decreased their milk supply. They had no choice but to introduce other foods as
the children were not getting enough (Yimyam & Morrow, 1999). A study carried out in two
Kenyan slums reported that mothers returned to work shortly after giving back, citing that their
economic situation could not allow them to stay home and care for the baby. During a focus
group discussion, a mother was quoted saying, "the baby will not eat the name "good care." In
addition, the rest of the family depended on the mother's income; hence she had to work. The
mothers also reported working for long hours and in environments that could not allow them to
bring their children with them. In light of this, they opted to leave them behind under the care of
caregivers such as relatives, siblings, neighbors, and in some circumstances, day and night care
centers. (Kimani-Murage et al. 2014).
1.1.3 Breast milk insufficiency
A study carried out in the Gambia found that low income impeded EBF due to the mothers'
inadequate access to and consumption of food, which meant that they could not produce enough
breast milk to nourish their infants. Another study carried out in rural Zimbabwe found that low
social-economic status impeded exclusive breastfeeding in two ways. Some mothers fed on poor
IN THE INFORMAL SETTLEMENTS.
1.1 Maternal factors
1.1.1 Maternal occupation
A review article on barriers to EBF in low- and middle-income countries revealed a negative
relationship between maternal occupation and EBF practices (Kavle et al., 2017). Women
working in the informal sector often face structural barriers such as lack of maternity leave
because the sector is not subject to government legislation which may hinder EBF (U.N. women
2016). Another article by the International Labour Organization further strengthens these
findings that women comprise a large proportion of the poor working population in most
developing countries. Further, lack of safeguard strategies to shield new mothers in the informal
setup reduces their capability to practice exclusive breastfeeding. These mothers are already
facing high economic risks. Due to the instability of their employment, they often feel obliged to
continue or resume economic activities earlier, leaving no time to practice EBF (ILO, 2003).
A systematic review of barriers to EBF by USAID in 25 priority countries, in a campaign to end
preventable child and maternal deaths findings show that maternal employment, especially that
which involves manual labor or those without workplace safeguards, such as breaks for
breastfeeding, was a barrier to EBF (Justine A. et al., 2017). In this study maternal occupation
was found to have both positive and negative influence. Those in informal and formal
employment had a higher likelihood of practicing mixed feeding than those in business due to
flexibility of work.
1.1.2 Time constraints
A study carried out in India and South Africa among mothers working in the informal sector
found they were knowledgeable about EBF and its benefits. However, they could not sustain it
due to family economic needs requiring them to return to work almost immediately. This double
burden put most women at a crossroads in deciding whether to return to work or stay home and
take care of the child. The non-conducive work environment where a baby cannot be taken to the
, workplace due to safety and hygiene and the lack of support from colleagues also discourage the
mothers from bringing their babies to work, limiting mother-child interaction time. Findings also
revealed that the nature of informal work of having no formal maternity protection such as
maternity leave or kitty to cushion them during the period further impeded their ability to
continue exclusive breastfeeding. In contrast, the study found that informal work offered some
mothers the independence and flexibility to practice exclusive breastfeeding in some cases.
(Antara R.C. & Aditi S. 2018).
In another study carried out in India among 120 mothers working in three informal occupations,
i.e., domestic workers, street vendors, and waste pickers, almost half (47%) of the mothers
resumed working within three months after delivery, while 21 % returned three months
following. The proportion of those who could sustain breastfeeding during working hours was
27%, with the rest opting to complement with other feeds. (Chowdhury A, Surie A, 2018).
In a study in Thailand among mothers working in the informal economy, they reported that long
working hours decreased their milk supply. They had no choice but to introduce other foods as
the children were not getting enough (Yimyam & Morrow, 1999). A study carried out in two
Kenyan slums reported that mothers returned to work shortly after giving back, citing that their
economic situation could not allow them to stay home and care for the baby. During a focus
group discussion, a mother was quoted saying, "the baby will not eat the name "good care." In
addition, the rest of the family depended on the mother's income; hence she had to work. The
mothers also reported working for long hours and in environments that could not allow them to
bring their children with them. In light of this, they opted to leave them behind under the care of
caregivers such as relatives, siblings, neighbors, and in some circumstances, day and night care
centers. (Kimani-Murage et al. 2014).
1.1.3 Breast milk insufficiency
A study carried out in the Gambia found that low income impeded EBF due to the mothers'
inadequate access to and consumption of food, which meant that they could not produce enough
breast milk to nourish their infants. Another study carried out in rural Zimbabwe found that low
social-economic status impeded exclusive breastfeeding in two ways. Some mothers fed on poor
