BREASTFEEDING EXPERIENCES, CHALLENGES AND COPING MECHANISMS AMONG FIRST TIME NURSING MOTHERS OF ADVANCE MATERNAL AGE IN IBADAN NORTH LOCAL GOVERNMENT AREA, OYO STATE

Abstract

Breastfeeding is a universal practice of providing essential nutrients for infants with immunological factors that prevent diseases, promote their optimal growth and development. It was recommended, promoted and supported by WHO, UNICEF and other agencies to be initiated as the first source of nutrient immediately after birth as a tool for achieving the sustainable development goal of optimal improvement in maternal and child health and nutrition. However, this recommendation is being challenged by an evident increase in mean age at first birth in both developed and developing countries in relation to advanced maternal age which has been proven to affect pregnancy outcomes and breastfeeding practices. This study was therefore designed to explore breastfeeding experiences, challenges and coping mechanisms among first time nursing mothers of advance maternal age in Ibadan North Local Government Area, Oyo State, Nigeria. The study was a hospital-led community-based descriptive cross-sectional explorative research. Fourteen consenting community women of advanced maternal age in Ibadan North LGA were selected by a purposive and snowballing sampling technique. In-Depth Interview (IDI) was conducted with all the participants using IDI guide. IDI guide included aspects that elicited information about socio-demographics and cover the area of focus of the research objectives including information on breastfeeding experiences, challenges and coping mechanisms among the respondents. All in-depth interviews were digitally recorded and transcribed verbatim. Data was analyzed using manual qualitative thematic analysis method as well as following Colaizzi’s phenomenological method steps to document the experiences, challenges and coping mechanisms of breastfeeding among the study participants. Interview transcriptions generated 64 nodes, 16 sub themes and five key themes. Mean age was 38.9±4.3 years and age of the children ranged from 1-7 months. All the respondents are Yoruba, majority (86.0%) of the respondents had completed bachelor degree education, two third (64.3%) were Christians, about one-fifth (21.4%)were businesswomen; all delivered through caesarean section and were all breastfeeding at the time of the study. The five key themes identified were: (a) becoming a mother (b) challenges and support for breastfeeding in the initial period after birth; (c) breastmilk quantification; (c) Natural phenomenon/medical intervention; (d) emotional and psychological aspects of breastfeeding. The twelve coping strategies used by the women to manage their concerns were: sharing feelings, redefining normal, caring for self, seeking support/advice, use of recommended substances, seeking medical intervention, advice from BF clinics, seeking significant others’ supports, use of pap and other liquid, continuous BF, adjustment and redefining normal, infant formula milk. This study provided a better understanding of the breastfeeding experiences of first time mothers in the study area as initiating and sustaining breastfeeding is still challenging for them. Overall, age, mode of conception, mode of delivery, their condition of being a first time mothers and ANC attendance influenced their breastfeeding experience, challenges experienced during breastfeeding initiation, exclusive breastfeeding and their general breastfeeding practices. Healthcare policy makers, healthcare workers should collaboratively put in place, a greater public awareness and laws that support breastfeeding among the respondents, while family members should endeavour to provide support that will help the respondents to have successful breastfeeding experience.