Overcoming challenges in Breast-feeding Support: Insights from midwives in a General Hospital setting

Abstract
Background: As the primary carers in a general hospital, midwives play a crucial role in breastfeeding support. However, difficulties in providing effective support and confronting cultural beliefs can hinder breastfeeding practices. Understanding midwifes' perspective on effective breastfeeding support is crucial for the development of targeted interventions and the improvement of breastfeeding support services.

Aim and Objective: The objective of this study was to analyze the various challenges faced by midwives in providing breastfeeding support within a typical hospital setting.

Method: In-depth interviews with midwives to gather valuable insights and experiences were employed. The data collected were analyzed using thematic analysis as a methodological approach to discern emerging themes and patterns with the help of ATLAS.ti software.

Results: The findings revealed two primary obstacles midwives encounter. First, insufficient personnel and time constraints which impeded their capacity to provide comprehensive support and education to the large number of women seeking assistance. Secondly, cultural beliefs about lactation posed additional obstacles. Misconceptions regarding the sufficiency of breast milk, concerns regarding breast appearance, and the importance of colostrum influenced mothers' ability to exclusively breastfeed. Cultural practices including the premature introduction of complementary foods and the discarding of colostrum impeded the promotion of exclusive breastfeeding.

Conclusion: The study showed that staffing and time constraints had a negative effect on provision of breastfeeding support by midwives while cultural norms prevented exclusive breastfeeding. Addressing these challenges by stakeholders' through increased healthcare funding and staffing of health facilities is necessary to ensure effective breastfeeding support, educating the community on the importance of colostrum andbreast appearance to eliminate cultural myths, ultimately leading to a successful breastfeeding.

KEYWORDS: Breastfeeding support, midwives, hospitals, challenges, cultural views,
exclusive breastfeeding