Peer-reviewed article
Psychosocial and context factors associated with breastfeeding and complementary feeding changes in Belize: a mixed methods approach.
Slekiene J, Gamma AE, Wade P, Robateau D, Oketch JA et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined breastfeeding and complementary feeding practices in Belize using data from national surveys between 2006 and 2016, combined with interviews and focus groups conducted in 2022. Researchers explored how maternal mental health and other psychosocial factors influence feeding decisions among caregivers of young children. While most mothers in Belize breastfeed, only about two-thirds exclusively breastfeed for the first six months as recommended, and many face barriers including mental health challenges.
Key points
- 93% of interviewed caregivers reported any breastfeeding, but only 82% practiced exclusive breastfeeding for the first six months
- 78% of mothers breastfed within one hour after birth
- Half of the women interviewed were at risk of common mental health disorders
- No direct significant association was found between maternal mental health and breastfeeding outcomes
- Mothers with poorer mental health had more children, less education, lower socioeconomic status, and greater awareness of breastfeeding barriers
Limitations
The qualitative sample was small (45 interviews) and the study found no significant direct link between maternal mental health and breastfeeding, suggesting the relationship is more complex than initially hypothesized. The findings cannot determine causality or isolate specific interventions that would improve feeding practices.
Abstract
Background UNICEF advocates for children's rights by ensuring their basic needs are met and their potential maximized. Reducing child mortality and improving health are central to this mission, particularly through breastfeeding and complementary feeding. This study aims to analyse these practices in Belize using data from three past Multi Indicator Cluster Studies (MICS) and conducted a research study that explores barriers and factors influencing breastfeeding, including the Baby-Friendly Hospital Initiative, with a focus on maternal mental health. The study examines breastfeeding within the first hour after birth, exclusive breastfeeding for the first six months (EBF), and continued breastfeeding for up to two years and beyond. Methods A mixed-methods design was used, combining quantitative MICS data (2006, 2011, 2015-16), desk reviews, and qualitative data collected in Belize in August-September 2022, to assess the context and psychosocial factors, including maternal mental health, that influence breastfeeding and complementary feeding practices among caregivers. Data collection involved 45 face-to-face interviews mainly with female caretakers of children under two, Key Informant Interviews, and Focus Group Discussions with caretakers and healthcare staff. Maternal mental health was assessed using the Self-Reporting Questionnaire (SRQ-20). Results The findings indicate that two out of three children were not exclusively breastfed for the first six months. Among the 45 interviewed caretakers, 93% reported overall breastfeeding (exclusive, non-exclusive, or complementary), 82% practiced EBF during the first six months, and 78% breastfed within one hour after birth. While general breastfeeding was common, EBF showed increasing trends, and early initiation was less frequent. Half of the woman interviewed were at risk of common mental health disorders. There was no significant direct association between mental health and breastfeeding. Correlation analysis showed that mothers with poorer mental health had more children, less education, lower socioeconomic status, and greater awareness of breastfeeding barriers. Conclusions While breastfeeding rates in Belize are improving, psychosocial vulnerabilities persist. Indirect links between maternal mental health and structural disadvantage, as well as the identified barriers to breastfeeding highlight the need for integrated, equity-focused public health interventions to enhance breastfeeding outcomes and address broader child nutrition challenges.