ABSTRACT

 Introduction and objectives:

 Breastfeeding is recommended for infants from birth to two years and beyond and is expected to be offered to be offered on demand. In developed countries, women have suffered abuse (verbally or physically confronted) and made to feel embarrassed for breastfeeding in public places. It is not clear if similar situations occur in developing countries where breastfeeding is typically universal. A better understanding of societal perception of breastfeeding in public is needed to promote and support breastfeeding as a public health strategy for addressing preventable child deaths. This study assessed societal as well as individual women’s perception and practice regarding breastfeeding in public in an urban setting in Southern Ghana, as well as factors associated with these outcomes. Methods: A cross-sectional study using an explanatory sequential mixed method study design was carried out. A survey which collected data on 300 women’s sociodemographic characteristics, obstetric history and their perception and practice of breastfeeding in public places was employed. Five Focus Group Discussions and five In-Depth Interviews were conducted with women and men to obtain qualitative information on women and community perceptions of breastfeeding in public places. Findings: Mean age of respondents was 31.2 ± 0.3 years. Ninety-four percent were married or cohabiting and 54.3% had received secondary education or higher. Women’s age between 30-34 years was associated with their perceptions of breastfeeding in public places. Eighty-five percent of women in the survey considered breastfeeding in public as an acceptable practice. Ninety-two percent of women reported previous practice of breastfeeding in a public place. Women who reported strong family support for (OR=3.27, v 95%CI =1.31-8.18) or having a spouse who was comfortable with breastfeeding in public (OR=3.99, 95%CI=1.50-10.57) were more likely to practice it. Majority of women reported the need to cover their breast when breastfeeding in public; such women were likely to perceive the practice as unacceptable (OR=0.13, 95%CI=0.03-0.43). Conclusions: Majority of women did not perceive breastfeeding in public as a problem. However, they are able to do so by finding a way to minimize their feelings of discomfort. Targeted public education and promotion of breastfeeding in public places will empower women to choose to breastfeed wherever they find themselves.