“What Time Will I Breastfeed the Baby?” Practical Issues in Realizing the Who Recommendations for Breastfeeding in Urban Poor Settings in Nairobi

Elizabeth W. Kimani-Murage, African Population and Health Research Center (APHRC)
Fredrick Murunga, African Population and Health Research Center (APHRC)
Catherine Kyobutungi, African Population and Health Research Center (APHRC)
Milka Wanjohi, African Population and Health Research Center (APHRC)
Peterrock Muriuki, African Population and Health Research Center (APHRC)
Nyovani Madise, University of Southampton
Paula Griffiths, Loughborough University

The WHO recommends exclusive breastfeeding for six months with extended breastfeeding for two years or beyond to meet the child’s nutritional requirements and achieve optimal growth, development and health. Poor breastfeeding practices are widely documented in sub-Saharan Africa, particularly in the urban slums, where most urban residents live. Only 2% of infants in Nairobi slums are exclusively breastfed for six months, while 15% are not breastfed beyond one year. This study aimed at establishing factors which contribute to breastfeeding practices in urban slums. The study involved interviews with mothers, community leaders and health professionals in two urban slums in Nairobi. Factors related to the ecological setting including socio-economic particularly related to the cash-based economic system in urban slums, and structural barriers are perceived key in shaping breastfeeding behaviors among urban poor mothers. Approaches targeted at improving breastfeeding practices in urban slums without considering the wider ecological setting are unlikely to be successful.