Facilitators and Barriers to Breastfeeding Practices of Mothers in a Selected Urban Community in Malaysia

Naleena Devi Muniandy, Fatin Iman Najihah Mohamad Yusof


This study was designed to explore the facilitators and barriers of breastfeeding practices among mothers in a selected urban population in Malaysia. This study reports the qualitative findings from a larger study that was conducted in two health clinics in Selangor, Malaysia. Ten mothers were recruited and an in-depth interview using grounded theory approach was used to obtain information. Interviews were transcribed and was manually arranged into codes and themes using thematic analysis. Facilitators to breastfeeding in this population were maternal factors (knowledge of breastfeeding, intention to breastfeed, perceived benefits of breastfeeding), social support and health care provider. Barriers to breastfeeding were insufficiency of breastmilk, employment and stigma of public breastfeeding. The findings of this study suggest that intervention to improve breastfeeding uptake should aim on increasing knowledge of mothers on coping with issues related to breastfeeding difficulties such as how to increase or sustain milk production and increasing awareness of employers and public on supporting breastfeeding mothers.


Adan RA, van der Beek EM, Buitelaar J K, Cryan JF, Hebebrand J, Higgs S, Schellekens H, Dickson SL. 2019. Nutritional psychiatry: Towards improving mental health by what you eat. Eur Neuropsychopharmacol 29(12):1321−1332. https://doi.org/10.1016/j.euroneuro.2019.10.011
Binns C, Lee M, Low WY. 2016. The long-term public health benefits of breastfeeding. Asia Pac J Public Health 28(1):7−14. https://doi.org/10.1177/1010539515624964
Braun V, Clarke V. 2006. Using thematic analysis in psychology. Qual Res Psychol 3(2):77−101. https://doi.org/10.1191/1478088706qp063oa
Carr LE, Elolimy A, Rosa F, Virmani MD, Munblit D, Yeruva L. 2021. Role of human milk bioactives on infants' gut and immune health. Front Immunol 12:290. https://doi.org/10.3389/fimmu.2021.604080
Chai Y, Nandi A, Heymann J. 2018. Does extending the duration of legislated paid maternity leave improve breastfeeding practices? Evidence from 38 low-income and middle-income countries. BMJ Global Health 3(5):e001032. https://doi.org/10.1136/bmjgh-2018-001032
Chang PC, Li SF, Yang HY, Wang LC, Weng CY, Chen KF, Chen W, Fan SY. 2019. Factors associated with cessation of exclusive breastfeeding at 1 and 2 months postpartum in Taiwan Int Breastfeed J 14(1):18. https://doi.org/10.1186/s13006-019-0213-1
Chang YS, Glaria AA, Davie P, Beake S, Bick D. 2020. Breastfeeding experiences and support for women who are overweight or obese: A mixed-methods systematic review. Matern Child Nutr 16(1):e12865. https://doi.org/10.1111/mcn.12865
Che'Muda CM, Ismail TAT, Ab Jalil R, Hairon SM, Sulaiman Z, Johar N. 2018. Maternal factors associated with the initiation of exclusive breastfeeding among mothers at one week after delivery in two selected hospitals in Kelantan, Malaysia. Malays J Med Sci 25(4):112−121. https://doi.org/10.21315/mjms2018.25.4.11
Coomson JB, Aryeetey R. 2018. Perception and practice of breastfeeding in public in an urban community in Accra, Ghana. Int Breastfeed J 13(1):1−10. https://doi.org/10.1186/s13006-018-0161-1
Emmott EH, Mace R . 2015. Practical support from fathers and grandmothers is associated with lower levels of breastfeeding in the UK millennium cohort study. Plos One 10(7):e0133547. https://doi.org/10.1371/journal.pone.0133547
Febrianingtyas Y, Februhartanty J , Hadihardjono DN. 2019. Workplace support and exclusive breastfeeding practice: A qualitative study in Jakarta, Indonesia. Malays J Nutr 25(1):129−142. https://doi.org/10.31246/mjn-2018-0107
Fox R, McMullen S, Newburn M. 2015. UK women's experiences of breastfeeding and additional breastfeeding support: A qualitative study of baby café services. BMC Pregnancy and Childbirth 15(1):1−12. https://doi.org/10.1186/s12884-015-0581-5
Glaser BG, Strauss AL. 2009. The Discovery of Grounded Theory: Strategies for Qualitative Research. New Brunswick (USA): Aldine.
Martin SL, McCann JK, Gascoigne E, Allotey D, Fundira D, Dickin KL. 2020. Mixed-methods systematic review of behavioral interventions in low- and middle-income countries to increase family support for maternal, infant, and young child nutrition during the first 1000 days. Current Developments in Nutrition 4(6):nzaa085. https://doi.org/10.1093/cdn/nzaa085
Mehlawat U, Puri S, Rekhi TK. 2020. Breastfeeding practices among mothers at birth and at 6 months in urban areas of Delhi-Ncr, India. J Gizi Pangan. 15(2):101−108. https://doi.org/10.25182/jgp.2020.15.2.101-108
National Health and Morbidity Survey. 2016. Maternal child health findings. Volume two: Maternal and child health findings. Institute for Republic Health, National Institute of Health, Ministry of Health Malaysia. http://iku.moh.gov.my/images/IKU/Document/REPORT/2016/NHMS2016ReportVolumeII-MaternalChildHealthFindingsv2.pdf [Accessed 6th July 2020].
Nguyen AN, van Langeveld AW, de Vries JH M, Ikram MA, de Graaf C, Mars M, Voortman T. 2021. Dietary taste patterns in early childhood: The generation r study. Am J Clin Nutr 113(1):63−69. https://doi.org/10.1093/ajcn/nqaa296
Raissian KM, Su JH. 2018. The best of intentions: Prenatal breastfeeding intentions and infant health. SSM-Population Health 5:86−100. https://doi.org/10.1016/j.ssmph.2018.05.002
Sheehan A, Gribble K, Schmied V. 2019. It's okay to breastfeed in public but.... . Int Breastfeed J 14(1):1−11. https://doi.org/10.1186/s13006-019-0216-y
Theodorah DZ, Mc'Deline RN. 2021."The kind of support that matters to exclusive breastfeeding" a qualitative study. BMC Pregnancy and Childbirth 21(1):1−8. https://doi.org/10.1186/s12884-021-03590-2
[UNICEF] United Nations Children's Fund. 2019. Infant and young child feeding. Adopting optimal feeding practices is fundamental to a child's survival, growth and development, but too few children benefit. UNICEF data. https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding/ [Accessed 15 April 2021].
[UNICEF/WHO] United Nations Children's Fund/World Health Organization. 2017. Global Breastfeeding Scorecard 2017: Tracking progress for brestfeeding policies and programmes. https://www.who.int/nutrition/publications/infantfeeding/global-bf-scorecard-2017.pdf [Accessed 14th April 2021].
Verduci E, Banderali G, Barberi S, Radaelli G, Lops A, Betti F, Riva E, Giovannini M. 2014. Epigenetic effects of human breast milk. Nutrients 6(4):1711−1724. https://doi.org/10.3390/nu6041711
Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC. 2016. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet 387(10017):475−490. https://doi.org/10.1016/S0140-6736(15)01024-7
[WHO] World Health Organization. 2020. Infant and young child feeding. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding [Accessed 15th April 2021].
Wagner EA, Chantry CJ, Dewey KG, Nommsen-Rivers LA. 2013. Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 Months. Pediatrics 132(4):e865−e875. https://doi.org/10.1542/peds.2013-0724
Wallenborn JT, Levine GA, Dos Santos AC, Grisi S, Brentani A, Fink G. 2021. Breastfeeding, physical growth, and cognitive development. Pediatrics 147(5). https://doi.org/10.1542/peds.2020-008029
Zakarija-Grković I, Šegvić O, Vučković Vukušić A, Lozančić T, Božinović T, Ćuže A, Burmaz T. 2016. Predictors of suboptimal breastfeeding: An opportunity for public health interventions. Eur J Public Health 26(2):282−289. https://doi.org/10.1093/eurpub/ckv203


Naleena Devi Muniandy
naleena@uitm.edu.my (Primary Contact)
Fatin Iman Najihah Mohamad Yusof
MuniandyN. D., & YusofF. I. N. M. (2021). Facilitators and Barriers to Breastfeeding Practices of Mothers in a Selected Urban Community in Malaysia. Jurnal Gizi Dan Pangan, 16(3), 179-188. https://doi.org/10.25182/jgp.2021.16.3.179-188

Article Details