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Barriers to Exclusive Breastfeeding in Middle Income Countries and China
AuthorSandquist, Melanie R.
Community Health Sciences
Community Health Sciences (Public Health)
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Intro Exclusive Breast Feeding (EBF) is recommended for the first 6 months of life as it conveys many important benefits to both mother and child. Unfortunately, many middle income countries fall short of WHO and UNICEF recommendations and goals for EBF. This literature review strives identify the drivers and barriers of EBF in middle income countries and China. Methods Searches in both Pubmed and Embase returned 32 results. Articles that were not peer reviewed, written before 2015 or in a language other than English were excluded, along with articles that did not include relevant discussion of drivers of formula or barriers to EBF in middle income countries. Articles that discussed formula, EBF, middle income countries, and China were included. A total of 22 articles were reviewed. Results The studies selected showed that middle income Asian countries have the most rapidly increasing formula markets, as well as low rates of EBF. The most common drivers of formula were country income/wealth while the most supported barriers to EBF were physical barriers (i.e. Cesarean section, multiple gestation), mother employment status, and no social support. There is little research on EBF in China. Although the studies that do exist identified a correlation between mother employment and formula consumption, they are not applicable to the general Chinese population. Discussion Further research into the determinants of EBF in middle income countries is necessary to inform future interventions. Further inquiry is particularly important in China, where EBF rates are low and formula sales high.