7 Barriers to Exclusive Breastfeeding in Africa
By: Chiamaka Wisdom-Asotah, MBBS, MPH. Freelance Health Writer and DLHA Volunteer. Reviewed by: Ibironke Taiwo, RN, RM, BNrSc.
An African woman breastfeeding her baby while on her feet. Pexels
Exclusive breastfeeding gives your baby the best start in life. It builds immunity, supports healthy growth, and deepens the mother-child bond.
In many African communities, breastfeeding is celebrated and widely acceptable. But exclusive breastfeeding, which is giving your baby only breast milk for the first six months isn’t always practiced, despite the known benefits.
So, what’s standing in the way?
From cultural beliefs and family pressures to workplace barriers and healthcare gaps, African mothers face challenges with exclusive breastfeeding. This article explores the 7 most common barriers and why understanding them is key to supporting mothers across the continent.
In many African countries, several cultural and traditional beliefs influence the practice of exclusive breastfeeding. [1]
Policy obstacles such as inadequate maternal leaves, limited public breastfeeding areas, in addition to inaccessible health information form roadblocks to the WHO’s goal of achieving 50% global coverage of breastfeeding by 2025. [2] While efforts are being put in place by some organisations to tackle these problems, there’s still much to be done, as only 18 out of 49 African countries are close to meeting this target.
Here are the common 7 breastfeeding challenges in Africa that you should be aware of:
In most African countries, there are challenges with accessing adequate healthcare services and information. Reasons for this are complex but include, low literacy levels within communities, limited resources and facilities especially in rural locations, poor funding for public health education, and inadequate training of health workers to implement exclusive breastfeeding practices.
During pregnancy, you should attend antenatal services and be taught about the importance of exclusive breastfeeding. It is also expected that at delivery, you should be guided to initiate breastfeeding for the first time. This is not always the case, especially in low resource settings. The result is that women are not well-informed, and their babies are not exclusively breastfed. [3]
When mothers don’t have accurate and helpful information, they are unable to make informed decisions about anything, including exclusive breastfeeding. [4] Implementing supportive policies and putting proper systems in place, can solve this challenge.
A community health worker educating African parents who are sitting and being attentive. Pexels. Click on image to enlarge.
Colostrum is the first milk that the breast of a new mother releases after delivery. It is concentrated with nutrients needed for your baby to thrive and be healthy, but ironically, some African cultures refer to it as ‘‘bad milk’’ [5]. This bias towards colostrum is said to be due to its thick yellow consistency. Myths like this make most African women not practice exclusive breastfeeding, denying their babies of its protective benefits.
In Pre-lacteal feeding, water or any liquid (like saline or herbs) is given to a baby before breastfeeding is initiated. This is a common practice in most African cultures and it is believed to protect the child, clean the baby’s stomach and augment a perceived reduced milk supply. Some other cultures believe that it quenches the baby’s thirst and allows the mother to rest after childbirth before breastfeeding begins. While these reasons may have been practised from generation to generation and possibly with no obvious harmful effects in some cases, they put your baby at risk of inadequate breastfeeding and subsequent death from infections, notably diarrhoea and pneumonia [4]
African women equally face barriers to breastfeeding from those who should support them – family. Women are pressured to give water to their babies and begin solids early, and many times, they can’t defend their stance. Sometimes, the advice from various family members is conflicting.
Portrait of an African woman holding her baby with her husband behind her, both smiling. Image credit: Leonardo ai
To make things worse, some fathers do not get involved to assist their wives in this vulnerable period, leaving them stressed and ready to follow misinformed advice. For this reason, the rate of exclusive breastfeeding in many African communities continues to diminish. [6]
There has been a rise in advertisements for infant formula lately. You may have seen the myriad of formulas available in the stores, and sadly, a many make it to the visually appealing billboards, garnering attention and increasing sales. This is how formula milk companies use the power of advertising to get their products to the public and drive sales. Companies that produce infant formula target health workers who attend to women and their babies. They provide them with free training, sponsorships and gifts, encouraging them to recommend formula feeding to mothers who would also receive free samples of infant formula at delivery.
The World Health Organization (WHO) has criticised these advertisement campaigns because they work against efforts to encourage the practice of exclusive breastfeeding [7, 8].
Returning to work after delivery can be quite challenging for new mothers. You may be caught between stabilising a breastfeeding routine for your baby and your job. Breastfeeding mothers require adequate support when they resume work whether they get maternity leave or not. Sadly, several workplaces do not provide the much-needed support, like paid or unpaid maternity leaves, and flexible work schedules for mothers to express and/or store milk and to breastfeed. Therefore all plans to practice exclusive breastfeeding become impossible.
An image depicting a stressed African mother sitting down at work with a breast pump containing milk. Image credit: Leonardo ai
Some workplaces also do not provide dedicated breastfeeding spaces for their workers, and some co-workers might be unsupportive. All these serve as barriers to exclusive breastfeeding [9].
Your religion can determine how you breastfeed your baby. While some religions are more likely to support the practice of exclusive breastfeeding, others enforce cultural practices such as pre-lacteal feed which isn’t safe for your baby. [1, 10]. This is one reason religious leaders shouldn’t be left out of public education efforts concerning exclusive breastfeeding.
For every challenge, there is a solution. While most African countries practice breastfeeding, it is usually not practised exclusively. What can be done?
1. Raise community awareness about the harmful effects of certain cultural practices that hinder exclusive breastfeeding, using targeted health education campaigns and local advocacy.
2. Train Hospital staff to educate mothers and help them accept exclusive breastfeeding promptly.
3. Regulate the marketing of commercial milk formula to prevent women from abandoning exclusive breastfeeding.
4. Establish workplaces policies to support breastfeeding mothers in performing their duties while also achieving healthy babies through exclusive breastfeeding.
5. Target Community Enlightenment: Governments should work together with traditional and religious leaders as well as other stakeholders to enlighten women and men in communities about the importance of exclusive breastfeeding.
6. Train Primary Care Workers: Community Health Workers and Traditional Birth Attendants need to be trained to educate families on the benefits of exclusive breastfeeding and to dispel common myths.
7. Well-baby clinics: Set up well-baby clinics within Primary Health Centres (PHCs), ensuring they are adequately staffed to monitor infant feeding, provide breastfeeding counselling, and support mothers with practical guidance.
Conclusion
The fight against obstacles limiting the adoption of exclusive breastfeeding in Africa is an on-going one that can be won if the right solutions like general and targeted public education, improvement in access to healthcare services, training of community health workers, supportive workplace policies, etc., are implemented.
1. Oyelana O, Kamanzi J, Richter S. A critical look at exclusive breastfeeding in Africa: Through the lens of diffusion of innovation theory. International Journal of Africa Nursing Sciences, 2021; Volume 14,100267. doi: 10.1016/j.ijans.2020.100267. Available from here.
2. UNICEF. This World Breastfeeding Week: UNICEF and WHO call for equal access to breastfeeding support. [Internet] 2024 August 1. UNICEF: Latin America and the Caribbean. [Accessed 22 May 2025]. Available from here.
3. Kinshella MLW, Prasad S, Hiwa T. et al. Barriers and facilitators for early and exclusive breastfeeding in health facilities in Sub-Saharan Africa: a systematic review. Glob Health Res Policy 2021; 6(21). doi: 10.1186/s41256-021-00206-2. Available from here.
4. Amzat J, Aminu K, Mantakari B, Ismail A, Almu B, kalmodi KK. Sociocultural context of exclusive breastfeeding in Africa: A narrative review. Health Science Reports 2024,7(5)e2115. Available from here
5. Tomori C. Overcoming barriers to breastfeeding. Best Practice & Research Clinical Obstetrics & Gynaecology, 2022; Volume 83, Pages 60-71, doi: 10.1016/j.bpobgyn.2022.01.010. Available from here.
6. Quebu SR, Murray D, Okafor UB. Barriers to Exclusive Breastfeeding for Mothers in Tswelopele Municipality, Free State Province, South Africa: A Qualitative Study. Children (Basel). 2023 Aug 13;10(8):1380. doi: 10.3390/children10081380. Available from here.
7. Horwood C, Mapumulo S, Haskins L. et al. Women’s exposure to commercial milk formula marketing: a WHO multi-country market research study. Global Health 2024; 20, 85. doi: 10.1186/s12992-024-01088-y. Available from here.
8. World Health Organization. More than half of parents and pregnant women exposed to aggressive formula milk marketing – WHO, UNICEF. [Internet]. 2022 February 22. WHO News release. [Accessed 22 May 2025]. Available from here.
9. Mirkovic KR, Perrine CG, Scanlon KS, Grummer-Strawn LM. Maternity Leave Duration and Full-time/Part-time Work Status Are Associated with US Mothers’ Ability to Meet Breastfeeding Intentions. Journal of Human Lactation. 2014;30(4):416-419. doi:10.1177/0890334414543522. Available from here.
10. Bernard JY, Rifas-Shiman SL, Cohen E, Lioret S, de Lauzon-Guillain B, Charles MA, Kramer MS, Oken E. Maternal religion and breastfeeding intention and practice in the US Project Viva cohort. Birth. 2020 Jun;47(2):191-201. doi: 10.1111/birt.12477. Available from here.
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Published: June 20 2025
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