Knowledge, attitude, perception, and practice of exclusive breastfeeding among lactating mothers in low-income countries: A systematic review

Abstract

Background: Exclusive breastfeeding is one of the critical determinants of maternal and child health, particularly in low-income countries, where it can considerably impact infant survival and development. Notwithstanding this, the rates of exclusive breastfeeding remain very low in such places, often being influenced by a host of factors. This present research has sought to review knowledge, attitudes, perceptions, and practice (KAPP) on exclusive breastfeeding among lactating mothers in low-income countries. 

Methods: A systematic review methodology involved sourcing and compiling data from multiple studies on exclusive breastfeeding in low-income countries. The review included qualitative studies, community-based cross-sectional studies, systematic reviews, and meta-analyses. Data were extracted about the participants' knowledge and understanding of exclusive breastfeeding; participants' attitudes and perceptions; actual breastfeeding practice; and the socio-economic, cultural, individual, and health system factors that impact these elements. This is a systematic review that appraises and summarises all available studies regarding KAPP on exclusive breastfeeding among lactating mothers from low-income countries. 

Results: Several determinants at the different levels that impact exclusive breastfeeding practice were identified through this review. Accordingly, attitudes toward and practice of breastfeeding are highly influenced by social norms and cultural beliefs, with community and family expectations often at the forefront in driving mothers' decisions. Socioeconomic factors, such as income, education, and accessibility to health facilities, may also influence; lower socioeconomic classes tend to have a reduced rate of exclusive breastfeeding. 

Conclusion: Results suggest the interplay of social, economic, cultural, and environmental factors in shaping the practice of exclusive breastfeeding in low-income countries. Target interventions aimed at changing such determinants could be effective for shifting breastfeeding rates significantly higher and hence improving maternal and child health outcomes. This research would, therefore, strongly emphasise comprehensive approaches to education, formulate policies, and involve communities in the support and promotion of exclusive breastfeeding among lactating mothers.