Breastfeeding in Ghana: Statistics, Misconceptions and Formula

Beautiful mural from my neighborhood of a breastfeeding woman.

Since I returned to Ghana with our daughter, I have gotten many comments about me breastfeeding her. Most often, I am met with surprise, raised eyebrows and reassuring comments such as “you have done well!” Many of these reactions seem to come out of the misconception that “white people do not breastfeed”. Nothing could be more wrong!

In my native Sweden, there is extensive education on breastfeeding both for parents-to-be in preparatory courses and at the hospital when your infant is just born. Breastfeeding is highly encouraged, and initially 97% of mothers breastfeed. When the baby is 2 months 88% breastfeed partially and 69% exclusively. At 6 months the share of breastfeeding mothers is at 65% (Statistics from Swedish national board for health and welfare for children born 2009. Additionally, there is stats for babies’ breastfeeding of 9 months as well as 12 months!)

Surviving Life in Sweden blog (written by an American in Sweden) has some experience on breastfeeding and is surprised how openly Swedish mothers feed their children:

“In Sweden, the attitude toward the boob is different. Seriously, they are everywhere – in often very non-sexual ways – and it’s not a big deal. You will be stared at if you wear a nursing burka USA style. If you are shy and your child will oblige lay a small cloth over your shoulder/baby – but nothing dramatic. And no – it’s not because Swedish ladies want the world to see their boobs, it’s because they just wanted to keep their baby fed and not be chained to the house all day.”

I guess this goes to say that when it comes to attitudes on breastfeeding, there are also differences in the Global north.

Moving onto the attitudes to breastfeeding in Ghana: some of the Ghanaians I have talked to about this topic have informed me of a new trend in Ghana where Ghanaian mothers do not breastfeed their children. Some not at all, some very briefly.

I was surprised when I heard this, had I not seen many mothers feeding their children in Ghana? When water security is a problem, why not breastfeed? I decided to do some research and realized this is not a new trend, but a major health problem for Ghana. The Linkages Project summarizes the situation like this:

“Nearly all mothers initiate breastfeeding in Ghana. However, sub-optimal breastfeeding practices begin on the first day. Only 25 percent of women initiate breastfeeding within the first hour after birth. Approximately 20 percent of mothers nationwide practice exclusive breastfeeding for the recommended period of the first six months. The low rate of exclusive breastfeeding is largely due to the introduction of water and other liquids at an early age. The Ghana Health Service estimates that sub-optimal breastfeeding practices contribute to about eight percent of infant deaths or about 3,300 infant deaths each year.”

Only 20% of mothers breastfeed exclusively? I continued my search and found some more assuring data. According to World Bank data the rate of mothers practicing exclusive breastfeeding to children under six months is 62,8%. However, considering that this number likely comes from health providers and the indicator on children under 5 seeing a health practitioner is only half the population or 51%, the 20% stated above might sadly be about accurate.

The good news is that education really seem to help. The Linkages Project reports big jumps in numbers of breastfeeding mothers after sensitization.The Breastfeeding Week (!) might also help bring awareness. So education seems to be step one.

But one friend was insisting that also well-educated Ghanaians refrain from breastfeeding. Can an explanation to this behavior can be found in the relatively short Ghanaian maternity leave of three months? Compare with the recommended breastfeeding time of 6 months and you see the discrepancy.

Or are there other reasons? Vanity (“I do not want stretched out breasts”), corporate miseducation (“formula is better”) or something else?

What do you think?

12 Replies to “Breastfeeding in Ghana: Statistics, Misconceptions and Formula”

  1. I am born and raised in London, England but have a Ghanaian background. Within theGhanain British culture where I was raised (there are a few different ones contrary to popular belief) breastfeeding was viewed much as how you describe it in Sweden. As common as drinking water, women would whip out their breasts and feed a baby that needed feeding. There was no shame and it was not sexualised. When I grew up slightly and saw more White English families I realised it was Not The Done Thing. I remember being surprised to hear quite openly negative remarks about how disgusting it was for women to breastfeed…particularly outside of the home! This view pervades British society to such an extent that in my current job I often hear that raising breastfeeding rates (initiation, through to 6 months) is a massive public health priority.

    So going back to Ghanaian women (at least in th UK), I think its a misguided case of copying what the ‘West’ do. Scandinavian countries do so much better than most of the ‘West’ on these key child-related indicators. They have a different way of thinking. But in Ghana there is little knowledge and understanding of the ways of that part of the ‘West’, which is probably why people were surprised to see you breastfeeding.

  2. Thanks Nsoromma for your comment! I think your story is a good illustration of that attitudes vary and that they matter. Maybe sexualizing babies’ food/ breastfeeding has much more to do with the issue than I first thought…

  3. Going back to work certainly makes it hard. I went back to work at four months and was exclusively breast feeding which meant I had to express, including at work. To be able to do that you need a very accommodating workplace. It’s not impossible though. I continued breast feeding (not exclusively) through to twelve months.

  4. This is a fascinating article not only on cross-cultural attitudes about breastfeeding but also about how these attitudes are changing (and not always in good ways). Here in the US when I was breastfeeding nearly 20 years ago, I would discreetly breastfeed in public (restaurants, benches), and although many people found it odd, few if any people criticized me for it. However, now, I cannot remember the last time I saw a breastfeeding mother in public. And apparently there has been much controversy about it: see this article: http://abcnews.go.com/Health/kasey-kahne-target-nurse-ins-public-breast-feeding/story.

    Where I found much more dissension was in breastfeeding my child after he was a year old. Very few American mothers continue to breastfeed older infants and toddlers and tend to wean them rather young. I continued until my son naturally weaned himself, which happened about 18-20 months. This was back in the very early days of the internet (before the WorldWide Web and I was a participant in a great support group called misc.kids via usenet groups. In fact, I just located the archives of the FAQ I compiled on this topic at http://www.faqs.org/faqs/misc-kids/breastfeeding/toddlers/. Enjoy!

  5. Fiona, I can imagine expressing/pumping daily is a chore! I invested in a simple but high-end pump and have used it a total of three times…many parts to wash, pumping for 10 minutes (now I know why baby is sweating while eating) and I have been lucky to be able to stay at home until now which means I just bring baby with me instead of the pump! Thanks for your comment!

  6. Thanks for this comment, I find it interesting that when breastfeeding in public is “breaking the norm” – actually nothing much happens if one does! Usenet groups? Wow. That is some modern history right there! The content of your FAQ looks timeless, though. Thank you for finding it for me!

  7. I was going to raise a point, but realised mentioned it later in your piece. I doubt the surprise at you breastfeeding has to do with your colour, I think it is mainly something that you don’t see “affluent” people doing in Ghana. (I too received many “you’ve done well” comments and there’s nothing white about me! 😉

    In addition to that, as you and Fiona mentioned, going back to work (and here, let’s remember, as I was harshly informed, there are extremely limited part time jobs in Ghana, so going back to work means full time, with approximately 45 minutes journey in and out) means most women will be away from home for 10-12 hours a day. It is practically impossible to pump enough to feed a baby for those hours.

    In addition, what I noticed we lack in Ghana is advice on breastfeeding and stimulating milk production. Unless you get traditional tips from aunties (eat groundnuts with their skin on, or drink palm nut soup, there’s not much advice or places to go to for advice if your milk production were to slow down. I, who’ve somehow become the breast milk guru among friends, managed to help two friend who would most likely have stopped completely, if not given the tips I learned at the Swedish child care centre.

    It is so common that milk production slows down, whether due to lack of sleep, stress or change in diet, and it is sad that something that can easily be increased would completely end, because people don’t know where to get advice from. Looking at those around me, ALL the mothers I know had the intention to breastfeed, but sadly, probably more than half stopped by three months, due to slow production or work commitments.

    I’ll stop myself here, it’s a topic I am passionate about and could go on forever. Great, informative piece with lots of interesting statistics!

  8. Ok, so you think there is a trend among affluent Ghanaians to NOT breastfeed? That is interesting too. Thanks for all your additional info, maybe we could start up Amningshjälpen (Swedish breastfeeding support org.) in Ghana!:-)

  9. Yes, will have to talk to you when I get back, my mum and I have been discussing a project within that area, btu we should definitely start up Amningshjälpen there! Let the milk flow! 🙂

  10. Having lived most of my adult life in the US where breastfeeding is a problem for working mothers, I took full advantage of being back home to breastfeed my second son well past 12 months. Yeah, I got the “you’ve done well” and “isn’t it time to wean” talk but I just refused to do it any other way except the way that I had chosen. Of course, I have an accommodating workplace but nonetheless, I pumped and all that to make it work. It seems in Ghana that most parents, working or not, affluent or not, just don’t want to make time for the children that no one forced them to have. And the non-breastfeeding issue is a part of that.

  11. Intressant! Vad jag förstår så var det på samma sätt här som i Ghana när vi var små 1970-1980. Att det var modernt att inte amma och om man gjorde det så var det max i någon månad.
    Nu tycker jag Sverige är ganska vettiga vad det gäller amning. Jag har mött på rabiata som tycker man ska amma tills barnen är flera år, och jag har stött på antiammare som tycker man lika gärna kan ta till flaskan. MEN det absolut vanligaste jag hör också från sjukvården är en lagom och i mina ögon sund inställning, försök amma så mycket som du orkar helst i 6 månader. Suger det musten ur dig som mamma eller om barnet inte blir mätt, ta hjälp av ersättning.

    Gällande det sexuella så skulle jag vilja slänga fram tutten precis som om den vore en termos, men det vågar jag inte. Jag är alldeles för pryd för det. Och indoktrinerad bröst=sexuellt. Jag skulle gärna hjälpa till att avsexualisera brösten. Men jag är diskret och har aldrig blivit bemött som att jag gör något konstigt när jag ammar på restauranger eller i annan offentlig miljö.

  12. Trakigt att en sadan trend fatt faste aven i Ghana. Detta ar ocksa ett problem i U.S.A. dar framst underutbildade tenderar att inte amma alls. Kanner igen mig mycket i att man maste skyla sig nar man ammar och det var skont att komma till Sverige dar laget ar sa mycket mer avslappnat (i detta avseende). Vet inte riktigt var denna trend kommit fran i U.S.A. men tror kanske att det delvis har att gora med den i ibland bara tva veckor langa mamma ledigheten men ocksa i en oversexualisering av brost och i feluppfattningen att modersmjolksersattning ar nyttigare for barnet. Mycket intressant amne!

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