How do we engage health professionals in supporting exclusive breastfeeding by mothers of young infants? A behavior analysis using the Reasoned Action Approach

Background: This presentation illuminates the challenge in defining and addressing broadly defined behaviors like “health professional support” with the goal of improving interventions for health professionals (HPs) to help them encourage exclusive breastfeeding.

Challenge: While current policies suggest that HPs “promote, support, and protect” breastfeeding, a review reveals that trainings emphasize knowledge acquisition over skill-development and that many different definitions of support exist. What EXACTLY should health professionals do to support? One challenge to increasing exclusive breastfeeding is to understand the factors underlying health professional behavior beginning with a specific definition of the support behavior.  

Methodology: Open-ended questions with 15 health professionals practicing in Kenyan public clinics identified what they meant by supporting exclusive breastfeeding and the beliefs they hold about practicing support behaviors.

Results: A content analysis revealed that the support actions included: giving information (15); demonstrating techniques (12); asking/listening (6); and observing a breastfeed (1).

Recommendations: The Reasoned Action Approach (RAA) argues that behavior change is more effective if the behavior is defined in terms of action, target, context and time. Researchers must first identify the specific behavior that HPs should do to support. Based on the importance of attachment and these findings, we recommend that support be defined as “observe a mother breastfeed a young infant (0-4 weeks) and give her feedback during postnatal visits”. Then formative research can identify the beliefs underlying this behavior so that training and environmental interventions can be designed to encourage HPs to provide support to mothers and to prolong exclusive breastfeeding.