Breastfeeding In Patriarchal Montenegro: The Good, The Bad, And The Ugly

Montenegrin Healthcare Staff 'Ill-Informed About, Or Disinterested In, Breastfeeding'

Considering that such large percentages of mothers reported experiencing practices that defy evidence-based medicine in maternity hospitals, such as formula being offered to babies without parental consent and babies being separated from their mothers through the nursery system, how competent did our respondents think their healthcare providers were when it comes to breastfeeding?

• 27.12 percent was confident that their healthcare providers were thoroughly informed about the benefits of breastfeeding, possible challenges, and how they can be overcome.
• 30.51 percent deemed that their healthcare providers were insufficiently informed about breastfeeding.
• A quarter believed that their healthcare providers were well-informed, but lacked motivation to actually help mothers overcome breastfeeding challenges or provide them with tips on establishing successful lactation, a trend we also observed in the rest of the region.

The remaining mothers either didn't want to commit to an answer, or believed that "some healthcare providers are well-informed, while others are not".

When we asked our respondents to share positive and negative experiences with breastfeeding-related healthcare, we received comments from mothers whose healthcare providers helped them with positioning, latch, and mastitis prevention. Most, however, shared negative stories. One comment that really stood out was: "I wanted to breastfeed, but because my baby was fed formula in the nursery, she was full every time she was brought to me and was not interested in the breast."

What Montenegrin Mothers Think Of Breastfeeding In Public

Despite the fact that 66 percent of our Montenegrin respondents stated that they believed mothers should have the legal right to breastfeed in public, only 50.7 percent felt comfortable doing this themselves. Comments from mothers opposed to breastfeeding in public were more strongly worded than those we previously received from participants in Serbia, Bosnia, and Croatia. "That's indecent and unpleasant for onlookers," one said, while another believed that "only women who want to draw attention to themselves would do that" — and these views offer a very fair representation of the remaining comments from women opposed to public breastfeeding we received.

Given that many mothers, most of whom have themselves breastfed or are still breastfeeding, feel this strongly about breastfeeding in public, it is almost a surprise that "only" 16.9 percent of those who did choose to nurse while out and about received negative comments, including that they were engaged in "morally questionable acts". Just over seven percent was met with positive reactions while nursing in public locations, with 26.76 receiving neutral reactions.

What Would Improve Breastfeeding Rates In Montenegro?

When presented with this question, the highest number of mothers who participated in our survey said that they believed the answer mainly lies in better healthcare provider education, with 20.38 percent answering this way. Better education of new mothers would be the best way to improve breastfeeding rates according to 17.83 percent of mothers.

Other proposed solutions were:

• Better social acceptance of breastfeeding (8.92 percent)
• More actively involved healthcare providers (11.46 percent)
• Strict enforcement of "Baby Friendly" protocols (8.92 percent)

Private pediatrician Dr Vjera Jankovic, meanwhile, told SteadyHealth that she believes that breastfeeding challenges such as mastitis and pain are, alongside worries about whether a mother has enough milk or not, the main reasons due to which the breastfeeding rate in Montenegro is not higher. She told us:

"What is needed is raised awareness of the benefits of breastfeeding, and that should primarily include pregnant mothers, who need to be fully informed of everything they can expect while breastfeeding. Likewise, we, healthcare workers, need to be engaged and motivated to help nursing mothers resolve all the challenges that they may encounter while breastfeeding."

What Can We Learn From Montenegro?

Of all the countries we surveyed, Montenegro was the one in which the highest number of mothers reported following the World Health Organization's guidelines in nursing exclusively during the first six months of their babies' lives. The finding that much lower numbers stopped breastfeeding because they believed they lacked milk was also especially notable. The Montenegrin survey shows that cultural attitudes towards breastfeeding might influence breastfeeding rates, but more than that, broader cultural attitudes play a role. It is no coincidence that Montenegro, the most traditionally patriarchal of the countries we surveyed, is home to mothers who breastfeed for longer — despite the fact that we found they were exposed to the same detrimental breastfeeding-related healthcare practices we observed in Serbia, Bosnia, and Croatia.  

While more mothers might breastfeed for longer in Montenegro compared to its direct neighbors, we also have to ask what their breastfeeding experience is like. Given the strong opposition towards breastfeeding in public among mothers themselves, we can only conclude that, more than focusing on increasing breastfeeding rates, what Montenegrin mothers could benefit from is a cultural shift in attitudes towards women.