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Breastfeeding has important health benefits for mothers and babies alike, yet few Bosnian mothers nurse their babies exclusively for six months as the World Health Organization recommends. What could be done to get more mothers nursing for longer?

"While we've never talked more about breastfeeding and the benefits it brings, as well as about the differences between formula and breast milk, it simultaneously appears — to me — that fewer and fewer women decide to nurse," pediatrician Gordana Mucibabic from Banja Luka said about her home country of Bosnia and Herzegovina.

SteadyHealth, looking into the social attitudes Bosnian mothers and the society that surrounds them have about breastfeeding, conducted an in-depth survey of 400 internet-using mothers within this country, which has gone through an immense amount of change over the last two and a half decades, from the break-up of Yugoslavia to civil war and the rebuilding of a new society. Bosnia and Herzegovina was organized into two administrative entities, the Bosniak-Croat Federation and the majority Serbian Republika Srpska. Hoping to understand potential differences between the two entities, we surveyed them separately in October 2016.

An impressive 93.46% of Bosnian mothers reported that they initiated breastfeeding, with low numbers, 4.2% from the Federation and 8.33% from Srpska, reporting they never nursed their babies at all.

In the Federation, the most popular reason for which mothers ended up formula-feeding their babies was a healthcare provider recommending this, while Srpska-based respondents most commonly answered that they had no breast milk, or not enough of it.

Existing research indicates that up to 5% of mothers anywhere in the world might not have (enough) breast milk to feed their babies, so why did nearly a third of respondents from Srpska report that this was the reason for which they turned to formula?

Gordana Mucibabic cited a broad range of factors surrounding newborns, mothers, and their social circles, adding that childbirth is always stress-inducing on some level, and that "effective and expert assistance is required to establish lactation within the first few days". Likewise, she reported, new mothers often encounter negative comments about breastfeeding within their own families, reducing their confidence and motivation.

Our survey confirms her view:

  • 24.42% of mothers in the Federation, and 21.59% of mothers in Srpska, had heard the idea that breastfed babies who cry a lot must be hungry and need formula.
  • 24.42% of Federation moms and a whopping 37.5% of Srpska-based respondents received the message that mothers themselves don't know whether or not they have enough milk.
  • 44.19% of Federation respondents and 32.95% of those in Srpska had friends and relatives who believed that breast milk can suddenly disappear. Conversely, 31% and 27% of our participants in the Federation and Srpska respectively held this view themselves, as well.

Though most mothers from both entities of Bosnia and Herzegovina heard positive messages about breastfeeding, including "breastfeeding is the most natural way to feed a baby", "breastfeeding in public is completely acceptable", and "breastfeeding mothers deserve practical and emotional support", significant numbers also heard very different messages. Approximately 10% in both entities had heard that "breastfeeding should be hidden away from society", for instance.

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