An Exploration of the Breastfeeding Policy and Practices in Achieving Baby Friendly Hospital Initiative in Samoa

<p><strong>This research explores the barriers and facilitators of exclusive breastfeeding and the effectiveness of Baby Friendly Hospital Initiative (BFHI) in improving breastfeeding practices for mothers in Samoa. Exclusive breastfeeding has a significant role in maternal and infant health and is essential for infant development and survival. In Samoa, exclusive breastfeeding rates at 6 months were at around 100% in the 1960’s. However, the rates continue to decline over the past decades, currently at 51.4 % in 2019. The decline in exclusive breastfeeding rates, especially for Samoan infants aged 3-6 months, is not well explained by the available data. A qualitative study design incorporating a modified Socio-Ecological Model framework, and Pacific research methods were employed to conduct this research. Breastfeeding mothers were recruited from immunisation clinics, and with their consent, each mother selected a family member to be included in focus group discussions. Key informants were recruited from government and private organisations. Semi-structured interviews and focus group discussions were utilised for data collection, and data was analysed thematically to draw out the key themes. The results show that the majority of the participants were aware of the benefits of breastfeeding and were willing to continue breastfeeding their babies until they were two years old or more. However, the working mothers experienced some challenges in continuing breastfeeding on returning to work after maternity leave due to lack of workplace support and policies. Other factors including socioeconomic status, traditional practices and beliefs, family support, inadequate postpartum assistance from health professionals and not promoting breastfeeding policies also influence Samoan women breastfeeding practices. The findings suggest increased breastfeeding awareness through improved mother friendly care, monitoring breastfeeding policies, proper guidance and support in hospitals including use of breastfeeding counsellors, workplace support and policies across all government and private sectors to promote exclusive breastfeeding in Samoa.</strong></p>