Researchers in Biratnagar, Nepal, asked 202 mothers of babies aged 6–23 months about their feeding practices from birth. They wanted to understand why so many mothers stop giving only breast milk and start adding water, formula, or other foods early on.
The study was small and conducted in one city in Nepal, so findings may not directly reflect Singapore families. However, the barriers mothers face—doubts about milk supply and balancing work—are common concerns across cultures.
Most mothers introduce other foods within the first four months
Only 37.6% of mothers exclusively breastfed their babies. Among those who didn't, over half gave their babies plain water mixed with milk, and about one-third introduced infant formula. The median time mothers lasted on exclusive breastfeeding was just four months. When asked why they mixed feeding, the top reason was worrying their milk wasn't enough. Work demands came second.
Knowledge about exclusive breastfeeding was scarce
Just one in five mothers (21.8%) had what researchers considered adequate knowledge of exclusive breastfeeding—what it means, why it matters, and how long to do it. This gap in understanding may have contributed to early introduction of other foods, since mothers without clear information might assume adding water or formula is necessary or helpful.
Family structure and breastfeeding problems shaped outcomes
Mothers living with extended or joint families (grandparents, in-laws, or other relatives) were nearly twice as likely to exclusively breastfeed compared to those living alone or with only a partner. Mothers without physical breastfeeding problems—such as pain, infection, or difficulty latching—were eight times more likely to exclusively breastfeed. Interestingly, mothers without formal education were also more likely to exclusively breastfeed, though the study didn't explore why.
Three ways to support exclusive breastfeeding
- Provide clear, early education on exclusive breastfeeding benefits and technique before and after birth to build maternal confidence.
- Address breastfeeding problems promptly through trained support (lactation consultant, midwife, or doctor) to prevent early abandonment.
- Involve family members—particularly partners and grandparents—in supporting the mother's feeding journey during the first six months.