Infant Feeding Perceptions and Barriers to Exclusive Breastfeeding in Urban and Rural Cameroon


  • Lem Ngongalah Department of Public Health, Collaboration for Research Excellence in Africa (CORE Africa)
  • Ngwa Niba Rawlings Department of Public Health, Collaboration for Research Excellence in Africa (CORE Africa)
  • Wepngong Emerson Department of Public Health, Collaboration for Research Excellence in Africa (CORE Africa); Mboppi Baptist Hospital, Douala
  • Oluwaniyi Titilope Nottingham Medical Hospital
  • Mumah Sharon Department of Public Health, Collaboration for Research Excellence in Africa (CORE Africa)



Breastfeeding, exclusive breastfeeding, EBF, infant feeding, perceptions, barriers, mothers, developing countries, Cameroon.


Background: Child malnutrition is highest in Sub-Saharan Africa. Over 45% of children in Cameroon die each year from malnutrition-related causes, most of which are preventable. Exclusive breastfeeding is a well-acknowledged and cost-effective intervention against malnutrition-related illnesses in children. However, the practice remains low in Cameroon. This study explored perceptions of mothers, care givers and key informants on infant feeding in Cameroon, and barriers to exclusive breastfeeding.

Methods: A qualitative methodology was used, comprising key informant interviews and focus group discussions with nursing mothers, grandmothers and health workers; in one urban and one rural area in Cameroon. Participants were selected using convenience, purposive and snowball sampling methods. Data were analysed using thematic analysis.

Results: Cameroonian mothers were supportive of breastfeeding. However, knowledge of exclusive breastfeeding and its benefits was poor. Mothers expressed doubts about its feasibility and showed concerns about satisfying their babies’ feeding and health needs. Barriers included factors which either affected women’s abilities to breastfeed or their babies’ satisfaction, family influences, other responsibilities, cultural and societal factors, and lack of support from the healthcare system.

Conclusions: This study highlighted a sizeable gap between mothers’ lived experiences and infant feeding recommendations. Living in rural areas was an added disadvantage. Developing effective strategies to increase exclusive breastfeeding rates requires that mothers’ needs be understood and that influencing factors be addressed. Supportive environments are also required to promote and protect the rights and abilities of mothers to breastfeed exclusively.


[1] WHO Ua. Joint child malnutrition estimates - Levels and trends (2017 edition) 2017 [cited 2018 Aug 13]: Available from: report/WBTi-Cameroon-2013.pdf.
[2] UNICEF. Nutrition in Cameroon 2016 [cited 2018 Aug 19]: Available from: nutrition.html.
[3] Lassi ZS, Mallick D, Das JK, Mal L, Salam RA, Bhutta ZA. Essential interventions for child health. Reproductive Health 2014; 11(1): S4.
[4] Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? The Lancet 2016; 387(10017): 491-504.
[5] Organization WH. Report of the expert consultation of the optimal duration of exclusive breastfeeding, Geneva, Switzerland, 28-30 March 2001. 2001.
[6] Organisation WH. Exclusive breastfeeding for optimal growth, development and health of infants 2017 [cited 2018 Aug 15]: Available from: exclusive_breastfeeding/en/.
[7] WHO, Mathers C. Global strategy for women's, children's and adolescents' health (2016-2030). Organization. 2017;2016(9).
[8] Kramer MS, Aboud F, Mironova E, Vanilovich I, Platt RW, Matush L, et al. Breastfeeding and child cognitive development: new evidence from a large randomized trial. Archives of General Psychiatry 2008; 65(5): 578-84.
[9] Bank W. Nutrition at a glance 2016 [cited 2018 Aug 13]: Available from: NUTRITION/Resources/281846-1271963823772/cameroon1711screen.pdf.
[10] Agunbiade OM, Ogunleye OV. Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up. International Breastfeeding Journal 2012; 7(1): 5.
[11] Otoo GE, Lartey AA, Pérez-Escamilla R. Perceived incentives and barriers to exclusive breastfeeding among periurban Ghanaian women. Journal of Human Lactation 2009; 25(1): 34-41.
[12] Setegn T, Belachew T, Gerbaba M, Deribe K, Deribew A, Biadgilign S. Factors associated with exclusive breastfeeding practices among mothers in Goba district, south east Ethiopia: a cross-sectional study. International Breastfeeding Journal 2012; 7(1): 17.
[13] IBFA. The World Breastfeeding Trends Initiative (WBTi) 2012 [cited 2018 Aug 20]: Available from:
[14] Imdad A, Yakoob MY, Bhutta ZA. Effect of breastfeeding promotion interventions on breastfeeding rates, with special focus on developing countries. BMC Public Health 2011; 11(3): S24.






General Articles