BARRIERS TO BREASTFEEDING IN THE NEONATAL INTENSIVE CARE UNIT AT SINDH INSTITUTE OF CHILD HEALTH AND NEONATOLOGY (SICHN), KORANGI 5, KARACHI: A QUANTITATIVE ANALYSIS OF MATERNAL EXPERIENCES.

Abstract

Objective: To identify and quantify the barriers to breastfeeding experienced by mothers of neonates admitted to the NICU at Sindh Institute of Child Health and Neonatology (SICHN), Korangi 5, Karachi.

Methods: A cross-sectional quantitative study was conducted at Children Hospital Korangi 5, Sindh Institute of Child Health and Neonatology, Karachi, among 126 mothers of neonates admitted to the NICU at SICHN over a six-month period from 15^th August 2024 to 14^th February 2025. A structured, pre-tested, interviewer-administered questionnaire assessed maternal demographics, clinical parameters, and self-reported barriers across maternal, neonatal, institutional, and socio-cultural domains. Data were analyzed using SPSS version 26.0; binary logistic regression identified independent predictors of breastfeeding failure (p≤0.05).

Results: Mean maternal age was 27.4±4.8 years. Breastfeeding initiation was achieved by only 27.0% of mothers. The leading barriers were perceived milk insufficiency (72.2%), lack of NICU privacy (68.3%), neonatal illness severity (64.3%), post-cesarean pain (61.1%), and inadequate lactation counseling (57.1%). Socio-cultural pressures were reported by 48.4%. On logistic regression, cesarean delivery (OR 3.12; 95% CI 1.67–5.84; p=0.001) and primiparity (OR 2.45; 95% CI 1.21–4.96; p=0.013) were independent predictors of breastfeeding failure.

Conclusion: Multiple interlocking barriers impede breastfeeding in the NICU at SICHN. Targeted, multi-level interventions encompassing enhanced lactation counseling, improved NICU infrastructure, and culturally sensitive family education are urgently needed