ADHERENCE TO EXCLUSIVE BREASTFEEDING: A CONCEPT ANALYSIS

Abstract

Adherence to treatment plans and nursing care plans has been proving to be difficult due to
patient’s multiplicity of wishes, views and biases. Positive outcomes to treatment adherence are
the key standard to improve quality of nursing care. Adherence to exclusive breastfeeding has
proven to be a difficult practice for most women because the meaning of the term, adherence to
exclusive breastfeeding, is not fully understood. Measuring and evaluating adherence is often
proving difficult since it is often a factor associated with patient biases, expectations and
knowledge. The major focus or aim of this paper is to clarify the concept of adherence to
exclusive breastfeeding. Only an estimated 35% breast feeding women are adhering to exclusive
breastfeeding globally. A concept analysis of adherence to exclusive breast feeding was done
using Walker and Avant method. The major antecedents of adherence to exclusive breastfeeding
are value of perception of exclusive breastfeeding, knowledge on benefits of exclusive
breastfeeding, mode of delivery, maternal age, maternal health, maternal role confidence,
socioeconomic status of the mother, social support from family, and active participation of the
mother. Attributes identified were ability to attach the baby to the breast, ability to provide
adequate breast milk, ability to give baby only breastmilk without any other feeds, ability of
baby to suckle and swallow and flow of adequate milk. The resultant consequences of adherence
to exclusive breastfeeding were maintained targeted healthy infant status such as weight and
height, absence of diarrhea and pneumonia related infections to the baby. This will lead to
improved quality of life of the baby. Empirical referents which are fundamental to future nursing
research methodology in adherence to exclusive breastfeeding and its enhancement are absence
or reduced diarrheal cases, other infections, increased uptake of exclusive breastfeeding, reduced
infant mortality rates, weight for age within ±2SD on the road to health card, high levels of
exclusive breastfeeding adherence and high scores of quality of life measurements. The results
and discussion from the analysis can be utilized as a foundation for development of adherence
models, tools and theories for measuring and evaluating adherence in health care settings.
Regardless of the complexity of adherence to EBF the definition provided of adherence to EBF
may facilitate a clearer understanding and standardization of methods and tools of measuring the
concept. Various factors that encompass a wider dimension of adherence to EBF need to be
addressed when reporting adherence to EBF.