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Facilitators and barriers of wet nursing across different cultures
Supporting breastfeeding during humanitarian emergencies is crucial to provide infants and young children with proper nutrition that protects them from high risk of malnutrition and infection. Wet nursing is defined as when women breastfeed other children in case their biological mothers are unable to breastfeed their own children due to illness or death. While wet nursing is included in recommendations for infant and young children feeding in emergencies, there is a lack of practical guidance for implementing the practice.
This thesis includes two papers: a narrative review and a qualitative study (semi-structured interviews) that aimed to identify potential facilitators and barriers to wet nursing across various cultures to inform the development of operational guidance on wet nursing in emergencies.
The findings from the narrative review reveal that wet nursing was associated with diverse experiences for wet nurses and community according to how it was practised and suggest that potential facilitators and barriers of wet nursing in emergencies are related to infant mortality rates, cultural and individual support, availability of wet nurses, and resources to support wet nursing.
The qualitative study revealed that implementing wet nursing in emergencies shares general factors affecting good breastfeeding practices, such as understanding the breastfeeding importance and the infant formula risks. Yet, wet nursing is also impacted by the risk of infection transmission, negative attitudes towards wet nursing and the need for culturally sensitive counselling to mediate wet nursing. Practical recommendations developed based on these findings would target three domains: planning and policies, knowledge, and continuous monitoring and evaluation.
Both studies highlighted that wet nursing could save infants’ lives in low-resourced settings like emergencies. Yet, implementing the practice needs applicable and adequate guidelines that consider the cultural and educational differences between communities, and adequate training and education for mothers, healthcare providers, breastfeeding counsellors and emergency workers.
