Table 3 Illustrative quotes for Behaviour

Infant feeding in the first 6 months

B1

“Yes, immediately, health workers placed the child on my breast and made me breastfeed, they gave me full information. They explained to me that it is necessary to breastfeed the child until the age of one.”

(Mother 3, Kara-Say city, Breastfeeding and formula)

B2

“I began breastfeeding one and a half days after I gave birth. The child had some issues [a bump on the head] and she was receiving phototherapy [light therapy], therefore, she was brought in for feeding after one and a half days, prior to that she was given formula.” (Mother 9, Naryn city, Exclusive breastfeeding)

B3

“I raised [all] four of my [older] children by breastfeeding; I didn’t give any food and breastfed them, except for [this] one child. My other children didn’t receive anything besides breastmilk; with them I breastfed exclusively until 5 months.”

(Mother 8, Uzgen district, Breastfeeding and formula)

B4

We have 100% [of mothers], breastfeeding. The mother says she has to give formula twice a day If a baby has a neurological disease, prematurity, twins, triplets, or the mother has postpartum depression and milk does not appear. Even so, we explain that she should breastfeed first, and then if there is not enough milk, she may give formula. All healthy moms with a vaginal delivery are 100% breastfeeding. (Doctor, Kara-Say city)

B5

“In the villages this happens more. In my practice, it was 2–3 times. The mother continues to breastfeed the baby, but when they cry, she gives additional food.” (Doctor, Uzgen district)

B6

“Only 1–2 mothers [give their babies formula]. The babies are usually given formula at the age of 1–3 months. Little children sleep continuously for 2–3 months, even if they move slowly and cry after 3 months, their grandmother immediately gives them at least one [dose of formula].” (Nurse, Uzgen district)

Supporting exclusive breastfeeding in the first 6 months

B7

“We explain that everything that each baby needs comes from breastmilk, and then we explain the importance of foremilk and hindmilk. If the baby sucks the foremilk, the baby will not gain weight, and then you will come complaining that the baby is not full. We give the information that hindmilk is rich in protein, carbohydrates, and energy.”

(Doctor, Kara-Say city)

B8

“When the woman is at home we visit her, we check whether the woman is breastfeeding, whether she holds it [the baby] correctly… then we will show her everything and explain everything. If there are things that she does not understand, we explain again and if the family has a son-in-law or mother-in-law present, we offer to help them with this too.” (Doctor, Naryn city)

B9

“The child comes for the weight check and vaccination, and we discuss these points. We train and we teach. We will discuss whether the baby is feeding. We ask, how she is feeding the baby, how often the child poops when he is full, whether the baby gets enough whole milk.” (Feldsher, At-Bashy district)

B10

“We say that milk contains water, and minerals, and do not give any additional food. We say that 95% of milk is water, don’t give water; We tell moms who give cookies to give less so that baby doesn’t get constipated. We say that animal milk is not good for a baby, it is poorly digested by the stomach.” (Nurse, Kara-Say city)

B11

“In the maternity hospital, they teach how to breastfeed properly, how long to breastfeed, how often. They emphasize that one should breastfeed until the age of 6 months. “(Mother 12, Naryn city, Exclusive breastfeeding)

B12

“The day we were discharged from the maternity hospital, we had a visit. Yes, they showed me how to hold the baby when breastfeeding, how to do it, they made me breastfeed and observed. They showed me everything, even though it is not my first child, and said that I should breastfeed for 6 months without giving other foods since breastmilk is healthy and beneficial.” (Mother 5, Uzgen district, Exclusive breastfeeding)

B13

“The main thing is to get information when you are pregnant. Now I think about this, and I don’t have any [written] information, I should have researched myself, now is the age of the Internet, I wish I had looked. If my sister said she couldn’t get enough of your milk, I wouldn’t have believed her if I had known about this [from information].”

(Mother 4, Bishkek city, Breastfeeding and other fluids/solids)