Table 4 Illustrative quotes for individual factors: capability and motivation

Capability

C1

“Everyone knows that exclusive breastfeeding is ideal for the child. Yes, I read on the websites that it is ideally suited for the child and improves immunity and [is needed] for growth and psychological development. Exclusive breastfeeding is feeding only with breastmilk without adding any complementary foods or additional foods.”

(Mother 19, Bishkek city, Exclusive breastfeeding)

C2

The child was thirsty after feeding, that’s why [gave water]. It is like with us, we also get thirsty after eating food right.”

(Mother 2, Kara-Say city, Breastfeeding and other fluids/solids)

C3

“The child was not getting satiated. I gave bananas because they are rich in vitamins. Then, when the child had constipation, I started giving a bit of apple for digestion purposes.” (Mother 18, Bishkek city, Breastfeeding and other fluids/solids)

C4

“After my breastmilk supply decreased, I developed nipple cracks. I had little milk even though I was eating more food. That’s why I began giving additional foods [formula]. I didn’t have enough milk and my child started crying in the evenings, wasn’t sleeping, that’s why.” (Mother 3, Naryn city, Breastfeeding and formula)

C5

“In the beginning, I had little breastmilk, but I continued to nurse when the child cried, and then the amount of milk increased, I breastfed until the age of 6 months.”

(Mother, Uzgen district, Exclusive breastfeeding)

C6

“Mothers tell us that the baby couldn’t suckle and let the breast out of his mouth.” (Nurse, Naryn City)

C7

“Sick mothers with HIV/AIDS do not breastfeed, we provide for them, children with congenital heart defects cannot suck the breast, and some children could not drink from a cup. There are medical indications for refusal of breastmilk [medication]. A woman with HIV/AIDS was breastfeeding for up to 3 months, all 3 months her baby had vomiting, diarrhoea, and fever, so she had to stop breastfeeding.” (Nurse, Kara-Say city)

C8

“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)

Motivation

M1

“Breastmilk is considered to be a source of the most essential nutrients for a baby. It is beneficial for both a child and a mother. Mother does not have to spend money to buy milk. And for a child, the first colostrum containing immunoglobulin is especially useful for the baby’s hearing and sight. Breastmilk is indispensable for the health, for the mental development of a child. It also prevents dangerous diseases for a mother such as mammary gland diseases, and cancer.” (Nurse, Uzgen district)

M2

“My breastmilk wasn’t coming out, the child was hungry, he was suckling on the nipple like on an empty pacifier and nothing was coming out so the child got tired and then didn’t want to suckle anymore.“

(Mother 16, At-Bashy district, Breastfeeding then switched to formula only)

M2

When you are at home and you are nursing the child in comfort. And when you are breastfeeding in a public place, you feel tense and when you feel tense, the milk doesn’t come out and the baby doesn’t suckle. Therefore, whenever we go anywhere, my husband says it is better to take milk formula with us so that I don’t struggle.

(Mother 20, Bishkek city, Breastfeeding and formula)