Table 5 Illustrative quotes for contextual factors: sociocultural and physical opportunity

Sociocultural opportunity

SO1

“When they came to us [in the past] with the purpose to offer their product, we told them that we would not offer the formula to mothers, however, we listened to them, thanked them, and saw them off.” (Doctor, Uzgen district)

SO2

“When representatives from Nutrilak come, they talk to the doctors, not to us. For example, they say that Nutrilak does not cause allergies, it has little sugar or it improves the immunity system, it is 80% similar to mother’s milk.” (Nurse, Bishkek city)

SO3

“Yes, everyone supported me: my mother-in-law, parents, brothers and sisters, husband. They always said that I have to breastfeed, that it is the best thing for the child. They shared their own feeding experience.” (Mother 10, Naryn city, Exclusive breastfeeding)

SO4

“Some of them [family members] told me that it would be better to switch to ‘Nutrilak’ and not breastfeed, some said that it is better not to give; according to the doctor, I did not go below the norm. I have friends who fed their child NAN.”

(Mother 7, Uzgen district, Breastfeeding and formula)

SO5

“Yes, we talked about feeding our babies. 1–2 of my close friends said that if the child is not satiated, I can give a bit of potato.”

(Mother 18, Bishkek city, Breastfeeding and other fluids/solids)

SO6

“Daughters-in-law listen to their mother-in-law. The mother-in-law puts food in the child’s mouth while the daughter-in-law is doing the housework. The mother-in-law says that she was fed the same way as she fed the child.” (Doctor, At-Bashy district)

SO7

“Due to the conditions, many females leave for labour migration, when the infants are 3–4 months of age, sometimes 2 months. They request grandmothers to look after their young infants, who they often feed artificially.” (Doctor, Uzgen district)

Physical opportunity

PO1

“A dummy breast, a baby doll is needed to show how milk is produced, how it should be applied, a breastfeeding cabinet is also needed. This should be provided by the state, the leadership of the medical organization.” (Doctor, Bishkek city)

PO2

“There is a shortage of office space and time for us. Therapists are sitting in one of our offices, or a pediatrician. A newborn comes in, and on the other hand an adult is sitting with a cough in the hospital, we hurry to let the baby leave quickly. We can’t explain everything to the mother.” (Nurse, Bishkek city)

PO3

“We have the Order of the Ministry of Health of the Kyrgyz Republic 144, 33, the Law of the Kyrgyz Republic ‘On protection of breastfeeding’. In all health facilities, everyone from doctors to directors, from nurses to drivers, should know the 11 steps towards breastfeeding.” (Doctor, Kara-Say city)