Karachi: Despite widespread awareness of the benefits of exclusive breastfeeding (EBF), mothers in Karachi’s urban slums face persistent social and cultural barriers that prevent them from following recommended infant feeding practices, a new study has revealed.
The qualitative study, conducted in the underserved settlements of Rehri Goth, Ibrahim Hyderi, Ali Akber Shah Colony, and Bhains Colony, involved 84 participants, including mothers, fathers, and grandmothers.
It was led by Fyezah Jehan of Aga Khan University with contributions from Sajid Iqbal (Shifa College of Nursing), Kheezran Ahmed, Sana Qaiser, Benazir Baloch, Yasmin Parpio, Yasir Shaikh, Imran Nisar (AKU), Maryam Mansoor (Brigham and Women’s Hospital), Ameer Muhammad (Vital Pakistan Trust), Amy Ginsburg (University of Washington), and Valerie Flaherman (UCSF).
Although most caregivers acknowledged the health benefits of breast milk, the study found that harmful beliefs, postpartum pain, inadequate counseling, and family pressure often forced mothers to abandon EBF.
Many mothers struggled due to insufficient milk, poor technique, and household responsibilities. Others were overruled by elder women who believed in myths—such as the evil eye preventing milk flow—or discouraged the use of expressed milk, calling it unhygienic.
“Mothers knew the benefits of breastfeeding but were frequently overruled by elders or burdened by emotional and physical stress,” the researchers noted.
Early supplementation with tea, “ghutti,” or formula milk was often introduced, especially if the child was perceived as weak or underweight. Health advice was mostly sought from family elders rather than professionals, further reinforcing unscientific practices.
While some mothers received dietary suggestions to improve milk supply, misconceptions and lack of structured support remained widespread. Less than 48% of Pakistani mothers practice EBF for six months, according to national data.
The study—funded by the Bill and Melinda Gates Foundation—recommended involving fathers and grandmothers in awareness efforts and integrating breastfeeding support into regular antenatal and postnatal visits. It stressed that exclusive breastfeeding cannot improve unless broader cultural and familial dynamics are addressed alongside maternal health.
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