# Balancing work and motherhood: nurse-mothers’ exclusive breastfeeding experiences in rural northern Ghana

## TL;DR

This study explores how nurse-mothers in rural northern Ghana balance work and exclusive breastfeeding, revealing challenges and potential solutions.

## Contribution

The study provides new insights into the structural and social barriers faced by working nurse-mothers in sustaining exclusive breastfeeding.

## Key findings

- Nurse-mothers have positive attitudes toward EBF but face challenges like time and privacy constraints.
- Many nurse-mothers discontinue exclusive breastfeeding after returning to work due to structural barriers.
- Participants suggested solutions like workplace lactation rooms and extended maternity leave to support EBF.

## Abstract

Exclusive breastfeeding (EBF) for the first six months is an evidence-based intervention to reduce child morbidity and mortality. Nurses play a critical role as promoters and role models for EBF; yet little is known about their personal perceptions and experiences, especially in rural Northern Ghana. This study explored nurse-mothers’ perceptions and lived experiences of EBF in Savelugu Municipality, Northern Ghana.

A qualitative exploratory design was used. Fifteen nurses who had delivered within the prior two years were purposively sampled. Semi-structured interviews were conducted between April–June 2023, audio recorded, and transcribed verbatim. Braun & Clarke's thematic analysis guided coding and theme development. Trustworthiness was supported through prolonged engagement, member checking, and an audit trail.

Three overarching themes emerged: (1) Perceptions of EBF: nurses had strong knowledge and positive attitudes toward EBF, though concerns about time, privacy, and work conflicts were evident; (2) Experiences of Practicing EBF: while most participants practiced EBF immediately postpartum, many discontinued or shifted to mixed feeding before six months upon returning to work; (3) Coping Strategies and Systemic Recommendations: participants relied on expression, night feeding, and family support when available, and suggested workplace lactation rooms, colleague support, family education, and longer maternity leave. These findings highlight the tension between professional knowledge/attitudes and structural realities such as short maternity leave and lack of lactation facilities.

Nurse-mothers value EBF but face substantial structural and social barriers that limit sustained adherence. Strengthening maternity leave policies, workplace lactation support, and family-inclusive education are essential to help nurses and working mothers more broadly meet EBF recommendations.