How Family Dynamics Undermine Maternal Choices in Türkiye

Breast milk is the fundamental biological fluid for the first stage of human life and is highly recommended as the main source of nutrition in the first 12 months. Due to its high concentration of probiotics and live cells, breast milk is an essential source of nutrients for infant development. However, due to socioeconomic and political factors, many women can’t provide the necessary amount for their infants. The World Health Organization (WHO) has set a goal of raising the rate of exclusive breastfeeding to 50%. 

By 2025, global breastfeeding rates have risen to 48%, close to achieving the targets set by the WHO. In 2024, Türkiye is reported to experience a 10% increase in breastfeeding according to UNICEF’s reports. Last week, Ankara Bilkent City Hospital published the study “Breastfeeding in Turkey: practices, barriers, and cultural dynamics for global insights”, an extensive study on breastfeeding practices in Türkiye with a wide range of parameters. The report holds great importance in assessing the changes in breastfeeding culture in Türkiye following the AKP government’s new legislation on working conditions for mothers.

Given the workload that childbirth and care place on mothers, the involvement of the extended family members plays a significant role in determining the mother’s decisions. The common trend in the world is that the support received from the extended family is in accordance with encouraging regular breastfeeding. In contrast, in Türkiye, lack of extended family involvement resulted in 1.9 times higher odds for exclusive breastfeeding in the first 6 months. This implies that in Türkiye, counterintuitively, mothers without the support of an extended family are nearly twice as likely to breastfeed their children. The response indicates that the family dynamics in Türkiye encourage women to start on formula. Mother’s tendency to use formula in the first six months may stem from the pressure within extended family members due to insufficient milk supply or the infant's irregular sleep pattern.

The possibility of switching to baby formula due to family pressure regarding the breast milk supply is supported by the proportionality between women experiencing insufficient milk production and formula usage. 75% of mothers who use formula reported experiencing insufficient milk supply, and those who took breastfeeding guidance didn’t show a significant difference in response. It is concluded that the confidence of mothers is more dependent on family advice than expert guidance. The dependence on family advice on starting non-complementary nutrient supplies is especially disadvantageous to mothers for their milk supply, as it violates the exclusive-breastfeeding criteria set by the WHO for the first 6 months. In Türkiye, approximately two-thirds of the babies were introduced to water and non-complementary food before 6 months. Therefore, preventing the spread of misinformation within the family and the social pressure that undermines maternal confidence should be the main priority.

Along with family dynamics, economic status is a significant determinant in shaping breastfeeding practices. It is proven that economic stress and insufficient working conditions experienced by mothers result in decreased breastfeeding durations. It is stated that mothers with low-income families are less likely to sustain breastfeeding to 24 months compared to those whose incomes meet or exceed their expenses. However, it is important to note that there wasn’t a significant difference in breastfeeding for the early breastfeeding mothers. It can be concluded that it is the long-term breastfeeding practices that are dependent on economic stability. 

The AKP government aims to increase birth rates and practices of breastfeeding in the “family year”. The new legislation aims to extend the paid maternity leave from 16 weeks to 24 weeks. Firstly, the new leave duration barely aligns with the WHO’s recommended minimum of 6 months leave. In addition, Bilkent’s study shows that family intervention and social pressure on women outweigh employment status or duration. However, this doesn’t mean paid maternity leave doesn’t have additional benefits for women’s mental and physical health. In addition, the existing legislation on “süt izni” and breastfeeding allowance is ineffective in highly populated cities, such as İstanbul, Ankara, and İzmir. The current “süt izni” grants mothers who return to work after childbirth 3 hours for the first 6 months and 1.5 hours till the baby reaches one year of age. In highly populated areas, even a one-way commute can exceed an hour; the current form of the law is only applicable to those in rural settlements. The existing laws are ineffective in addressing the social pressure put on women and meeting the limitations imposed by urban living.