Vol.:(0123456789) 1 3 Maternal and Child Health Journal https://doi.org/10.1007/s10995-018-2430-4 Exploring the Experiences of Middle Income Mothers in Practicing Exclusive Breastfeeding in Nairobi, Kenya Caroline W. Wainaina 1,2  · Milka Wanjohi 2  · Frederick Wekesah 2  · Gillian Woolhead 1  · Elizabeth Kimani‑Murage 2 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Objectives To establish exclusive breastfeeding (EBF) practice, women are encouraged to initiate breastfeeding of their newborns within one hour of delivery and breastfeed exclusively for the frst 6 months of the infant’s life. Research in Kenya has shown evidence of a reduced rate of EBF with an increase in socio-economic class (SES). This study explores the experiences of middle-income women so as to understand their attitudes and practices of EBF and to contribute toward the Baby Friendly Hospital (BFHI) and Baby Friendly Community Initiatives (BFCI) programs in Kenya. Methods A qualita- tive study using nine in-depth interviews and two focus group discussions were conducted with middle-income women with a child < 2 years. Thematic content analysis was used to analyze the data. Results The majority of the women interviewed did not achieve EBF and this was attributed to many challenges that they encountered such as; inadequate workplace sup- port including short maternity leave, lack of designated breast feeding facilities fexible hours and breastfeeding breaks. Support structures were highlighted as either inadequate or lacking while the internet was preferred by most of the women for breastfeeding information. Mass media was seen as more credible, though some women indicated that there was lack of depth in the information it provided. Conclusion The study showed that majority of women were unable to EBF for the frst 6 months. Women experienced inadequate social, healthcare and workplace support and preferred online sites for informa- tion on breastfeeding than the healthcare professionals or mass media. Recommendation There is need to implement policies at the workplace that promote a breastfeeding friendly environment. There is also a need for more research on role of mass media in promotion of optimal breastfeeding practices, especially how to reach this population. There is a need for continued advocacy on social support including spousal, relatives, and other community members at the community level. Keywords Exclusive breastfeeding · Breastfeeding support · Workplace support for breastfeeding · Qualitative · Breastfeeding information · Middle class Signifcance Most quantitative research has focused on challenges and practices of exclusive breastfeeding in the low income popu- lations in SSA, and especially in Kenya. None have focused on qualitative methodology in the higher socioeconomic sta- tus (SES) to explore their breastfeeding practice. This study will seek to fll the knowledge gap of how the higher SES practices establish exclusive breastfeeding (EBF) and inform future interventions to address any challenges they face. * Caroline W. Wainaina caroline.wainaina@online.liverpool.ac.uk; cwainaina@aphrc.org Milka Wanjohi mwanjohi@aphrc.org Frederick Wekesah fwekesah@aphrc.org Gillian Woolhead gillian.woolhead@online.liverpool.ac.uk Elizabeth Kimani-Murage ekimani@aphrc.org 1 School of Public Health, Laureate Online Education, University of Liverpool, Liverpool, UK 2 African Population Health Research Center (APHRC), Nairobi, Kenya