Developing an intervention to improve the child-feeding behaviors of rural mothers in western Uganda

We compared the positive deviance (PD) approach in Save the Children's field guide with a case-control study (CCS) to identify behaviors associated with good nutritional status in Afghan refugee children 6 to 24 months of age in the Northwest Frontier Province (NWFP), Pakistan. The positive deviance inquiry (PDI), utilizing observations and interviews with mothers, fathers, and secondary caregivers in eight households, identified 12 feeding, caring, and health-seeking behaviors that were not widely practiced. The CCS, using the same selection criteria and content as the PDI with 50 mother-child pairs not in the PDI, yielded six significant associations with good nutritional status. Both the PDI and CCS detected feeding behaviors. The PDI alone identified complex phenomena (active feeding and maternal affect). The CCS alone confirmed the beneficial use of health services. The PD approach was an affordable, participatory, and valid method to identify feeding behaviors and other factors associated with good nutrition in this context.

A study on the rural-urban differences in breast-feeding practices by black Zimbabwean parents.

This paper presents a picture of the general patterns of complementary feeding behaviours in urban Ghana. A focused ethnographic study protocol for assessing complementary feeding developed for the Global Alliance for Improved Nutrition was used to collect data from caregivers of children 6-24 months of age. We examined the multiple factors that influence the selection of foods for infants and young children in this urban setting, and found that economic factors, health beliefs and other nurturing-related values, access to food and issues of convenience all play important roles. We conclude that the interactions of nurturance, cost and time are vectors that affect feeding decisions.

Current infant feeding guidelines of UNICEF/UNAIDS/WHO for HIV-infected women recommend the avoidance of breastfeeding or to breastfeed exclusively. In the context of a prevention of HIV mother-to-child transmission programme we assessed the feeding practices in peripheral areas of Tanzania and Uganda. A total of 237 mothers in south-western Tanzania and 424 mothers in western Uganda attending urban and rural antenatal care services as well as village women were interviewed with regard to duration of breastfeeding, time of introduction of additional nutrients and type of solid and liquid nutrients. The average reported duration of breastfeeding was 24 months in Tanzania but 18 months in Uganda (P < 0.001). Solid nutrients were added on average at month 6 in both areas while liquids were given significantly earlier in Tanzania (month 4) than in Uganda (month 5; P < 0.001). A total of 19% and 48% of the study participants, respectively, stated to breastfeed their infants exclusively at the age of 4 months in Tanzania and Uganda. Age between 26 and 35 years, urban residence and ethnic group were the risk factors for earlier introduction of nutrients in Uganda. In Tanzania, solid maize porridge was the most frequent (94%) and often single nutrient given during breastfeeding, while in Uganda combinations of nutrients such as bananas, millet and beans were used. Milk was the most frequently added fluid in Uganda whereas in Tanzania various liquids such as liquid maize porridge, milk, juice or water were used. Feeding practices differed considerably in the two countries. According to the interviewees, exclusive breastfeeding was rarely practiced in Tanzania. Our findings underline the necessity to promote exclusive breastfeeding if infant feeding recommendations are to be realized and emphasize the need to assess the local situation in order to ensure that locally appropriate information and recommendations are given to the target groups.

Guatemala has one of the highest rates of child stunting in the world, which especially impacts rural indigenous agricultural communities. Despite decades of intensive nutrition research and interventions, only rarely have nutrition programs successfully lowered the rate of stunting in these settings. The bulk of nutritional interventions in Guatemala are targeted at the education of female caregivers. However, women's ability to implement best practices in infant breastfeeding and complementary feeding are often constrained by external factors. This study evaluated the knowledge, beliefs, and practices of female caregivers, as well as the attitudes of fathers, toward breastfeeding and infant feeding in a rural Guatemalan village.Clinical work, participant-observation, surveys, interviews, and focus groups were conducted in a rural Guatemalan village in conjunction with a child feeding program from August 2008 to January 2011.Male employment status, mental health, and attitudes towards child rearing and parenting responsibilities are often principal factors in infant growth failure.Successful child feeding programs must include educational elements for men and should consider structural elements that provide a safety net for unexpected changes in domestic finances.

Apart from basic determinants, appropriate child care practices are important in prevention of growth faltering and undernutrition. Providing safe and appropriate quality complementary foods is crucial to child growth and development. However, some children in low-income communities grow normally mainly due to proper caregiver feeding behaviors. Hence, the objective of this study was to determine caregivers' feeding styles as well as to indentify predictors in Derashe special district, Southern Ethiopia.A community based cross-sectional study design was employed in the seven randomly selected Kebeles (smallest administrative unit) of Derashe special district. A total of 826 caregivers provided data pertaining to socio-demographic variables. However, 764 caregivers had complete data for the outcome variable (caregiver feeding style). A multistage stratified sampling technique was used to identify study subjects. An adapted Caregiver's Feeding Styles Questionnaire (CFSQ) was used to gather information about caregivers' feeding styles. Multivariate multinomial logistic regression was employed to identify predictors of caregivers' feeding style.The majority (80.6%) of caregivers were biological mothers. Nearly seventy-six percent of the caregivers practiced a responsive feeding style. Caregivers other than the biological mother favoured a laissez-faire feeding style, while caregivers residing in rural Kebeles were more responsive. Caregivers with a breastfeeding frequency of more than eight times predicted both laissez-faire (RRR = 1.88; 95% CI = 1.03-3.41) and controlling (RRR = 1.7; 95% CI = 1.02-2.85) feeding styles as compared to responsive feeding.Responsive feeding was the commonest style practiced by the caregivers. Many of the caregivers who were rural residents and birth parents have been responsive in child feeding. The instruments needed to be validated in the Ethiopian context and an additional prospective study based on direct observation of caregiver-child interactions is recommended.

A comparative study was carried out in three localities in Kenya: Kwale, Mbooni and Lwak in an attempt to identify dietary factors important in designing community based nutrition interventions. The data indicate geographical differences in age at weaning, reasons for termination of breastfeeding, the variety in the diets consumed and the nutrient intake adequacy. However, there was no difference in the duration in breastfeeding and, for children above 6 months (a period when weaning is recommended) rarely was there any food termed as "baby food" but children consumed bits and portions of the family food. In all the localities, there was no statistical difference between households with malnourished children and those without in most of the factors. Households with children admitted in the nutritional rehabilitation centres in the localities were, however, different in most of the characteristics examined. It is concluded that dietary interventions should be targeted to households and not children, mothers' care and nutrition are of paramount importance if the nutrition condition of their children is to be improved and, planning of nutritional interventions should be specific to the districts.

ABSTRACTThis article explores food culture and child-feeding practices, focusing on children below five years among the Bena and Luguru ethnic groups located in Njombe and Mvomero rural districts in Tanzania. In these two societies existing cultural norms, and beliefs related to child feeding focusing on breastfeeding and complementary feeding were investigated aiming at understanding how every-day practices on child feeding are socially and culturally constructed by actors including parents or guardians, thus giving cultural meanings that are attached to every-day realities on child feeding. The article is part of a larger research project whose overall purpose was to investigate the outcome of milk-based nutrition interventions involving dairy goat and cattle-keeping with the aim among others to improve health and nutritional status of family members, especially children below five years in societies where prevalence of malnutrition particularly undernutrition is rather high. Methods used included parti...

The study determined the influence of sociocultural practices on food and nutrition security of children and women in Karamoja subregion, located in northeastern Uganda. Sixteen focus group discussions were conducted among 133 participants. Data were analyzed using qualitative content analysis. Findings indicate that cultural norms, myths, and taboos restrict consumption of animal-sourced foods and some green vegetables by women. Sociocultural practices promoted prelacteal feeding, affecting the implementation of World Health Organization's recommendations for exclusive breast feeding. In conclusion, sociocultural practices influence food and nutrition security, exposing women and children to the risk of malnutrition and associated consequences.

The first 1000 days is "window of opportunity" for nutrition and vital for physical growth, brain development and the immune system. None of previous studies explored qualitatively child-feeding practices in the developing countries like Ethiopia. The aim of the study was to explore barriers and facilitators of child-feeding practices in Gozamin District, Northwest Ethiopia.A qualitative study was conducted by using 12 in-depth interviews and 4 Focus Group Discussions (n = 32) from Feb. 15/2016 - March 10/ 2016 in eight Kebeles. Purposive sampling technique was used to recruit the participants. The quality of the research findings was checked by using credibility, dependability, transferability and conformability. Data were analyzed using qualitative data analysis software package Atlas ti-7.Early initiation of breast-feeding and complementary feeding, exclusive breast-feeding, minimum meal frequency and minimum dietary diversity were the emerged theme in the study. Breastfeeding up to 2 years and above and timely initiation of a complementary feeding were commonly good practice in the area. Dietary diversity, discarding colostrums, pre-lacteal feeding like butter and bottle-feeding were the commonly harmful practices in the area. The most frequently mentioned barriers of child feeding were socio-cultural influences, traditional community practices, workload and poverty.Most of the children were suffered from harmful child feeding practices such as pre-lacteal feeding, discarding colostrums and bottle-feeding. Child dietary diversity and complementary food preparation were the major problem in the study area. Therefore, supports on complementary food preparation and diversity food should be given more attention to enhance child-feeding practice in rural Ethiopia.

To explore and gain an in-depth understanding of the factors influencing child feeding practices among rural caregivers in Rwanda.In-depth semi-structured qualitative interviews were conducted. Purposive sampling was used to recruit participants. Interviews were audio-recorded, transcribed verbatim and coded. Data were analysed inductively using thematic analysis.Rutsiro District, Western Province, Rwanda.Participants included twenty-four mothers (median age 32 years) with children 6-23 months old.We identified five key themes: (i) breast-feeding practices and role in food supply; (ii) family v. children's food preparations; (iii) food classification systems and their influence on child feeding decisions; (iv) child feeding during diarrhoeal episodes and (v) influence of poverty on child feeding practices and child care.Mothers' infant and young child feeding decisions are informed by information both from health workers and from traditional/own knowledge. Navigating through this information sometimes creates conflicts which results in less than optimal child feeding. A nutrition educational approach that is cognisant of maternal perceptions should be employed to improve child feeding practices. Efforts to improve child feeding practices must be complemented by programmes that enhance household economic opportunities and access to foods.

The knowledge, attitude and practices of complementary feeding among caregivers in the developing countries have been rated poor [1]. Caregivers’ nutrition education on complementary feeding...

Inadequate feeding practices contribute to poor nutrition among Peruvian children. In response, Peru’s Lambayeque Regional Government funded an initiative in its four poorest districts to improve n...

Breast feeding has been recognized as a child survival strategy, while breast feeding programmes have been increasingly implemented in many communities. This study assesses the effectiveness of a breast feeding education programme launched through the primary health care programme in the rural communities of Nigeria. Late trimester pregnant women were enrolled into the study and given a questionnaire on knowledge, attitudes, and practices (KAP) about breast feeding. Women in the study group (n = 126) received breast feeding counselling before and after delivery, while those in control group (n = 130) did not receive any counselling. Both groups were monitored after delivery and followed with the KAP questionnaire. The results of the study showed marked improvements in the intervention group for colostrum feeding (p = 0.0000). Moreover, 31.6% of the mothers in the intervention group practised timely initiation of breast feeding compared to 5.6% of the controls, and the prevalence of exclusive breast feeding at 4 months was 39.8% in the intervention group compared to 13.9% for the controls. Multivariate analysis showed that the intervention was a powerful and the only significant predictor of the increase in breast feeding behaviours (p = 0.0000), and that an early initiation of breast feeding is a strong predictor of exclusive breast feeding at 4 months of age. It is concluded that breast feeding promotion in rural communities is feasible and can lead to behavioural changes.During December 1993 to October 1994, in Nigeria, a breast feeding promotion project was implemented in Ife South Local Government Area (LGA), and its impact was evaluated. It consisted of training workshops on breast feeding for community health workers, breast feeding promotional posters displayed in prenatal care clinics and in homes, handouts on breast feeding, breast feeding talks in the clinics and in homes, and individual counseling on breast feeding before and after delivery. Pregnant women were enrolled in the program during the late trimester. During April-October 1994, researchers conducted a follow-up study of the effects of the breast feeding promotion program in the intervention area, by comparing relevant data from the intervention area and the control area Atakumosa LGA. The study methods were focus group discussions and interviews. The intervention group consisted of 126 women 15-44 years old. The control group consisted of 130 women 15-49 years old. Women in the study group were more likely to believe that infants should received colostrum after the intervention than before it (75% vs. 29.8%; p = 0.00001). More women in the study group put their infants immediately to the breast than women in the control group (31.6% vs. 5.6%). They were also more likely to be fully breast feeding at 4 months than mothers in the control group (39.8% vs. 13.9%). Stepwise multiple logistic regression analyses were conducted to determine whether the breast feeding promotion program had a positive independent effect on early initiation of breast feeding and on full breast at 4 months. They revealed that the intervention was indeed a significant predictor of early initiation of breast feeding (odds ratio [OR] = 10.71) and of full breast feeding at 4 months (OR = 5.29). Further, initiation of early breast feeding was the strongest and most significant predictor of full breast feeding at 4 months (OR = 5.6). These findings suggest that breast feeding promotion in rural villages is feasible and improves breast feeding practices.