Background: Responsive feeding (RF) is an evidence-based behaviour in complementary feeding. Although included in the infant feeding guidelines of Sri Lanka, it is doubtful whether knowledge and practices entailed to RF is established in the Sri Lankan community. Objectives: To explore the knowledge and practices of RF among mothers having nine month old infants and to explore attitudes of public health midwives (PHMs) towards the concept. Method: A qualitative study was conducted using in-depth interviews in caregivers of 9 month old infants and focused group discussions in PHMs of Nuwaragam Palatha Central area in Anuradhapura district. Interviews were tape recorded, transcribed and thematic analysis performed. Results: None of the mothers effectively practised the full concept of RF. Only a few mothers have prepared a separate feeding place. Although signals of hunger and satiety were identified, most mothers did not use them in an appropriate manner in feeding. Letting the child watch television and taking the child round the garden were common suboptimal practices. Mothers stated the difficulty in introducing new food to their children indicating lack of reciprocity between them and children. The public health midwives also had poor understanding on total concept of RF. Conclusions: PHMs and mothers having nine month old infants have poor understanding and practices on the concept of RF.

BackgroundResponsive feeding (RF) is a strategy that has a positive impact on growth, caregiver behaviours and dietary intake of children. But concern given to RF in national nutrition programmes is inadequate. Our aim is to explore the knowledge and practices on RF among mothers having infants of 9 months in Nuwaragam Palatha Central (NPC) MOH area, Anuradhapura. MethodsWe conducted a qualitative study using in-depth interviews with mothers who were purposefully selected to represent different socio-demographic backgrounds. In-depth interviews were conducted according to Family Health International guidelines. Data analysis was done using framework approach. Ethical clearance was obtained for the study. Results Though mothers practice some components of the four step approach of RF, none of them seem to have effectively practiced the full concept in feeding their child. Only few mothers have prepared a separate feeding place. But, even those mothers were unable to stick to that place. And the preparation of the place was not satisfactory to meet the child's desires. Mothers were good at identifying hunger and satiety signs. However, majority of mothers were not feeding their children in response to hunger signs but according to a time table made on their own. Letting the child watch television and taking the child around the garden were major factors of distraction while feeding. Mothers stated the difficulty in introducing new food to their children indicating the lack of reciprocity between the child and the caregiver. ConclusionsThe concept of RF is not effectively practiced in the community of NPC, MOH area.

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BackgroundResponsive feeding (RF) is recognized as an effective intervention in preventing under nutrition in young children. Our observations within the community have shown that the practice of this concept is not satisfactory. Our aim is to explore the knowledge and perceptions on RF among Public Health Midwives (PHM) in Nuwaragam Palatha Central (NPC) MOH area, Anuradhapura. MethodsWe conducted a qualitative study using focus group discussions with two groups of PHMs each including 9 participants in NPC, MOH area. They were conducted according to Family Health International guidelines. Data analysis was done using framework approach. Ethical clearance was obtained for this study. ResultsNone of these groups seems to have a clear understanding about the full concept of RF. All of them accepted that the mothers should feed their children in a separate place that is comfortable, attractive and free of distractions. Some of the PHMs knew that children should be fed according to a time table made according to child's hunger signs. But mothers have made their own timetables for this purpose. They knew the importance of responding to the child promptly with age appropriate food and the importance of incorporating Early Childhood Care and Development concept while feeding though it is not practiced in their fields. Neither the PHMs were aware of reciprocity nor mother and child having reciprocity during feeding revealing that concept is not practiced in this setting. ConclusionPHMs have lack of understanding regarding the full concept, which could be a probable cause for the lack of practice of RF in the community.

BackgroundMeasles vaccine was introduced to the expanded program of immunization