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Introduction Responsive feeding has been proven to be an effective feeding method for children who are at early stages of development. The concept is not popular at the primary health care level and it is reported as a missing link in the current nutrition program in Sri Lanka. Objective To explore responsive feeding practices among caregivers who have an infant aged between 6 to 12 months and residing in rural Anuradhapura. Methods A qualitative approach was adopted. The study was carried out in Padaviya Medical Officer of Health area. Study participants were 18 mothers and all ten Public Health Midwives. Diary studies, interviews and focus group discussion were conducted to collect data. The framework approach was used to analyze the data. Results Pleasant and healthy feeding environment is non-existent. Identification of hunger and satiety cues was poor and hunger sensitive schedule to feed the child was absent. Feeding situations commenced in an emotionally supportive manner, but were not optimally utilized to promote psycho-social stimulation. During the feeding caregivers neglect emotional support and ultimately moves to forceful feeding. Conclusions The knowledge, attitude and practices are poor on responsive feeding among caregivers and health workers. This may contribute to poor growth and development in children. Action is needed to implement RF practices in the community.

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.

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