Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort

Mushaphi, Lindelani Fhumudzani; Mahopo, Cloupas; Nesamvuni, C.; Baloyi, Brenda; Mashau, Ellen; Richardson, J. E.; Dillingham, Rebecca; Guerrant, Richard L.; Ambikapathi, Ramya

doi:10.1177/0379572117696662

Cited by 23 publications

(35 citation statements)

References 19 publications

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“…This observation may be attributed to a strong influence of family members in decisions around infant feeding, as seen in many rural communities in SA. [21,22] A similar observation was highlighted also by other authors, noting a lack of autonomy and decision-making power among young mothers and decisions around infant feeding involving considerable input from the extended family. [27,28] The WHO recommends that breastfeeding should be initiated within an hour after birth.…”

Section: Discussionsupporting

confidence: 67%

“…We further also observed that several mothers were advised by elders on infant feeding practices, similar to observations from two other SA studies. [21,22] If elderly family members are indeed still having a notable role in advising and supporting mothers on infant feeding issues, it might be wise to develop intervention programmes targeting elderly women.…”

Section: Discussionmentioning

confidence: 99%

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Breastfeeding knowledge and practices among mothers of children younger than 2 years from a rural area in the Limpopo province, South Africa

2019

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Appropriate feeding practices during infancy and early childhood are critical for a child's growth and development. [1,2] Breastfeeding provides optimal and complete nutrition during the first 6 months of a baby's life, offers immunologic benefits to the baby and contributes to the psychological relationship between the mother and child. [3,4] The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) therefore recommend that mothers breastfeed exclusively for the first 6 months of their baby's life, [4] with nutritionally adequate and safe complementary foods being introduced along with continued breastfeeding for up to 2 years. Although breastfeeding is widely practised in developing countries such as South Africa (SA), India and Indonesia, [5-8] previous studies have reported that exclusive breastfeeding is rare. [6-8] The majority of mothers in these settings are reported to introduce complementary liquids within the first 7 days of the infant's life. [6,7] This can be attributed to a lack of knowledge about infant feeding, cultural and socioeconomic factors and inconsistent advice given to new mothers. [9,10-13] According to Meyer et al. [14] and Black et al., [15] SA mothers tend to introduce food, tea and water fairly early while still breastfeeding. Infant feeding practices in SA differ from those conventionally seen in the rest of Africa, as the rate of breastfeeding is low and the use of formula milk is common. [14,16] A study by Mushaphi et al. [5] in villages around the Vhembe district of the Limpopo province of SA showed that 91.3% of infants were given both breastmilk and food, and 95.5% were fed a mixture of breastmilk and water. It is estimated that, globally, only 40% of babies are exclusively breastfed. [17] Knowledge of and a positive attitude towards breastfeeding do not necessarily translate to proper infant feeding practices, as shown by an earlier study from Nigeria. [18] Previous studies have reported mothers' perception of not having enough breastmilk, the return to work or school and poor knowledge about breastfeeding as factors that contribute to a low rate of exclusive breastfeeding. [5,19-21] Family and community pressure was also cited as notable reasons for mothers' early introduction of complementary foods, with previous studies showing that grandmothers or elderly women often advise mothers to introduce complementary foods as early as 1 month after birth owing to the perceived inadequate supply of breastmilk. [5,21,22] Even if mothers have adequate knowledge about infant feeding, a lack of independent decision-making can result in poor infant feeding practices. [23-25] The objective of this study was to determine the level of knowledge about breastfeeding and the associated practice among mothers of children younger than 24 months in rural areas of the Limpopo province, SA. It was conducted as a follow-up to a 2004 study in the province's Vhembe district, which investigated infant feeding practices and the associated nutritional status of children younger ...

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Breastfeeding knowledge and practices among mothers of children younger than 2 years from a rural area in the Limpopo province, South Africa

2019

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“…While we could not find evidence of any qualitative research linked with the large multi-country cohorts cited above, with the exception of the Brazilian and South African contributors to COHORTS [10][11][12][13][14][15], several smaller or single-country studies have had at least one associated qualitative component [16][17][18][19][20][21][22][23][24][25]. Many of these can be considered mixed methods studies, defined as studies which combine both qualitative and quantitative approaches and involve a degree of mixing or integrating of the two, at one or more stages of the study (such as planning, data collection, analysis or interpretation).…”

Section: Introductionmentioning

confidence: 99%

The contribution of qualitative research within the PRECISE study in sub-Saharan Africa

Daniele

Martínez-Álvarez

Etyang³

et al. 2020

Reprod Health

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The PRECISE Network is a cohort study established to investigate hypertension, fetal growth restriction and stillbirth (described as "placental disorders") in Kenya, Mozambique and The Gambia. Several pregnancy or birth cohorts have been set up in low-and middle-income countries, focussed on maternal and child health. Qualitative research methods are sometimes used alongside quantitative data collection from these cohorts. Researchers affiliated with PRECISE are also planning to use qualitative methods, from the perspective of multiple subject areas. This paper provides an overview of the different ways in which qualitative research methods can contribute to achieving PRECISE's objectives, and discusses the combination of qualitative methods with quantitative cohort studies more generally. We present planned qualitative work in six subject areas (health systems, health geography, mental health, community engagement, the implementation of the TraCer tool, and respectful maternity care). Based on these plans, with reference to other cohort studies on maternal and child health, and in the context of the methodological literature on mixed methods approaches, we find that qualitative work may have several different functions in relation to cohort studies, including informing the quantitative data collection or interpretation. Researchers may also conduct qualitative work in pursuit of a complementary research agenda. The degree to which integration between qualitative and quantitative methods will be sought and achieved within PRECISE remains to be seen. Overall, we conclude that the synergies resulting from the combination of cohort studies with qualitative research are an asset to the field of maternal and child health.

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“…Breastfeeding mothers need to be informed about strategies to prevent problems; at the same time, they need support in order to overcome problems they may face. Health care providers have been identi ed by mothers as the primary source of information on breastfeeding (12,13). Thus, the former could support mothers in preventing breastfeeding problems or managing them if they occurred.…”

Section: Introductionmentioning

confidence: 99%

Common Breastfeeding Problems and Their Effect on The Continuation of Exclusive or Predominant Breastfeeding in Kinshasa

Babakazo

Bosonkie

Mafuta

et al. 2020

Preprint

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Background: Breastfeeding has numerous advantages for infant, mother and society. However, many mothers discontinue breastfeeding due to problems they encounter. This study aimed to identify problems commonly experienced by breastfeeding mothers during the first six months in Kinshasa and to determine their effect on the continuation of exclusive or predominant breastfeeding.Methods: A prospective cohort study was carried out in Kinshasa from October 2012 to July 2013. A total of 422 mother-infant couples were recruited shortly after being discharged from twelve maternity facilities in Kinshasa and followed-up for six months. Interviews were conducted at the mother’s house during the first week after birth, and thereafter at monthly intervals for six months. Data included mother’s sociodemographic characteristics, the breastfeeding problems she experienced and information on child’s feeding. The Cox Proportional Model was used to determine the effect of breastfeeding problems on the continuation of exclusive or predominant breastfeeding.Results: Cracked or sore nipples, insufficient production of milk and breast engorgement were the most commonly experienced problems by lactating mothers. The problems occurred mainly during the first week (17.1%; CI95% 13.7–21.1) and the rest of the first month (16.2%; CI95% 12.8–20.3). Experiencing breastfeeding problems during any period negatively affected the continuation of exclusive or predominant breastfeeding.Conclusions: The first month after birth presents the most risk for the occurrence of breastfeeding problems. Those problems negatively affect the course of breastfeeding. Mothers should be supported as soon as possible after delivery, to improve their breastfeeding performance and to be informed on how to maintain breast milk supply.

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Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort

Cited by 23 publications

References 19 publications

Breastfeeding knowledge and practices among mothers of children younger than 2 years from a rural area in the Limpopo province, South Africa

Breastfeeding knowledge and practices among mothers of children younger than 2 years from a rural area in the Limpopo province, South Africa

The contribution of qualitative research within the PRECISE study in sub-Saharan Africa

Common Breastfeeding Problems and Their Effect on The Continuation of Exclusive or Predominant Breastfeeding in Kinshasa

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