Responsive feeding practices among caregivers in rural Anuradhapura; a missing component in infant feeding!

Abstract

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.

Knowledge, Attitudes, and Practices of Responsive Feeding in Rural Sri Lanka (A Qualitative Study)

“…However, many primary health care workers are unaware of it making RF the missing link in the current nutrition program [13]. Previous studies showed the knowledge on the RF among mothers as well as Public Health Midwives (PHM) are inadequate [14,15]. Sri Lankan study showed the RF practices improve eating behaviors and child growth [16].…”

A comparison of observed feeding practices of infants and young children aged 6–23 months to national responsive feeding recommendations in Sri Lanka

“…Not all distractions may be considered to be negative, however: short, but intentional distractions may be positive if effectively used to refocus a child during feeding (Moore et al, 2006 ). In our study and others in Sri Lanka, however, distractions were not brief, but employed throughout entire feeding episodes and often resulted in children moving around the house (Lucas et al, 2021 ; Senevirathne et al, 2015 ). Ensuring consistent mealtime structures, such as having a fixed location for eating and using minimal distractions, may be associated with less food fussiness during feeding (Finnane et al, 2017 ).…”

Infant and young child feeding (IYCF) practices from birth to 2 years: A longitudinal follow-up study in healthy children from Colombo, Sri Lanka

“…Our study found that 86% of infants between 6-24 months were fed in a specific place similar to Jeyakumaran's study in Jaffna (80%). Responsive feeding, including feeding in a specific place, in seated position, with a non-distractive environment, according to hunger cues, at a regular time, while responding to the child in an emotionally supportive manner without forcing, scolding or physical restraint were seen in all infants at the initiation of CF, with a lowest of 79% at 6-8 months which improved to 93% by 2 years in contrast to the previous reported studies where authoritarian feeding style was used in 82% care givers of children aged 3-5 years in Colombo 13 , knowledge regarding responsive feeding was seen in only 25-49% caregivers of infants aged 4-12 months in Bibile 14 , responsive feeding was not effectively practised 9 months of age according to a qualitative study in Anuradhapura 15 , 64% of preschool teachers agreed that force feeding was necessary in Nuwara Eliya 16 and where only 22.7% used responsive feeding in children between 4-23 months in Jaffna 17 . Individualized counselling, which was the key difference between our study population and the DHS 2016/2017 group as well as the other reported studies, is the most likely reason for the high adherence to IYCF guidelines in our study population, which also enabled our study population to achieve the 2020 IYCF national targets.…”