Social circumstances and cultural beliefs influence maternal nutrition, breastfeeding and child feeding practices in South Africa

Chakona, Gamuchirai

doi:10.1186/s12937-020-00566-4

Cited by 67 publications

(71 citation statements)

References 40 publications

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“…While initiation of breastfeeding was high, there were low rates of EBF among HIV-negative women with introduction of liquids and other foods prior to 3 months [ 72 – 75 ]. In some instances, weaning occurred as early as 2 months [ 76 ]. HIV-positive women expressed fear of HIV transmission to their infants, as well as school and work commitments as reasons for discontinuation of EBF [ 68 , 77 – 80 ].…”

Section: Resultsmentioning

confidence: 99%

Breastfeeding inequities in South Africa: Can enforcement of the WHO Code help address them? – A systematic scoping review

Vitalis

Vilar‐Compte

Nyhan

et al. 2021

Int J Equity Health

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Introduction Suboptimal breastfeeding rates in South Africa have been attributed to the relatively easy access that women and families have had to infant formula, in part as a result of programs to prevent maternal-to-child transmission (MTCT) of HIV. This policy may have had an undesirable spill-over effect on HIV-negative women as well. Thus, the aims of this scoping review were to: (a) describe EBF practices in South Africa, (b) determine how EBF has been affected by the WHO HIV infant feeding policies followed since 2006, and (c) assess if the renewed interest in The Code has had any impact on breastfeeding practices in South Africa. Methods We applied the Joanna Briggs Institute guidelines for scoping reviews and reported our work in compliance with the PRISMA Extension (PRISMA-ScR). Twelve databases and platforms were searched. We included all study designs (no language restrictions) from South Africa published between 2006 and 2020. Eligible participants were women in South Africa who delivered a healthy live newborn who was between birth and 24 months of age at the time of study, and with known infant feeding practices. Results A total of 5431 citations were retrieved. Duplicates were removed in EndNote and by Covidence. Of the 1588 unique records processed in Covidence, 179 records met the criteria for full-text screening and 83 were included in the review. It was common for HIV-positive women who initiated breastfeeding to stop doing so prior to 6 months after birth (1–3 months). EBF rates rapidly declined after birth. School and work commitments were also reasons for discontinuation of EBF. HIV-positive women expressed fear of HIV MTCT transmission as a reason for not breastfeeding. Conclusion The Review found that while enforcing the most recent WHO HIV infant feeding guidelines and the WHO Code may be necessary to improve breastfeeding outcomes in South Africa, they may not be sufficient because there are additional barriers that impact breastfeeding outcomes. Mixed-methods research, including in-depth interviews with key informants representing different government sectors and civil society is needed to prioritize actions and strategies to improve breastfeeding outcomes in South Africa.

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Section: Resultsmentioning

confidence: 99%

Breastfeeding inequities in South Africa: Can enforcement of the WHO Code help address them? – A systematic scoping review

Vitalis

Vilar‐Compte

Nyhan

et al. 2021

Int J Equity Health

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“…It cannot be disputed that good nutrition is a major determinant of positive pregnancy outcome. The link between poverty and malnutrition during pregnancy has been well established in South Africa [ 69 , 71 ], hence the study focusing on other contributing factors of malnutrition (such as food taboos) has been poorly established. Not much is known on the negative or positive effects of food taboos on pregnancy outcomes of Zulu women.…”

Section: Discussionmentioning

confidence: 99%

“…Not much is known on the negative or positive effects of food taboos on pregnancy outcomes of Zulu women. A study done on Xhosa speaking people in the Eastern Cape, South Africa, also highlighted that cultural beliefs are some of major drivers which influence the eating habits during pregnancy and infant feeding [ 71 ]. It was thus important to evaluate if cultural beliefs also influence dietary intake of pregnant women in other cultures.…”

Section: Discussionmentioning

confidence: 99%

Traditional food taboos and practices during pregnancy, postpartum recovery, and infant care of Zulu women in northern KwaZulu-Natal

Ramulondi

Wet

Ntuli

2021

J Ethnobiology Ethnomedicine

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Background Traditional practices and beliefs influence and support the behavior of women during pregnancy and childbirth in different parts of the world. Not much research has been conducted to examine whether and how cultural traditions continue to shape maternity experiences of Zulu women. The aim of this study is to establish the extent at which women in certain rural communities adhere to traditional food taboos and practices during pregnancy, postpartum recovery, and infants feeding, in comparison to what is recommended by health care workers. Methods A survey was conducted in the rural northern KwaZulu-Natal between 2017 and 2020. A total of 140 women between the ages of 18 and 90 years were interviewed and they were chosen purposively based on their experiences in pregnancy, postpartum recovery, infant care, and their willingness to share the knowledge. Data were analyzed using descriptive statistics. Results Most (64%) of the participants said that they adhered to these cultural food taboos and practices. The most common foods avoided were certain fruits [mango, naartjie, orange, papaya, and peach], butternut, eggs, sweets (sugar, commercial juice, sweet food, and honey), chili, ice, and alcohol. The most recommended foods during pregnancy were leafy vegetables, fruits (except the avoided ones), liver, and fish. For postpartum recovery, women mostly consumed soft porridge, all fruits and vegetables, beetroot, and tea. Food not allowed for children younger than 2 years included meat, sugar and sweets, and chewable foods. Conclusion Differences on food taboos and practices between participants who received formal education and those who did not received it were insignificant. The beliefs about the detrimental effects of some foods were not backed up by scientific research. Restriction of some orange/yellow colored fruits during pregnancy that are rich in vitamin A and/or C may affect daily requirements of these micronutrients, and the foods recommended during pregnancy and postpartum period would not provide all the essential nutrients required for successful pregnancy. However, some of the food taboos would protect women from unhealthy eating. Our findings provide a basis for developing culturally appropriate nutritional mediation programs for Zulu women with a view to provide effective nutritional counseling.

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“…The 2015 Millennium Development Goal has reported that one third of all children who are undernourished in the world live in sub-Saharan Africa (SSA) [ 8 ]. In these countries, the adequacy and diversity of diet in most households are affected by poverty, insufficient knowledge, social circumstances, cultural beliefs and practices of caregivers [ 5 , 9 ]. In particular, the relationship between dietary diversity and the nutritional status of preschool children is well-established [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Dietary Diversity and Nutritional Status of Preschool Children in North West Province, South Africa: A Cross Sectional Study

2020

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Preschool children consume diets inadequate to meet their macro and micronutrient requirements, which ultimately affect their nutritional status due to lack of dietary diversity. A cross sectional study was conducted to investigate the association between dietary diversity scores (DDS) and the nutritional status of 379 preschool children in North West Province of South Africa. A 24 h qualitative recall by mothers of their children’s food consumption was used to calculate DDS based on 12-foods groups following Food and Agriculture Organization protocols. DDS was calculated by counting each of 12-food groups and classified as low (≤4), medium (5–8) and high (9–12). The weight and height of children were measured and height-for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BAZ) z-scores were calculated based on 2006 WHO standards. Stunting, underweight and thinness were defined as HAZ, WAZ and BAZ < −2SD, respectively. Linear and logistic regression analyses were used to assess the association between DDS and the nutritional indicators. Mean age for children was 4 ± 0.7 years, and the prevalence of stunting (29%), underweight (13%) and thinness (6%) was observed. Mean DDS was 4.39 ± 1.55 out of 12-food groups, with a prevalence of 61% and 39% for low and medium DDS, respectively. Cereals (100%) accounted for the main food group consumed, while fish and other seafood (17%) were the least consumed. Consumption of a diversified diet was associated with lower odds of being stunted [AOR = 0.25, 95%CI: 0.10 to 0.92] among the four-year olds, while in the unadjusted model, 5-year-olds had lower odds of being underweight [OR = −0.32, 95%CI: −0.57 to 0.07]. The findings of this study reinforce the importance of continued nutrition education of mothers, caregivers and preschool staff on the need to ensure consumption of diverse food sources in order to improve the nutritional status of children. Further studies are recommended on the association of DDS with the nutritional status, and factors associated with low dietary diversity among preschool children.

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Social circumstances and cultural beliefs influence maternal nutrition, breastfeeding and child feeding practices in South Africa

Cited by 67 publications

References 40 publications

Breastfeeding inequities in South Africa: Can enforcement of the WHO Code help address them? – A systematic scoping review

Breastfeeding inequities in South Africa: Can enforcement of the WHO Code help address them? – A systematic scoping review

Traditional food taboos and practices during pregnancy, postpartum recovery, and infant care of Zulu women in northern KwaZulu-Natal

Dietary Diversity and Nutritional Status of Preschool Children in North West Province, South Africa: A Cross Sectional Study

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