Prenatal infant feeding intentions and actual feeding practices during the first six months postpartum in rural Rwanda: a qualitative, longitudinal cohort study

Ahishakiye, Jeanine; Bouwman, L.I.; Brouwer, Inge D.; Vaandrager, L.; Koelen, M.A.

doi:10.1186/s13006-020-00275-y

Cited by 18 publications

(26 citation statements)

References 39 publications

(45 reference statements)

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“…The findings from this study confirm some aspects we found in our previous studies: mothers face challenges to appropriately breastfeed their children such as poverty, food insecurity and heavy workload [ 14 , 22 ]. However, participants also showed the ability to cope with those challenges by using different coping strategies.…”

Section: Discussionsupporting

confidence: 90%

Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

et al. 2021

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Background Mothers in low-income countries face many challenges to appropriately feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child’s life. Methods This qualitative longitudinal study recruited a purposive sample of 17 mothers who followed the infant and young child feeding recommendations (IYCF). They were selected from a larger study of 36 mothers. In-depth interviews were conducted with mothers of the total group (36 mothers) within the first week, at 4th, 6th, 9th and 12th months postpartum. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. Results Coping strategies included improving mothers’ own diet for adequate breastmilk production, prioritizing child feeding over livelihood chores, livelihood diversification and mothers’ anticipatory behaviors such as preparing child’s food in advance. Some of those coping strategies were shifting overtime depending on the development of the children. Personal factors such as breastfeeding self-efficacy, religious beliefs and perceived benefits of breastfeeding were among the facilitating factors. Additionally, social support that mothers received from family members, other mothers in the community, Community Health Workers (CHWs) and health professionals played an important role. Conclusion In challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support. Nutrition promotion interventions that aim to improve IYCF should consider strengthening mothers’ capability in gaining greater control of their IYCF practices and the factors facilitating their appropriate IYCF practices.

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Section: Discussionsupporting

confidence: 90%

Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

et al. 2021

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“…The ndings from this study con rm some aspects we found in previous studies: mothers face challenges to appropriately breastfeed their children such as poverty, food insecurity and heavy workload [14,18]. However, our mothers also showed the ability to cope with those challenges by using different coping strategies.…”

Section: Discussionsupporting

confidence: 88%

“…First, we identi ed the major challenges faced by participants (n=36) for appropriate breastfeeding and complementary feeding practices. Results have been published elsewhere [14,18]. In order to identify the coping strategies and the factors that facilitated coping for appropriate breastfeeding and complementary feeding practices, in this part of the study we focused attention to mothers who followed the recommended IYCF practices from birth until 1 year of child's life.…”

Section: Discussionmentioning

confidence: 99%

“…Recent research showed that inadequate IYCF practices contribute to stunted growth among Rwandan children under the age of ve years [11,12]. In our previous studies on factors that impede appropriate breastfeeding and complementary feeding practices, we found that mothers encounter several challenges for appropriate IYCF practices, including mother's perception of breastmilk insu ciency, adverse breastfeeding experience, health concerns for the mother and the babies, excessive workload for the mother, poverty, food insecurity, and lack of support from signi cant family members [13,14]. Similar challenges have been found in other studies (13)(14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 98%

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Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

Ahishakiye

Vaandrager

Brouwer

et al. 2020

Preprint

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Purpose Mothers in low income countries face many challenges to appropriately (breast) feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who strive and succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child’s life.Methods Mothers (n=17) who followed the recommended infant and young child feeding (IYCF) practices were selected from a larger sample of 36 mothers. Mothers of the total group were interviewed within the first week, at four, six, nine and twelve months postpartum. In the analysis, coping strategies and factors facilitating coping were extracted.Results Coping strategies included mothers’ effort to strengthen their diet to improve breastmilk production, balancing work and child feeding, prioritizing childcare, preparing child’s food in advance active uptake of the recommendations and persistence in overcoming barriers. Personal and social factors facilitated these coping strategies of the mothers.ConclusionIn challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support.

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“…In Uganda and Rwanda, studies suggest that the negative influence of female family members, such as sisters, mothers and mothers-in-law, leads to suboptimal feeding practices for the baby [24,25]. The study in Uganda also links the non-observance of exclusive breastfeeding to the belief that breastmilk is not enough to satiate the baby and the perception that breastfeeding is indicative of poverty [24].…”

Section: Discussionmentioning

confidence: 99%

Insights on exclusive breastfeeding norms in Kinshasa: findings from a qualitative study

Wood

Gage

Bidashimwa

2020

BMC Pregnancy Childbirth

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Background For optimal growth and development, the World Health Organization recommends that children be exclusively breastfed for the first 6 months of life. However, according to the nationally-representative 2013–2014 Demographic and Health Survey, under 50% of babies in the Democratic Republic of Congo are exclusively breastfed. Although breastfeeding was common in the capital city of Kinshasa, one in five newborns received alternatives to breastmilk during the first 3 days of life. This analysis aimed to identify social norms influencing exclusive breastfeeding, the role of a young first-time mother’s (FTM’s) social network for her choice to exclusively breastfeed, and perceived social sanctions associated with breastfeeding practices in Kinshasa. Methods The qualitative analysis was based on a vignette presented during 14 focus group discussions, with a purposively selected sample (n = 162) of FTMs age 15–24, and the male partners, mothers and mothers-in-law of FTMs age 15–24 in three health zones in Kinshasa in 2017. Thematic content analysis was performed to identify concepts and patterns in the participants’ discussions. Results Overall, community norms were not supportive of exclusive breastfeeding. The main barriers to exclusive breastfeeding were the belief held by most FTMs that exclusive breastfeeding was an uncommon practice; the desire to avoid negative sanctions such as name-calling and mockery for refusal to give babies water in the first 6 months of life; the desire to please key members of their social networks, specifically their mothers and friends, by doing what these influencers expected or preferred them to do; FTMs’ own lack of experience with infant feeding; and trust placed in their mothers and friends. Conclusion Social norms can be maintained by the belief about what others do, perceived expectations about what individuals ought to do, the negative sanctions they can face and their preference to conform to social expectations. Thus, addressing cultural beliefs and targeting sensitization efforts to key influencers that provide support to FTMs are needed to promote exclusive breastfeeding in Kinshasa. In doing so, strategies should address the barriers to exclusive breastfeeding including related misconceptions, and improve FTMs’ self-efficacy to overcome the influence of others.

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Prenatal infant feeding intentions and actual feeding practices during the first six months postpartum in rural Rwanda: a qualitative, longitudinal cohort study

Cited by 18 publications

References 39 publications

Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

Insights on exclusive breastfeeding norms in Kinshasa: findings from a qualitative study

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