Maternal perspectives on infant feeding practices in Soweto, South Africa

Objective: To (i) describe the infant feeding practices of South African women living in Soweto and (ii) understand from the mothers' perspective what influences feeding practices.

Design: Semi-structured focus group discussions (FGD) and in-depth interviews (IDI) were conducted, and data were analysed using thematic analysis. Setting: Soweto, South Africa.

Participants: Nineteen mothers were stratified into three FGD according to their baby's age as follows: 0-6-month-olds, 7-14-month-olds and 15-24-month-olds. Four mothers from each FGD then attended an IDI.

Results: Although mothers understood that breast-feeding was beneficial, they reported short durations of exclusive breast-feeding. The diversity and quality of weaning foods were low, and 'junk' food items were commonly given. Infants were fed using bottles or spoons and feeding commonly occurred separately to family meal times. Feeding practices were influenced by mothers' beliefs that what babies eat is important for their health and that an unwillingness to eat is a sign of ill health. As such, mothers often force-fed their babies. In addition, mothers believed that feeding solid food to babies before 6 months of age was necessary. Family matriarchs were highly influential to mothers' feeding practices; however, their advice often contradicted that of health professionals.

Conclusions: In South Africa, interventions aimed at establishing healthier appetites and eating behaviours in early life should focus on: (i) fostering maternal self-efficacy around exclusive breast-feeding; (ii) challenging mixed feeding practices and encouraging more responsive feeding approaches and (iii) engaging family members to promote supportive household and community structures around infant feeding.

Infant feeding, Qualitative, South Africa

10.1017/S1368980020002451

1368-9800

3602-3614

Wrottesley, Stephanie V.

9c93c674-7f64-413d-b05e-f1c5db19c31a

Prioreschi, Alessandra

04875305-6e91-4199-98bb-8154707060c4

Slemming, Wiedaad

df5ca240-2702-4079-afe2-c453b7bb1aa3

Cohen, Emmanuel

54d61496-8c90-47b4-a8ef-3671bc5fb02f

Dennis, Cindy Lee

76dd19d8-54fd-4093-95fe-73fdca266831

Norris, Shane A.

1d346f1b-6d5f-4bca-ac87-7589851b75a4

10 August 2021

Wrottesley, Stephanie V.

9c93c674-7f64-413d-b05e-f1c5db19c31a

Prioreschi, Alessandra

04875305-6e91-4199-98bb-8154707060c4

Slemming, Wiedaad

df5ca240-2702-4079-afe2-c453b7bb1aa3

Cohen, Emmanuel

54d61496-8c90-47b4-a8ef-3671bc5fb02f

Dennis, Cindy Lee

76dd19d8-54fd-4093-95fe-73fdca266831

Norris, Shane A.

1d346f1b-6d5f-4bca-ac87-7589851b75a4

Wrottesley, Stephanie V., Prioreschi, Alessandra, Slemming, Wiedaad, Cohen, Emmanuel, Dennis, Cindy Lee and Norris, Shane A. (2021) Maternal perspectives on infant feeding practices in Soweto, South Africa. Public Health Nutrition, 24 (12), 3602-3614. (doi:10.1017/S1368980020002451).

Record type: Review

Abstract

Objective: To (i) describe the infant feeding practices of South African women living in Soweto and (ii) understand from the mothers' perspective what influences feeding practices.

Design: Semi-structured focus group discussions (FGD) and in-depth interviews (IDI) were conducted, and data were analysed using thematic analysis. Setting: Soweto, South Africa.

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More information

Published date: 10 August 2021

Additional Information: Funding Information: Acknowledgements: The authors thank the mothers who took part in the current research and the research teams whose work we represent here. Financial support: S.V.W., A.P. and S.A.N. are supported by the DSI-NRF Centre of Excellence in Human Development at the University of the Witwatersrand, Johannesburg, South Africa. S.V.W. is also supported by the University Research Office and School of Clinical Medicine at the University of the Witwatersrand, Johannesburg, South Africa. The research was supported by the South African Medical Research Council and Canadian Institutes of Health Research. Conflict of interest: There are no conflicts of interest. Authorship: S.V.W. conceptualised and wrote the manuscript. A.P., W.S. and E.C. conceptualised and managed the study. S.V.W., A.P., W.S. and E.C. developed the focus group discussion and/or in-depth interview guides and analysed the data. S.A.N. was the main investigator of the project and acquired the funding. All authors were involved in interpretation of results and reviewed the manuscript. All authors gave final approval of the version to be submitted. Ethics of human subject participation: The current study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all research involving study participants was approved by the University of the Witwatersrand’s Research Ethics Committee (Medical; approval numbers M171129 and M170707). Written informed consent was obtained from all participants. Publisher Copyright: © 2021 Cambridge University Press. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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