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Ahmed F, Shahid M, Cao Y, Qureshi MG, Zia S, Fatima S, Guo J. A Qualitative Exploration in Causes of Water Insecurity Experiences, and Gender and Nutritional Consequences in South-Punjab, Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312534. [PMID: 34886260 PMCID: PMC8657084 DOI: 10.3390/ijerph182312534] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/24/2022]
Abstract
Although water insecurity has been discussed in general, its impacts on mothers’ physical and mental health, and infants’ and young children’s feeding (IYCF), has largely been ignored. This study explores household water insecurity experiences and their association with optimal health and nutrition of women and children in the Rajanpur district of Punjab Province. Using focus group discussions (FGDs) and key informants (KIIs) interviews from an area with high maternal-child malnutrition prevalence, a qualitative study was conducted to describe local experiences of water acquirement and arrangement, and of the consequences of water insecurity. The findings highlight that rural Western marginalized populations of the Rajanpur district rely on brackish, canal, or flood surface water as the water supply is absent, which intensifies mothers’ work burden and stress, and often makes them victims of violence, stigma, and sickness. Water fetching impacts women in unforeseen ways, impacting the psychosocial and physical health of mothers engaged in maternal breastfeeding. Water insecurity, originally rooted in regional disparities, compounds with gender inequities, which leads to maternal stress and child sickness. Justice in water resources is imperative and urgent in the deprived South of Punjab province for improving public health nutrition.
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Affiliation(s)
- Farooq Ahmed
- Department of Anthropology, Quaid-I-Azam University, Islamabad 44000, Pakistan;
- Department of Anthropology, University of Washington, Seattle, WA 98105, USA
| | - Muhammad Shahid
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing 100029, China;
| | - Yang Cao
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing 100029, China;
- Correspondence: ; Tel.: +86-173-1948-0430
| | | | - Sidra Zia
- Independent Researcher, Islamabad 44000, Pakistan;
| | - Saireen Fatima
- Fazaia Medical College, Air University, Islamabad 44000, Pakistan;
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100091, China;
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Schuster RC, Butler MS, Wutich A, Miller JD, Young SL. "If there is no water, we cannot feed our children": The far-reaching consequences of water insecurity on infant feeding practices and infant health across 16 low- and middle-income countries. Am J Hum Biol 2020; 32:e23357. [PMID: 31868269 PMCID: PMC7537364 DOI: 10.1002/ajhb.23357] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/09/2019] [Accepted: 11/05/2019] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Infant feeding plays a critical role in child health and development. Few studies to date have examined the link between household water insecurity and infant feeding, and none in a cross-cultural context. Therefore, we examined the perceived impact of household water insecurity in four domains: breastfeeding, non-breastmilk feeding, caregiver capabilities, and infant health. Our research was conducted as part of the Household Water Insecurity Experiences (HWISE) study. METHODS We interviewed respondents from 19 sites in 16 low- and middle-income countries (N = 3303) about the link between water insecurity and infant feeding. We then thematically analyzed their open-ended textual responses. In each of the four domains (breastfeeding, non-breastmilk feeding, caregiver capabilities, infant health), we inductively identified cross-cultural metathemes. We analyzed the distribution of themes across sites quantitatively and qualitatively. RESULTS Water was perceived to directly affect breastfeeding and non-breastmilk feeding via numerous pathways, including timing and frequency of feeding, unclean foods, and reduced dietary diversity. Water was perceived to indirectly affect infant feeding through caregiver capabilities by increasing time demands, exacerbating disease, undernutrition, and mortality, and requiring greater efficacy of caregivers. Respondents made connections between water challenges and infant health, for example, increased risk of infectious diseases, undernutrition, and mortality. CONCLUSIONS These findings suggest that water presents many, and sometimes unexpected, challenges to infant feeding. By systematically investigating biocultural pathways by which water impacts infant and young child feeding, it will be possible to understand if, and how, water security can be leveraged to improve child nutrition and health.
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Affiliation(s)
- Roseanne C Schuster
- Center for Global Health, School for Human Evolution and Social Change, Arizona State University, Tempe, Arizona
| | - Margaret S Butler
- Department of Anthropology, Northwestern University, Evanston, Illinois
| | - Amber Wutich
- Center for Global Health, School for Human Evolution and Social Change, Arizona State University, Tempe, Arizona
| | - Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, Illinois
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Moimaz S, Rocha N, Garbin C, Rovida T, Saliba N. Factors affecting intention to breastfeed of a group of Brazilian childbearing women. Women Birth 2017; 30:e119-e124. [DOI: 10.1016/j.wombi.2016.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 09/09/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
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Kestler-Peleg M, Shamir-Dardikman M, Hermoni D, Ginzburg K. Breastfeeding motivation and Self-Determination Theory. Soc Sci Med 2015; 144:19-27. [DOI: 10.1016/j.socscimed.2015.09.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 08/22/2015] [Accepted: 09/04/2015] [Indexed: 11/24/2022]
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Matsuyama A, Karama M, Tanaka J, Kaneko S. Perceptions of caregivers about health and nutritional problems and feeding practices of infants: a qualitative study on exclusive breast-feeding in Kwale, Kenya. BMC Public Health 2013; 13:525. [PMID: 23721248 PMCID: PMC3681582 DOI: 10.1186/1471-2458-13-525] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 05/20/2013] [Indexed: 11/23/2022] Open
Abstract
Background Despite the significant positive effect of exclusive breast-feeding on child health, only 32% of children under 6 months old were exclusively breast-fed in Kenya in 2008. The aim of this study was to explore perceptions and feeding practices of caregivers of children under 6 months old with special attention to the caregivers’ indigenous knowledge, perceptions about the health and nutritional problems of their infants, and care-seeking behaviors that affect feeding practices. Methods The study was exploratory and used an inductive approach. In all, 32 key informants, including mothers, mothers-in-law, and traditional healers, were interviewed in-depth. The number of participants in free-listing of perceived health problems of babies, in ranking of the perceived severity of these health problems, and in free-listing of food and drink given to children under 6 months old were 29, 28, and 32, respectively. Additionally, 28 babies under 6 months old were observed at home with regard to feeding practices. Data obtained using these methods were triangulated to formulate an ethnomedical explanatory model for mothers who do not practice exclusive breast-feeding. Results The informants stated that various types of food, drink, and medicine were given to infants under 6 months old. Direct observation also confirmed that 2- to 3-month-old babies were given porridge, water, juice, herbal medicine, and over-the-counter medicine. Mothers’ perceptions of insufficient breast milk production and a lack of proper knowledge about the value of breast milk were identified in key informant interviews, free-listing, and ranking as important factors associating with the use of food and drink other than breast milk; in addition, perceived ill health of babies appears to be associated with suboptimal practice of exclusive breast-feeding. Caregivers used various folk and popular medicines from the drugstore, their own backyard or garden, and traditional healers so that the mother or child would not be exposed to perceived risks during the vulnerable period after birth. Conclusions Mothers should be advised during their antenatal and postnatal care about exclusive breast-feeding. This should be done not as a single vertical message, but in relation to their concerns about the health and nutritional problems of their babies.
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Affiliation(s)
- Akiko Matsuyama
- School of International Health Development, Nagasaki University, Nagasaki, Japan.
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Abstract
OBJECTIVE The proposed objective of this research is twofold: (1) it examines the significance of emotions to the breastfeeding experience in relation to cognition, and (2) it analyzes the extent to which emotions and cognition are connected to breastfeeding. MATERIALS AND METHODS An empirical research work has been carried out based on a questionnaire that was administered in a maternity hospital in the autumn of 2008, in order to gather information regarding cognitive and emotional aspects of breastfeeding behavior. The final sample comprised 311 breastfeeding mothers, and the sampling error was 5.55%. RESULTS The research shows that breastfeeding is not only more of an emotional reaction than a rational decision, but also demonstrates that the emotional development of breastfeeding is independent from the cognitive process. CONCLUSIONS A new approach in the literature of breastfeeding is put forward in which the predominant cognitive techniques and theories are complemented by highlighting the importance of understanding the target group and implementing suitable and affective actions. Specific practical implications are provided for social marketing campaigns as well as future lines of research.
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Affiliation(s)
- Gonzalo Díaz Meneses
- Faculty of Economics and Business Administration, University of Las Palmas de Gran Canaria, The Canary Islands, Spain.
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Morgado CMDC, Werneck GL, Hasselmann MH. Rede e apoio social e práticas alimentares de crianças no quarto mês de vida. CIENCIA & SAUDE COLETIVA 2013; 18:367-76. [DOI: 10.1590/s1413-81232013000200008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Accepted: 07/10/2011] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste trabalho foi investigar a associação entre rede e apoio social e as práticas alimentares de lactentes no quarto mês de vida. Estudo seccional com 294 crianças selecionadas em 4 Unidades de Saúde do município do Rio de Janeiro/RJ/Brasil. Para avaliar as práticas alimentares foi aplicado um recordatório 24h, para medir rede social foram feitas perguntas relacionadas ao número de amigos e parentes "com quem a mãe pode contar" e participação em atividades sociais. A versão em português da escala empregada no "Medical Outcomes Study" foi utilizada para aferir apoio social. Análises foram realizadas por meio de modelos de regressão logística multinomial. A maioria dos lactentes recebeu leite de peito (84%), mas apenas 16% o receberam exclusivamente. Crianças filhas de mães com menor número de parentes com quem contar e com baixo apoio social apresentaram maior chance de estarem em aleitamento artificial em relação ao aleitamento materno exclusivo (AME). Destaca-se a necessidade de integrar os membros da rede social da mulher à atenção pré-natal, ao parto e puerpério para prover o apoio social que atenda as suas necessidades e, assim, contribuir para manutenção do AME.
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Reinsma K, Bolima N, Fonteh F, Okwen P, Yota D, Montgomery S. Incorporating cultural beliefs in promoting exclusive breastfeeding. AFRICAN JOURNAL OF MIDWIFERY AND WOMEN'S HEALTH 2012; 6:65-70. [PMID: 26973717 DOI: 10.12968/ajmw.2012.6.2.65] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Since 2003, the World Health Organization has recommended exclusive breastfeeding for the first 6 months of life. In the Northwest region of Cameroon approximately 90% of women initiate breastfeeding, yet only 34% of these women exclusively breastfeed for the recommended six months. AIM To determine influences on women's exclusive breastfeeding practices. METHODS Semi-structured interviews were conducted with six women and six men followed by focus group discussions with three groups of women and three groups of men in the Kumbo West Health District, Northwest region, Cameroon. All participants were selected using theoretical sampling to assure triangulation. RESULTS Three themes emerged that influence exclusive breastfeeding practices: woman's readiness to exclusively breastfeed; cultural influences towards exclusive breastfeeding; and perceived constraints to exclusive breastfeeding. CONCLUSION These emergent themes were used to create a theoretical framework that is useful for developing a breastfeeding health education intervention in non-Western settings.
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Affiliation(s)
- Kathryn Reinsma
- School of Public Health, Loma Linda University, California, USA
| | | | - Florence Fonteh
- Department of Biomedical Sciences, University of Dschang, Cameroon
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Lhussier M, Bangash S, Dykes F, Zaman M, Lowe NM. Development and implementation of a nutrition intervention programme in North West Pakistan: a realist framework. Health Promot Int 2011; 27:453-62. [DOI: 10.1093/heapro/dar067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Laanterä S, Pölkki T, Ekström A, Pietilä AM. Breastfeeding attitudes of Finnish parents during pregnancy. BMC Pregnancy Childbirth 2010; 10:79. [PMID: 21126368 PMCID: PMC3003624 DOI: 10.1186/1471-2393-10-79] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 12/02/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding attitudes are known to influence infant feeding but little information exists on the prenatal breastfeeding attitudes of parents. The purpose of this study was to describe Finnish parents' prenatal breastfeeding attitudes and their relationships with demographic characteristics. METHODS The electronic Breastfeeding Knowledge, Attitude and Confidence scale was developed and 172 people (123 mothers, 49 fathers) completed the study. The data were analysed using factor analysis and nonparametric methods. RESULTS Breastfeeding was regarded as important, but 54% of the respondents wanted both parents to feed the newborn. The mean rank values of breastfeeding attitudes differed significantly when parity, gender, education, age, breastfeeding history and level of breastfeeding knowledge were considered. The respondents who were expecting their first child, were 18-26 years old or had vocational qualifications or moderate breastfeeding knowledge had more negative feelings and were more worried about breastfeeding than respondents who had at least one child, had a higher vocational diploma or academic degree or had high levels of breastfeeding knowledge. Respondents with high levels of breastfeeding knowledge did not appear concerned about equality in feeding. CONCLUSIONS Both mothers and fathers found breastfeeding important. A father's eagerness to participate in their newborn's life should be included in prenatal breastfeeding counselling and ways in which to support breastfeeding discussed. Relevant information about breastfeeding should focus on the parents who are expecting their first child, those who are young, those with low levels of education or those who have gaps in breastfeeding knowledge, so that fears and negative views can be resolved.
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Affiliation(s)
| | - Tarja Pölkki
- Institute of Health Sciences, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014 University of Oulu, Finland
| | - Anette Ekström
- School of Life Sciences, University of Skövde, PO Box 408, SE-54128 Skövde, Sweden
| | - Anna-Maija Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Social and Health Care Center of Kuopio, PO Box 1627, FI-70211, Kuopio, Finland
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Abstract
Despite the WHO recommendations that babies should be breastfed exclusively for six months and thereafter for up to two years and beyond this pattern of feeding is far from the global norm. Although breastfeeding is triggered through biological mechanisms which have not changed with time, the perception of breastfeeding as a phenomenon is variable, as it not only reflects cultural values of motherhood but is also negotiable from the perspective of the individual. This paper argues that relationships are central to encouraging breastfeeding at an organisational, family and staff-parent level. This shifts our conceptualisations away from the primary focus of breastfeeding as nutrition which, in turn, removes the notion of breastfeeding as a productive process, prone to problems and failure.
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Affiliation(s)
- Fiona Dykes
- University of Central Lancashire, Preston, UK.
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Hall Moran V, Lowe N, Crossland N, Berti C, Cetin I, Hermoso M, Koletzko B, Dykes F. Nutritional requirements during lactation. Towards European alignment of reference values: the EURRECA network. MATERNAL & CHILD NUTRITION 2010; 6 Suppl 2:39-54. [PMID: 22296250 PMCID: PMC6860587 DOI: 10.1111/j.1740-8709.2010.00276.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
There is considerable variation in reference values for micronutrient intake during lactation across Europe. The European Micronutrients Recommendations Aligned project aims to harmonize dietary recommendations throughout Europe. Recommended nutrient intakes during lactation are based on limited data and are often extrapolated from known secretion of the nutrient in milk with adjustments for bioavailability, so that differences between values can be partly ascribed to differences in methodological approaches and how these approaches were applied. Few studies have considered the impact of lactation on the mother's nutritional status. Rather, focus has been placed on the influence of maternal nutritional status on the composition of her breast milk. Most common nutritional deficits in breast milk are the result of maternal deficiencies of the water-soluble vitamins, thiamine, riboflavin and vitamins B6 and B12. Other than maternal vitamin A status, which to some extent is reflected in breast milk, concentrations of fat-soluble vitamins and most minerals in breast milk are less affected by maternal status. Factors relating to suboptimal maternal nutritional status during lactation include maternal age, diet and lifestyle factors and spacing of consecutive births. Recent research is providing new knowledge on the micronutrient requirements of lactating women. Identifying needs for research and improving understanding of the differences in values that have been derived by various committees and groups across Europe will enhance transparency and facilitate the application of dietary recommendations in policy-making decision and their translation into recommendations for lactating women. Given the wide variation in breastfeeding practices across Europe, making nutritional recommendations for lactating women is complex and challenging. Thus, it is crucial to first examine the cultural practices within and across European populations and to assess its relevance before making recommendations.
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Affiliation(s)
- Victoria Hall Moran
- Maternal & Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, Preston, PR1 2HE, UK.
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Abstract
PURPOSE The purpose of this study was to describe breastfeeding knowledge of childbearing parents as well as to discover the demographic variables related to it, and evaluate the use of a web-based survey. SUBJECTS AND METHODS The electronic Breastfeeding Knowledge, Attitude and Confidence scale was developed, and the data were collected at eight maternity healthcare clinics in Finland. All the families who visited those clinics between March 2 and April 3, 2009 were invited to the study, and 123 pregnant mothers and 49 fathers completed the survey. FINDINGS AND CONCLUSIONS The respondents correctly answered 68% of the items related to breastfeeding knowledge. The most usual lack of knowledge concerned how to increase lactation, sufficiency of breast milk in hot weather, sufficiency of breast milk for 4 months after birth, and the need to pump the breasts after alcohol consumption. Differences in the breastfeeding scores existed when gender, parity, age, living with spouse, educational level, smoking, time of pregnancy and breastfeeding history were considered. The web-based survey was well suited to the data collection, but the weak response rate requires attention. Parents need more information about ways to increase lactation and reasons to start complementary feeding.
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Hermoso M, Tabacchi G, Iglesia-Altaba I, Bel-Serrat S, Moreno-Aznar LA, García-Santos Y, García-Luzardo MDR, Santana-Salguero B, Peña-Quintana L, Serra-Majem L, Moran VH, Dykes F, Decsi T, Benetou V, Plada M, Trichopoulou A, Raats MM, Doets EL, Berti C, Cetin I, Koletzko B. The nutritional requirements of infants. Towards EU alignment of reference values: the EURRECA network. MATERNAL & CHILD NUTRITION 2010; 6 Suppl 2:55-83. [PMID: 22296251 PMCID: PMC6860534 DOI: 10.1111/j.1740-8709.2010.00262.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This paper presents a review of the current knowledge regarding the macro- and micronutrient requirements of infants and discusses issues related to these requirements during the first year of life. The paper also reviews the current reference values used in European countries and the methodological approaches used to derive them by a sample of seven European and international authoritative committees from which background scientific reports are available. Throughout the paper, the main issues contributing to disparities in micronutrient reference values for infants are highlighted. The identification of these issues in relation to the specific physiological aspects of infants is important for informing future initiatives aimed at providing standardized approaches to overcome variability of micronutrient reference values across Europe for this age group.
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Affiliation(s)
- Maria Hermoso
- Division of Metabolic Diseases and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
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Locke A. 'Natural versus taught': competing discourses in antenatal breastfeeding workshops. J Health Psychol 2009; 14:435-46. [PMID: 19293305 DOI: 10.1177/1359105309102200] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article is an analysis of talk in breastfeeding workshops that are part of National Childbirth Trust antenatal classes. Using audio-recordings from breastfeeding workshops antenatal classes, the data were analysed using a qualitative, discursive methodology based in part on the premises outlined by Potter and Wetherell (1987) and Edwards and Potter (1992, 2001). The analysis demonstrates how there are two main discourses of breastfeeding constructed by the breastfeeding counsellor-breastfeeding as natural, and breastfeeding as learnt. In particular, it notes how these two main discourses of breastfeeding that are seemingly in competition with one another, operate concurrently within the teaching of breastfeeding, and enable the breastfeeding counsellor to manage issues and concerns around breastfeeding.
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