Feeding practices of mothers and/or caregivers of infants below the age of 6 months in South Africa

MSc (Nutrition), North-West University, Potchefstroom Campus, 2015Background: Breastfeeding is widely recognised as the ideal approach for improving child survival and feeding new-born babies and young infants. The World Health Organisation (WHO) recommends exclusive breastfeeding (EBF) for the first 6 months of life with timely introduction of complementary foods at 6 months and continued breastfeeding for up to two years and beyond. The feeding practices of mothers are widely influenced by different factors which may be embedded within different contexts of life. Aim: This study explored the infant feeding practices of mothers and/or caregivers of infants below the age of 6 months. Method: This cross sectional study was conducted in four provinces in South Africa. In total, 40 health facilities were randomly selected in the four provinces and visited including metropolitan and non-metropolitan health facilities over the geographical area of the provinces. Fixed structured interviews were conducted and data on the feeding practices of mothers were collected using a questionnaire which had both open and closed-ended questions. Qualitative data were coded under different themes. The sample size comprised of mothers and/or caregivers of babies aged 6 months and below. A 24-hour recall was completed for all infants. Dietary intake and diversity were assessed using the FAO dietary diversity list consisting of 12 different food groups. Descriptive statistics, crosstabs and Pearson chi-square tests were used. Results: A total of 580 mothers/caregivers of infants below the age of 6 months were interviewed. Ninety-five % (n=551) were biological mothers. A total of 490 (85%) were breastfeeding at the time of the interviews. Ninety % had initiated breastfeeding during the first hour after delivery. At the time of the study, 12% (n=4) of the women were practising exclusive breastfeeding (EBF) for the recommended 6 months. Sixteen % (n=90) were not breastfeeding at the time the interviews were conducted. More than two thirds (64%) had exclusively breastfed their infants but stopped at the time of the interviews and 36% (n=32) did not breastfeed their babies at all. Twelve % (n=4) of the mothers stopped breastfeeding from as early as one month. The most cited reasons by the participants for breastfeeding cessation were the need to return to work or school. Reasons for not breastfeeding at all included the mothers HIV status, poor health and insufficient milk production. Forty-one % (n=239) of the mothers believed that breastfeeding contains adequate nutrients for the child and 5.7% (33) did not know why breastfeeding is important. Nearly half (49%) were giving infant feeding formula. Seventy % (n=220) of the women were giving either infant feeding formula or other liquids in addition to breast milk. The most stated reason for giving other liquids or foods was the belief that breast milk was not enough for the infant. Almost two thirds (56%) of the mothers gave their infants fortified infant feeding formula. Only one infant (0.2%) met the minimum standard of dietary diversity. Complementary food was introduced from as early as one month, and 73% of the women reported that their infants were receiving dietary supplements. Conclusion: Breastfeeding still remains a universal practice in the country. Sustained exclusive breastfeeding is still a cause of concern and 6 month EBF rates remain very low. Both mothers and caregivers had sound understanding of the importance of breastfeeding. Early initiation of complementary foods is still a norm and wide problem in the country. The dietary diversity of complementary diets given to babies was nutritionally inadequate.Master