Consumer testing of the preliminary Paediatric Food-Based Dietary Guidelines (PFBDG) among mothers with infants younger than 6 months in selected urban and rural areas in the Western Cape

Aim: To determine the comprehensibility of the preliminary paediatric food-based dietary guidelines (PFBDG) for infants younger than 6 months in South Africa. Methods: This qualitative study used focus group discussions held in the Western Cape to evaluate the comprehensibility and the understandability of the preliminary PFBDG. Groups were convened according to area of residence (rural, urban formal and urban informal) and ethnicity (white, coloured and black) to reflect the Western Cape population. Focus group discussions were conducted in the participant's home language, namely Afrikaans, English or Xhosa. The purposive sample included 89 women with infants younger than 6 months divided in 20 groups. Results: In general, mothers understood the guidelines and could reportedly implement them, but constraints such as having to go back to work, being tired and not having enough breast-milk were volunteered. There were very few problems regarding the PFBDG terminology except with the word ‘regularly' in the context of the oral hygiene guideline. With regard to the breast-feeding guideline there was some confusion over whether other foods could be included while breast-feeding. Suggestions were made to include ‘only' in the breast-feeding guideline. Some of the participants did not know anything about cleaning the infant's mouth, and suggested it be changed to the overall hygiene of the infant. Conclusion: The findings from this study indicate that it may be possible to use one set of dietary guidelines for infants younger than 6 months for all ethnic groups living in the Western Cape, provided that these guidelines are accompanied by supportive documentation citing examples and reasons for the implementation of the guidelines. Recommendations were made for the PFBDG Work Group to revise the preliminary PFBDG for infants younger than 6 months for implementation and further action