Cry, the beloved bottle: infant-feeding knowledge and the practices of mothers and caregivers in an urban township outside Bloemfontein, Free State province

Objectives: To investigate knowledge of and practices regarding bottle-feeding preparation, as well as the nutrient content and microbial safety of bottles that are prepared by mothers and caregivers for infants aged 0-24 months.Design: Cross-sectional descriptive survey.Setting: Urban township, Mangaung, outside Bloemfontein.Subjects: A sample of 189 mothers or caregivers of healthy infants aged 0-24 months, who were exclusively formula fed or mixed fed with breast milk and infant formula or cow’s milk, were randomly selected in a household survey.Outcome measures: An interviewer-administered questionnaire and/or observed practices were used for data collection. Bottle-feed samples were also collected and analysed for nutrient and microbial content.Results: Mother and caregiver knowledge on infant feeding was poor. An acceptable method for preparing a bottle feed in five steps was evaluated. Only 4.2% of the total sample applied all five steps. A total of 84.5% (n = 160) of all the collected feeds was contaminated with E coli. A lower level of maternal education was associated with a greater likelihood of feed contamination. The predominant source of bottlefeeding preparation information was clinic staff (28%).Conclusion: The findings were indicative of a lack of knowledge, and possibly resource limitations, to facilitate safe bottle-feeding practices. Acknowledgement of clinic staff as a source of infant-feeding information highlights the role of healthcare workers as facilitators of appropriate infant-feeding practices.Keywords: infant feeding practices, breastfeeding, bottle feeding, mixed feedin