Jeanine Ahishakiye1,2, Lenneke Vaandrager3, Inge D Brouwer4, Maria Koelen3. 1. Department of Human Nutrition and Dietetics, College of Medicine and Health Sciences, University of Rwanda, P.O Box 3286, Kigali, Rwanda. jahishakiye@nursph.org. 2. Health and Society Chair Group, Wageningen University and Research, P.O Box 8130, 6700EW Wageningen, The Netherlands. jahishakiye@nursph.org. 3. Health and Society Chair Group, Wageningen University and Research, P.O Box 8130, 6700EW Wageningen, The Netherlands. 4. Division of Human Nutrition and Health, Wageningen University and Research, P.O Box 17, 6700AA Wageningen, The Netherlands.
Abstract
BACKGROUND: Mothers in low-income countries face many challenges to appropriately feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child's life. METHODS: This qualitative longitudinal study recruited a purposive sample of 17 mothers who followed the infant and young child feeding recommendations (IYCF). They were selected from a larger study of 36 mothers. In-depth interviews were conducted with mothers of the total group (36 mothers) within the first week, at 4th, 6th, 9th and 12th months postpartum. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. RESULTS: Coping strategies included improving mothers' own diet for adequate breastmilk production, prioritizing child feeding over livelihood chores, livelihood diversification and mothers' anticipatory behaviors such as preparing child's food in advance. Some of those coping strategies were shifting overtime depending on the development of the children. Personal factors such as breastfeeding self-efficacy, religious beliefs and perceived benefits of breastfeeding were among the facilitating factors. Additionally, social support that mothers received from family members, other mothers in the community, Community Health Workers (CHWs) and health professionals played an important role. CONCLUSION: In challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support. Nutrition promotion interventions that aim to improve IYCF should consider strengthening mothers' capability in gaining greater control of their IYCF practices and the factors facilitating their appropriate IYCF practices.
BACKGROUND: Mothers in low-income countries face many challenges to appropriately feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child's life. METHODS: This qualitative longitudinal study recruited a purposive sample of 17 mothers who followed the infant and young child feeding recommendations (IYCF). They were selected from a larger study of 36 mothers. In-depth interviews were conducted with mothers of the total group (36 mothers) within the first week, at 4th, 6th, 9th and 12th months postpartum. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. RESULTS: Coping strategies included improving mothers' own diet for adequate breastmilk production, prioritizing child feeding over livelihood chores, livelihood diversification and mothers' anticipatory behaviors such as preparing child's food in advance. Some of those coping strategies were shifting overtime depending on the development of the children. Personal factors such as breastfeeding self-efficacy, religious beliefs and perceived benefits of breastfeeding were among the facilitating factors. Additionally, social support that mothers received from family members, other mothers in the community, Community Health Workers (CHWs) and health professionals played an important role. CONCLUSION: In challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support. Nutrition promotion interventions that aim to improve IYCF should consider strengthening mothers' capability in gaining greater control of their IYCF practices and the factors facilitating their appropriate IYCF practices.
Authors: Jennifer Burns; Jillian A Emerson; Kimberly Amundson; Shannon Doocy; Laura E Caulfield; Rolf D W Klemm Journal: Food Nutr Bull Date: 2016-04-06 Impact factor: 2.069
Authors: Theogene Dusingizimana; Janet L Weber; Thiagarajah Ramilan; Per O Iversen; Louise Brough Journal: Public Health Nutr Date: 2020-07-02 Impact factor: 4.022
Authors: Stephen Arpadi; Ashraf Fawzy; Grace M Aldrovandi; Chipepo Kankasa; Moses Sinkala; Mwiya Mwiya; Donald M Thea; Louise Kuhn Journal: Am J Clin Nutr Date: 2009-06-24 Impact factor: 7.045
Authors: Jeanine Ahishakiye; Laura Bouwman; Inge D Brouwer; Eric Matsiko; Margaret Armar-Klemesu; Maria Koelen Journal: J Health Popul Nutr Date: 2019-12-12 Impact factor: 2.000