IYCF Practices, Beliefs, and Influences in SNNP ... - Alive & Thrive

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and gain weight,” “the child wanted to eat more,” and “feeding more food will hasten the recovery.” Othermothers said that they keep on feeding children the same way they did when the child was ill andexplained that they do this because ill children do not have a good appetite and are unable to eat more.They were concerned that the child would vomit if forced to eat more. Some mothers reported that theybreastfeed their recovering child more frequently but are not willing to give other foods. A mother inMareka explained that she breastfeeds frequently because she wants to see her child “cured completely,become strong and look beautiful.”When told that the recommendation is to increase the amount of food for two weeks after an episode ofillness, many mothers, in all three areas, said they are willing to do so if advised to by a health worker.Almost all of the FGD participants agreed that giving a child more food during the recovery periodmakes sense and would help a child to restore what had been lost during the illness.4.2 What are key factors? How can mothers and family members be motivated to adoptrecommended practices and improve young child feeding?• Mothers and community members already recognize the connection between good feedingpractices and healthy, growing childrenInterviews and FGDs in all three communities revealed a high value placed on having healthy, growingchildren, and an existing understanding of the connection between child feeding and growth and health.Those who perceive children as doing well and growing strong in their community were asked forreasons. In unprompted responses, improved child feeding was ranked in third place, followingimmunization and improved access to health services. Children were thought to be healthy becausethey are fed a variety of nutritious foods and specific foods, such as mixtures of grain, milk, and eggs.Similarly those mothers who said that children in the community are doing poorly mentioned poorfeeding practices or lack of specific foods as one of the main reasons. Mothers expressed a strong desirefor children to be healthy and to grow up “strong and fat,” and many mothers mentioned this desire asone of the main motivators for recent changes that they had made to improve feeding of their child. Inaddition, several mothers also spoke of the importance of child feeding for good mental development andof a desire for children to grow up intelligent, become educated and have a good future.Illness in the communities, especially malaria and diarrheal diseases, were also mentioned by many asreasons for poor growth in children. In addition to immunizations, medical care, and good hygiene,feeding the child well and feeding of specific foods are seen as key strategies to protect children fromillness. Many mothers mentioned specifically that good food helps children fight illness.• Many mothers are well aware of key breastfeeding messages, but less aware of specific messagesand recommended practices for complementary feedingMost of the mothers interviewed know the key messages for breastfeeding and spoke specifically aboutbreastfeeding on demand, the number of times to breastfeed, and breastfeeding for at least 2 years. Theystressed the importance to giving only breastmilk for the first six months. Many of those who are22
following recommended practices were able to explain the justification for doing so and mentioned thatthey tried the new practices after learning from a HEW or a clinic health worker.Most mothers know to start introducing foods at 6 months and are able to recite the reasons not to giveother fluids or start solid foods too early. Many mothers also know to prepare soft foods and gruels fortheir child, with some mentioning specifically the importance of using several grains and pulses. A fewmothers are aware of the need to add other foods to enhance the gruel, mentioning oil, butter, milk orvegetables. Mothers and community members also know of the recommendation to feed a variety offoods to the child, with many mentioning giving their child specific fruits, vegetables, milk products,eggs and animal products. Most of the understanding, however, appears to be focused on the idealsituation, with mothers less confident about identifying healthy options that could easily be prepared athome.Fewer mothers appeared to know key messages related to feeding frequency, quantity and feedingduring illness. Only a few mothers know how many times it is recommended to feed children ofdifferent age groups. Even though educational materials and posters illustrate the recommendedquantity of food (in terms of coffee cups) for each meal, there was no mention in any of the discussionsabout food quantity. There was also some confusion with messages about increasing fluids andcontinuing to give food during illness, and there was very little mention of increased feeding afterillness for recovery.• Mothers already prepare special foods for young children and feed them separatelyMothers in all three areas customarily prepare and feed gruels and porridge for young children.Although observations showed that food preparations are often more of a liquid than a semi-solid form,at least the basic practice is in place and can be built on and improved. All HEWs stressed the need toeducate mothers about adding nutritious foods to porridge.• Common practice of bottle feeding and challenge of feeding child while mother is awayBottle feeding was identified, in all three communities, not so much as a substitute for breastfeeding, butas a preferred way to serve liquids and thin gruels to young children. Bottle use appears to be one of themajor reasons why gruels are made too thin. While cup and spoon feeding is recommended for children,mothers rarely mentioned using spoons for feeding children (during interviews) and they rarelypracticed this behavior (during household observations). Mothers, fathers, grandmothers, andcommunity leaders explained that the traditional method of feeding young children is to use a cup andthe mother’s hand, and that there is some concern in the community that using the hand for feeding inthis way is unhygienic. Feeding from a bottle is perceived as a more hygienic option in the community,even by one VHCW, who said he promotes bottle feeding for this reason. In addition, because the foodis thin and liquid, bottle feeding is also seen as a clean way to feed with less spillage.Bottles are also viewed as a convenient and clean way for storing infant foods for later use. Motherscommented that it is easy for family members to feed a child with a bottle during their absence. HEWsare already convinced of the problems associated with bottle feeding but say that VCHPs and manycommunity members do not yet see this as a problem.23
Page 5: AcknowledgmentsAlive & Thrive ackno
Page 8 and 9: GlossaryAabilaAtekanaBessoBullaChik
Page 10 and 11: contribution towards child growth a
Page 12 and 13: 1. BackgroundIn Ethiopia, A&T’s g
Page 14 and 15: 3.2 Sampling techniquesSite Selecti
Page 16 and 17: • Evening discussions were held t
Page 18 and 19: important for protection. A few mot
Page 20 and 21: Other mothers in these areas with o
Page 22 and 23: Consistency of foods. Children are
Page 24 and 25: In the mother interviews, some moth
Page 26 and 27: “To feed the child meat, fish, an
Page 28 and 29: When mothers were asked how they en
Page 32 and 33: • Some mothers are already giving
Page 34 and 35: Mothers explained that husbands are
Page 36 and 37: HEWs. Most mothers who talked about
Page 38 and 39: Working more with VCHPs could also
Page 40 and 41: 5. Summary and Implications for Pro
Page 42: other hand, the potential burden of

IYCF Practices, Beliefs, and Influences in SNNP ... - Alive & Thrive

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