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

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