Semega-Janneh I J, Bøhler E, Holm H, Matheson I, Holmboe-Ottesen G
Nutrition Unit, Department of State for Health, The Gambia, Institute for Nutrition Research, University of Oslo, Norway.
Health Policy Plan. 2001 Jun;16(2):199-205. doi: 10.1093/heapol/16.2.199.
Sub-optimal breastfeeding practices still prevail in many countries, especially in traditional rural communities. Despite high breastfeeding initiation rates and long total duration of breastfeeding, exclusive breastfeeding is a rare practice. In the present study, quantitative methods were used to identify current infant feeding practices in 12 rural communities in The GAMBIA: Results indicated that delayed initiation of breastfeeding, prelacteal feeding and failure to practice exclusive breastfeeding were widespread. Qualitative data further indicated that current beliefs and practices were strongly influenced by traditional beliefs and practices. These were kept very much alive by elders, both women and men, including husbands. The results also showed an unexpected support for bottle-feeding from both male and female elders who considered it part of the modernization process. A strategy for promoting early initiation of breastfeeding, feeding of colostrum and exclusive breastfeeding for 6 months in rural communities should therefore incorporate traditional beliefs and practices into modern messages on optimal breastfeeding. Traditional beliefs and practices in the study setting that could be used in this way included knowledge from the population's acquaintance with the newborns of their livestock. It also included the traditional practice of mothers taking their very young children with them when going to work in the fields. The paper suggests such a strategy by developing a matrix to establish linkages between modern and traditional knowledge on a specific practice. Such linkages facilitate the acceptance of recommendations on infant feeding by mothers in these communities. The strategy recommends an expanded target group to include elders and husbands, as the data show that these groups are highly influential in matters regarding patterns of child feeding.
在许多国家，尤其是传统农村社区，次优母乳喂养做法仍然普遍存在。尽管母乳喂养开始率较高且母乳喂养总时长较长，但纯母乳喂养却很少见。在本研究中，采用定量方法来确定冈比亚12个农村社区当前的婴儿喂养做法：结果表明，母乳喂养开始延迟、开奶前喂养以及未进行纯母乳喂养的情况普遍存在。定性数据进一步表明，当前的观念和做法受到传统观念和做法的强烈影响。包括丈夫在内的男女长辈使这些传统观念和做法得以长久留存。结果还显示，男性和女性长辈对奶瓶喂养意外地表示支持，他们认为这是现代化进程的一部分。因此，在农村社区推广早开奶、初乳喂养和6个月纯母乳喂养的策略应将传统观念和做法纳入关于最佳母乳喂养的现代信息中。研究环境中的传统观念和做法可通过这种方式加以利用，其中包括人们对家畜幼崽的了解。这还包括母亲在田间劳作时带着年幼孩子的传统做法。本文通过制定一个矩阵来建立关于特定做法的现代知识与传统知识之间的联系，从而提出了这样一种策略。这种联系有助于这些社区的母亲接受关于婴儿喂养的建议。该策略建议扩大目标群体，将长辈和丈夫纳入其中，因为数据显示这些群体在儿童喂养模式相关问题上具有很大影响力。
