Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, Georgia 30322, USA.
Matern Child Nutr. 2012 Apr;8(2):199-214. doi: 10.1111/j.1740-8709.2010.00272.x. Epub 2010 Sep 28.
This study aimed to document whether food insecurity was associated with beliefs and attitudes towards exclusive breastfeeding (EBF) among urban Kenyan women. We conducted structured interviews with 75 human immunodeficiency virus (HIV)-affected and 75 HIV-status unknown, low-income women who were either pregnant or with a child ≤24 months and residing in Nakuru, Kenya to generate categorical and open-ended responses on knowledge, attitudes and beliefs towards EBF and food insecurity. We facilitated six focus group discussions (FGD) with HIV-affected and HIV-status unknown mothers (n = 50 women) to assess barriers and facilitators to EBF. Of 148 women with complete interview data, 77% were moderately or severely food insecure (FIS). Women in FIS households had significantly greater odds of believing that breast milk would be insufficient for 6 months [odds ratio (OR), 2.6; 95% confidence interval (95% CI), 1.0, 6.8], that women who EBF for 6 months would experience health or social problems (OR, 2.7; 95% CI, 1.0, 7.3), that women need adequate food to support EBF for 6 months (OR, 2.6; 95% CI, 1.0, 6.7) and that they themselves would be unable to follow a counsellor's advice to EBF for 6 months (OR, 3.2; 95% CI, 1.3, 8.3). Qualitative analysis of interview and FGD transcripts indicated that the maternal experience of hunger contributes to perceived milk insufficiency, anxiety about infant hunger and a perception that access to adequate food is necessary for successful breastfeeding. The lived experience of food insecurity among a sample of low-income, commonly FIS, urban Kenyan women reduces their capacity to implement at least one key recommended infant feeding practices, that of EBF for 6 months.
本研究旨在记录粮食不安全是否与肯尼亚城市女性对纯母乳喂养（EBF）的信念和态度有关。我们对 75 名艾滋病毒（HIV）感染者和 75 名 HIV 状况未知的低收入妇女进行了结构化访谈，这些妇女处于怀孕或有 24 个月以下儿童的状态，并居住在肯尼亚纳库鲁，以生成有关 EBF 和粮食不安全的知识、态度和信念的分类和开放式回答。我们组织了六次焦点小组讨论（FGD），有 HIV 感染者和 HIV 状况未知的母亲参加（50 名女性），以评估 EBF 的障碍和促进因素。在有完整访谈数据的 148 名妇女中，有 77%的人处于中度或重度粮食不安全状态（FIS）。处于 FIS 家庭的妇女更有可能认为母乳在 6 个月内不足[比值比（OR），2.6；95%置信区间（95%CI），1.0，6.8]，6 个月内进行 EBF 的妇女会出现健康或社会问题（OR，2.7；95%CI，1.0，7.3），妇女需要足够的食物来支持 6 个月的 EBF（OR，2.6；95%CI，1.0，6.7），以及她们自己无法遵循顾问的建议进行 6 个月的 EBF（OR，3.2；95%CI，1.3，8.3）。访谈和 FGD 记录的定性分析表明，母亲的饥饿感会导致认为母乳不足、对婴儿饥饿的焦虑以及认为获得足够的食物是成功母乳喂养的必要条件。在一个低收入、普遍粮食不安全的肯尼亚城市妇女样本中，粮食不安全的实际经历降低了她们实施至少一项关键推荐婴儿喂养实践的能力，即 6 个月内进行纯母乳喂养。
