Jessri Mahsa, Farmer Anna P, Olson Karin
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Human Nutrition Division, Alberta Institute of Human Nutrition, and The Center for Health Promotion Studies, University of Alberta, Edmonton, Alberta, Canada.
Matern Child Nutr. 2015 Oct;11(4):673-86. doi: 10.1111/mcn.12048. Epub 2013 Jun 18.
The aim of this study was to examine the barriers to following complementary feeding guidelines among Middle Eastern mothers and the cultural considerations of practitioners from an emic perspective. This is a two-phase focused ethnographic assessment of infant feeding among 22 Middle Eastern mothers in Western Canada who had healthy infants aged <1 year. Data were collected through four focus groups conducted in Arabic/Farsi, and were further complemented by comprehensive survey data collected in the second phase of study. Mothers' main criterion for choosing infant foods was whether or not foods were Halal, while food allergens were not causes for concern. Vitamin D supplements were not fed to 18/22 of infants, and mashed dates (Halawi), rice pudding (Muhallabia/Ferni) and sugared water/tea were the first complementary foods commonly consumed. Through constant comparison of qualitative data, three layers of influence emerged, which described mothers' process of infant feeding: socio-cultural, health care system and personal factors. Culture was an umbrella theme influencing all aspects of infant feeding decisions. Mothers cited health care professionals' lack of cultural considerations and lack of relevance and practicality of infant feeding guidelines as the main reasons for ignoring infant feeding recommendations. Early introduction of pre-lacteal feeds and inappropriate types of foods fed to infants among immigrant/refugee Middle Eastern mothers in Canada is cause of concern. Involving trained language interpreters in health teams and educating health care staff on cultural competency may potentially increase maternal trust in the health care system and eventually lead to increased awareness of and adherence to best practices with infant feeding recommendations.
本研究的目的是从中位视角审视中东母亲遵循辅食喂养指南的障碍以及从业者的文化考量。这是一项针对加拿大西部22名有1岁以下健康婴儿的中东母亲进行的两阶段重点人种志婴儿喂养评估。数据通过以阿拉伯语/波斯语进行的四个焦点小组收集，并在研究的第二阶段收集的综合调查数据进一步补充。母亲选择婴儿食品的主要标准是食品是否为清真食品，而食物过敏原并不令人担忧。22名婴儿中有18名未服用维生素D补充剂，捣碎的枣（哈拉维）、大米布丁（穆哈拉比亚/费尔尼）和糖水/茶是常见的首批辅食。通过对定性数据的不断比较，出现了三层影响因素，描述了母亲的婴儿喂养过程：社会文化、医疗保健系统和个人因素。文化是影响婴儿喂养决策各个方面的一个总主题。母亲们指出，医疗保健专业人员缺乏文化考量以及婴儿喂养指南缺乏相关性和实用性是忽视婴儿喂养建议的主要原因。加拿大中东移民/难民母亲中过早引入哺乳前喂养以及给婴儿喂食不适当类型的食物令人担忧。在医疗团队中配备训练有素的语言口译员，并对医护人员进行文化能力培训，可能会增加母亲对医疗保健系统的信任，并最终提高对婴儿喂养建议最佳做法的认识和依从性。
