Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.
Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA.
Matern Child Nutr. 2018 Apr;14(2):e12537. doi: 10.1111/mcn.12537. Epub 2017 Oct 4.
Worldwide, mothers with young children receive many messages about infant feeding. Some messages are generated by health providers and others by the households, communities, and social contexts in which women live. We aimed to determine the scope of infant feeding messages in urban Haiti and to examine intracultural differences in salience of these messages and their alignment with international guidelines. We applied the method of free listing with 13 health workers and 15 human immunodeficiency virus (HIV)-infected and 15 HIV-uninfected mothers with infants 0-6 months old at Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince, Haiti. Participants listed all messages women receive about infant feeding and specifically about HIV and infant feeding. Message salience was determined by frequency of mention and recall order; messages were coded for key themes. For all groups, the World Health Organization infant feeding recommendations were salient, especially those related to exclusive breastfeeding. Messages across all groups focused on infant health outcomes, with less emphasis on maternal outcomes. Cultural beliefs were also elicited and showed higher salience for mothers than health workers, particularly for consequences of poor maternal nutrition. Health workers' free lists were poorly correlated to those of mothers, whereas those of mothers were highly correlated, regardless of HIV status. Inasmuch as many salient messages were culturally generated, and differences existed between mothers and health workers, we conclude that it is important for health workers to acknowledge the broader infant feeding message environment, and discrepancies within that environment, to address successes and failures in the messages reaching mothers, given potential consequences for mothers' breastfeeding behaviours.
在全球范围内，有年幼子女的母亲会收到许多有关婴儿喂养的信息。其中一些信息是由卫生提供者提供的，另一些则是由妇女生活的家庭、社区和社会环境提供的。我们旨在确定海地城市中婴儿喂养信息的范围，并研究这些信息的显著性在不同文化群体之间的差异及其与国际指南的一致性。我们应用自由列举法，在海地太子港的海地卡波西肉瘤和机会性感染研究小组（Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes）中，对 13 名卫生工作者以及 15 名艾滋病毒感染者和 15 名艾滋病毒阴性的 0-6 个月大婴儿母亲进行了调查。参与者列出了妇女们收到的所有关于婴儿喂养以及特别关于艾滋病毒和婴儿喂养的信息。信息的显著性通过提及的频率和回忆的顺序来确定；信息按关键主题进行编码。对于所有群体，世界卫生组织的婴儿喂养建议都很显著，尤其是那些关于纯母乳喂养的建议。所有群体的信息都集中在婴儿的健康结果上，而对母亲的结果关注较少。还引出了文化信仰，这些信仰对母亲的重要性高于卫生工作者，尤其是对不良产妇营养后果的重视。卫生工作者的自由清单与母亲的清单相关性较差，而母亲的清单相关性很高，无论其艾滋病毒状况如何。由于许多显著的信息是文化产生的，而且母亲和卫生工作者之间存在差异，我们得出结论，卫生工作者必须承认更广泛的婴儿喂养信息环境，以及该环境中的差异，以解决传达给母亲的信息的成败问题，因为这对母亲的母乳喂养行为可能会产生潜在影响。
