University of California, Berkeley, USA.
Department of Preventive & Restorative Dental Sciences and Center to Address Children's Oral Health, University of California, San Francisco, USA.
J Health Popul Nutr. 2020 Jul 27;39(1):7. doi: 10.1186/s41043-020-00215-w.
Childhood malnutrition has been a longstanding crisis in Mumbai, India. Despite national IYCF (Infant Young Child Feeding) guidelines to promote best practices for infant/toddler feeding, nearly one-third of children under age five are stunted or underweight. To improve child nutrition, interventions should address the cultural, social, and environmental influences on infant feeding practices. This study is an in-depth qualitative assessment of family barriers and facilitators to implementing recommended nutrition practices in two Mumbai slum communities, within the context of an existing nutrition education-based intervention by a local non-governmental non-profit organization.
The population was purposively sampled to represent a variety of household demographics. Data were collected through 33 in-depth semi-structured interviews with caregivers (mothers and paternal grandmothers) of children age 0-2 years. Transcripts were translated and transcribed, and analyzed using qualitative analysis procedures and software.
A complex set of barriers and facilitators influence mothers'/caregivers' infant-toddler feeding practices. Most infants were fed complementary foods and non-nutritious processed snacks, counter to IYCF recommendations. Key barriers included: lack of nutrition knowledge and experience, receiving conflicting messages from different sources, limited social support, and poor self-efficacy for maternal decision-making. Key facilitators included: professional nutrition guidance, personal self-efficacy and empowerment, and family support. Interventions to improve child nutrition should address mothers'/caregivers' key barriers and facilitators to recommended infant-toddler feeding practices.
Nutrition interventions should prioritize standard messaging across healthcare providers, engage all family members, target prevention of early introduction of sugary and non-nutritious processed foods, and strengthen maternal self-efficacy for following IYCF recommended guidelines.
印度孟买的儿童营养不良问题由来已久。尽管国家婴幼儿喂养（Infant Young Child Feeding，IYCF）指南提倡最佳婴幼儿喂养实践，但仍有近三分之一的五岁以下儿童发育迟缓或体重不足。为改善儿童营养状况，干预措施应针对影响婴幼儿喂养实践的文化、社会和环境因素。本研究深入评估了两个孟买贫民窟社区中家庭在实施推荐营养实践方面的障碍和促进因素，这是一个地方非营利性非政府组织在现有营养教育干预基础上进行的研究。
采用目的抽样法，以代表各种家庭人口统计学特征的方式对人群进行抽样。通过对 33 名 0-2 岁儿童的照顾者（母亲和祖母）进行深入的半结构化访谈来收集数据。对访谈记录进行翻译和转录，并使用定性分析程序和软件进行分析。
一系列复杂的障碍和促进因素影响着母亲/照顾者对婴幼儿的喂养实践。大多数婴儿都食用补充食品和非营养加工零食，与 IYCF 建议相悖。主要障碍包括缺乏营养知识和经验、从不同来源收到相互矛盾的信息、社会支持有限以及母亲在育儿决策方面的自我效能感低。主要促进因素包括专业的营养指导、个人的自我效能感和赋权、以及家庭支持。改善儿童营养的干预措施应针对母亲/照顾者在推荐婴幼儿喂养实践方面的主要障碍和促进因素。
营养干预措施应优先在医疗保健提供者中传递统一的信息，让所有家庭成员参与，并以预防早期引入含糖和非营养加工食品为目标，同时增强母亲遵循 IYCF 推荐指南的自我效能感。
