Mlambo Motlatso G, Peltzer Karl
Department of Institutional Research and Business Intelligence, Risk and Advisory Services, University of South Africa, Pretoria, South Africa.
Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Health SA. 2020 Aug 5;25:1372. doi: 10.4102/hsag.v25i0.1372. eCollection 2020.
Despite enormous interventions aimed at preventing mother-to-child transmission (MTCT) of HIV, cultural practices on mixed infant feeding remain prevalent. Complementary food provision to infants seems to be the most common and acceptable form of infant feeding highly endorsed by grandmothers.
This study aimed to explore the perceptions of grandmothers and HIV-infected mothers on infant feeding practices in the context of prevention of mother-to-child transmission.
This study was undertaken in two primary healthcare facilities in the Mpumalanga province, South Africa.
A qualitative exploratory narrative design was used to conduct four focus group discussions with 32 purposefully selected grandmothers and 21 in-depth interviews with postnatal HIV-infected women in the two identified health facilities. Data were analysed using an interthematic inductive analysis approach, resulting in major themes and subthemes supported by participants' excerpts.
Four themes emerged showing (1) high mixed feeding endorsement because of the need to adhere to conventional practices, strengthen the umbilicus and have fuller, fat and calmer babies; (2) infant feeding fallacies and stigma reflected by exclusive breastfeeding period confusion, breastfeeding scepticism and infant feeding stigma; (3) breastfeeding endorsement for other disease prevention and family support for breastfeeding and (4) conflict between traditional and western infant feeding approaches.
Total elimination of MTCT of HIV in a rural context calls for targeted education for grandmothers addressing their perceptions and practices of infant feeding. The knowledge of the identified factors encouraging mixed infant feeding can assist in designing programmes to change community beliefs on infant feeding. Cultural, social and psychosocial factors should be addressed when making recommendations for exclusive breastfeeding for HIV-positive mothers.
尽管为预防艾滋病毒母婴传播（MTCT）采取了大量干预措施，但混合喂养的文化习俗仍然普遍存在。为婴儿提供辅食似乎是最常见且可接受的喂养方式，得到了祖母们的高度认可。
本研究旨在探讨祖母和感染艾滋病毒的母亲在预防母婴传播背景下对婴儿喂养方式的看法。
本研究在南非姆普马兰加省的两个初级卫生保健机构开展。
采用定性探索性叙事设计，在两个选定的卫生机构与32名经过特意挑选的祖母进行了四次焦点小组讨论，并对21名产后感染艾滋病毒的妇女进行了深入访谈。使用主题间归纳分析方法对数据进行分析，得出主要主题和子主题，并辅以参与者的摘录。
出现了四个主题，分别是：（1）由于需要遵循传统习俗、强化脐带以及让婴儿更丰满、肥胖和安静，所以高度认可混合喂养；（2）婴儿喂养误区和耻辱感，表现为对纯母乳喂养期的困惑、对母乳喂养的怀疑以及婴儿喂养耻辱感；（3）认可母乳喂养对预防其他疾病的作用以及家庭对母乳喂养的支持；（4）传统与西方婴儿喂养方式之间的冲突。
要在农村地区彻底消除艾滋病毒母婴传播，就需要针对祖母开展有针对性的教育，解决她们对婴儿喂养的看法和做法。了解那些鼓励混合喂养的因素有助于设计相关项目，以改变社区对婴儿喂养的观念。在为感染艾滋病毒的母亲推荐纯母乳喂养时，应考虑文化、社会和心理社会因素。
