Makerere University College of Health Sciences, School of Public Health, New Mulago Hospital Complex, P.O. Box 22864, Kampala, Uganda.
BMC Pregnancy Childbirth. 2021 Jan 30;21(1):100. doi: 10.1186/s12884-021-03581-3.
Appropriate breastfeeding is vital for infant and young child nutrition. Annually, oral clefts affect 0.73 per 1000 children in Uganda. Despite this low incidence, children with a cleft face breastfeeding difficulty which affect their nutrition status. In addition, knowledge on maternal experiences with breastfeeding and support is limited. We explored maternal perceptions, experiences with breastfeeding and support received for their children 0 to 24 months with a cleft attending Comprehensive Rehabilitative Services of Uganda (CoRSU) Hospital.
This cross-sectional study combined quantitative and qualitative methods. We consecutively recruited 32 mothers of children with a cleft aged 0 to 24 months attending CoRSU hospital between April and May 2018. A structured questionnaire collected data on breastfeeding practices and device use (n = 32). To gain a broad understanding of mothers' perceptions and experiences with breastfeeding and support received, we conducted two Focus Group Discussions (in each, n = 5), and 15 In Depth Interviews. Descriptive statistics were analyzed using SPSS software. Qualitative data were analyzed thematically.
Of the 32 children with a cleft, 23(72%) had ever breastfed, 14(44%) were currently breastfeeding, and among those under 6 months, 7(35%) exclusively breastfed. Of 25 mothers interviewed in IDIs and FGDs, 17(68%; IDIs = 8/15, FGD1 = 5/5 and FGD2 = 4/5) reported the child's failure to latch and suckle as barriers to breastfeeding. All ten mothers who used the soft squeezable bottle reported improved feeding. Nineteen (76%) mothers experienced anxiety and 14(56%), social stigma. Family members, communities and hospitals supported mothers with feeding guidance, money, child's feeds and psycho-social counselling. Appropriate feeding and psycho-social support were only available at a specialized hospital which delayed access.
Breastfeeding practices were sub-optimal. Mothers experienced breastfeeding difficulties, anxiety and social stigma. Although delayed, feeding, social and psycho-social support helped mothers cope. Routine health care for mothers and their children with a cleft should include timely support.
适当的母乳喂养对婴儿和幼儿的营养至关重要。在乌干达，每年有 0.73%的儿童患有口腔裂。尽管发病率较低，但患有唇裂的儿童在母乳喂养方面存在困难，这会影响他们的营养状况。此外，关于产妇母乳喂养体验和支持的知识有限。我们探索了在乌干达综合康复服务（CoRSU）医院就诊的 0 至 24 个月唇腭裂儿童的母亲对母乳喂养的看法、经验和获得的支持。
这是一项结合了定量和定性方法的横断面研究。我们连续招募了 2018 年 4 月至 5 月期间在 CoRSU 医院就诊的 0 至 24 个月唇腭裂儿童的 32 位母亲。一份结构式问卷收集了母乳喂养实践和设备使用的数据（n=32）。为了全面了解母亲对母乳喂养的看法和经验以及获得的支持，我们进行了两次焦点小组讨论（每组 n=5）和 15 次深入访谈。使用 SPSS 软件分析描述性统计数据。定性数据采用主题分析法进行分析。
32 名唇腭裂儿童中，23 名（72%）曾进行过母乳喂养，14 名（44%）正在进行母乳喂养，其中 6 个月以下的儿童有 7 名（35%）纯母乳喂养。在接受 IDI 和 FGD 访谈的 25 位母亲中，17 位（68%；IDI=8/15，FGD1=5/5，FGD2=4/5）报告说，孩子无法衔乳和吸吮是母乳喂养的障碍。所有使用软挤压奶瓶的 10 位母亲都报告说改善了喂养。19 位（76%）母亲感到焦虑，14 位（56%）感到社会耻辱。家庭成员、社区和医院为母亲提供喂养指导、金钱、孩子的喂养品和心理社会咨询方面提供支持。只有在专门的医院才能获得适当的喂养和心理社会支持，但这会导致获得支持的时间延迟。
母乳喂养实践并不理想。母亲经历了母乳喂养的困难、焦虑和社会耻辱。尽管延迟，但喂养、社会和心理社会支持帮助母亲应对。唇腭裂儿童的常规保健应包括及时的支持。
