Hoekstra Nadia E, Craven Dalton M, Tsidya Mercy, Thom Annie, Bula Agatha, van der Zalm Marieke, Mvalo Tisungane, McCollum Eric D
UNC Project-Malawi, Lilongwe, Central Region, Malawi
Global Program in Pediatric Respiratory Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
BMJ Open. 2025 Jun 8;15(6):e094793. doi: 10.1136/bmjopen-2024-094793.
To determine caregiver knowledge of, attitudes towards, and perceptions of feeding practices for infants admitted to a tertiary referral hospital with severe pneumonia, and to identify community feelings about nasogastric tube feeding in Malawi.
The paediatric ward of a government tertiary referral hospital in Lilongwe, Malawi.
From March through April 2023, we conducted in-depth interviews with 14 mothers of infants 0-12 months of age hospitalised with severe pneumonia who had been enrolled in an observational study evaluating feeding and swallowing in breastfed infants. In-depth interviews assessed mothers' attitudes towards hospital feeding practices including nasogastric tube feeding, along with community perceptions of nasogastric tubes. Data were analysed using a thematic analysis approach to assess themes and subthemes of transcripts.
Mothers understood that children with pneumonia are at risk of 'choking' during oral feeding; however, they had substantial worries about both withholding breastfeeding and providing nasogastric feeds to their infants through a nasogastric tube. Community perceptions of nasogastric tubes were widely negative and included beliefs that nasogastric tubes cause children to 'choke' and die and that medical providers want to harm children. Mothers held strong beliefs about the benefits of breastfeeding.
There are alarming misconceptions in the community around nasogastric tubes and the intentions of medical providers. This leads to maternal concerns about this hospital feeding practice, poor adherence to medical recommendations, and mistrust in the broader healthcare system. To improve hospital outcomes of children with severe pneumonia, caregiver and community education is needed.
确定在一家三级转诊医院住院治疗的重症肺炎婴儿的照料者对喂养方式的了解、态度和看法，并了解马拉维社区对鼻胃管喂养的看法。
马拉维利隆圭一家政府三级转诊医院的儿科病房。
2023年3月至4月，我们对14名0至12个月大因重症肺炎住院的婴儿的母亲进行了深入访谈，这些母亲参与了一项评估母乳喂养婴儿喂养和吞咽情况的观察性研究。深入访谈评估了母亲们对包括鼻胃管喂养在内的医院喂养方式的态度，以及社区对鼻胃管的看法。使用主题分析方法对数据进行分析，以评估访谈记录的主题和子主题。
母亲们明白肺炎患儿在经口喂养时有“窒息”风险；然而，她们对不给婴儿母乳喂养以及通过鼻胃管给婴儿提供鼻饲喂养都非常担心。社区对鼻胃管的看法普遍负面，包括认为鼻胃管会导致儿童“窒息”死亡以及医疗人员想伤害儿童。母亲们坚信母乳喂养的好处。
社区对鼻胃管和医疗人员意图存在令人担忧的误解。这导致母亲们对这种医院喂养方式感到担忧，对医疗建议的依从性差，以及对更广泛的医疗保健系统不信任。为改善重症肺炎患儿的医院治疗效果，需要对照料者和社区进行教育。
