Infant feeding practices: Realities and mindsets of mothers in southern Africa
Infant feeding practices: Realities and mindsets of mothers in southern Africa
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DOI：
10.1080/09540120701336400
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发表时间：
2007-10-01
影响因子：
1.7
通讯作者：
Mkhatshwa, H.
中科院分区：
文献类型：
--
作者：
Busekens, I.;Jaffe, A.;Mkhatshwa, H.
在发展中国家，纯母乳喂养的婴儿感染艾滋病毒的风险低于混合喂养的婴儿。在南非、纳米比亚和斯威士兰的11个资源匮乏地区进行了人种学研究，以了解如何利用咨询卫生工作者、孕妇和新妈妈的看法和经验来改进婴儿喂养咨询。尽管有预防母婴传播（PMTCT）项目，但很早就开始混合喂养仍然是常态；“水即生命”和“奶是一种液体”的传统观念与当前的预防母婴传播教育相悖，奶被视为液体“饮品”而非“真正的食物”。这加剧了“母乳不足综合征”，感到无助的母亲认为自己的母乳以及自身存在缺陷——“不够好”。婴儿喂养深植于传统的亲密关系中；亲属和养家糊口的人都对婴儿喂养的选择和方式有影响，甚至有决定权。在父权制和暴力社会中，传统的权力差异阻碍了艾滋病毒感染情况的轻易或完全披露以及安全套的协商；艾滋病毒感染状况对大多数伴侣和亲属隐瞒。这种保密的环境意味着，母亲觉得自己不敢忽视的传统建议和权威往往无视母亲及其婴儿的艾滋病毒感染状况和生存需求。
Exclusively breastfed infants in developing countries are at lower risk of HIV transmission than mixed-fed infants. Ethnographic research was conducted in eleven low-resource settings across South Africa, Namibia and Swaziland to understand how the perceptions and experiences of counselling health workers, pregnant women and recent mothers could be used to improve infant feeding counselling. Despite prevention of mother-to-child transmission (PMTCT) programmes, very early mixed-feeding remains the norm; traditional conceptualisations of 'water as life' and 'milk as a fluid' are holding up against current PMTCT education, with milk considered liquid 'drink' rather than 'real food'. This aggravates an 'insufficient milk syndrome' where disempowered mothers perceive their breastmilk, and themselves, as deficient-'not good enough'. Infant feeding is embedded within traditional relationships of intimacy; both relatives and breadwinner have influence and even authority over options and modes of infant feeding. In patriarchal and violent societies, traditional power differentials prohibit easy or complete HIV disclosure or condom negotiation; HIV status remains hidden from most partners and relatives. This context of secrecy means that the traditional advice and authority, which the mothers feel they dare not disregard, is often blind to the mother and her infant's HIV status and survival needs.