Gendered perceptions on infant feeding in Eastern Uganda: continued need for exclusive breastfeeding support.
Gendered perceptions on infant feeding in Eastern Uganda: continued need for exclusive breastfeeding support.
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DOI：
10.1186/1746-4358-5-13
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发表时间：
2010-10-26
影响因子：
3.5
通讯作者：
Tumwine JK
中科院分区：
文献类型：
--
作者：
Engebretsen IM;Moland KM;Nankunda J;Karamagi CA;Tylleskär T;Tumwine JK
在资源匮乏的环境中，建议艾滋病毒阳性母亲选择“纯母乳喂养”（EBF）或“纯替代喂养”（ERF）。可接受性、可行性、可负担性、可持续性和安全性（AFASS）是世界卫生组织（WHO）在过去十年中对ERF的先验标准。“AFASS”已成为预防艾滋病毒母婴传播领域许多工作者的简称。因此，无论社会规范如何，都建议不要母乳喂养。在婴儿死亡率高的地区，婴儿前半期的EBF与儿童的巨大健康益处有关。但是，即使EBF已经被推荐了十年，很少有母亲在实践它。我们开始了解父亲和母亲的婴儿喂养观念，以及EBF和ERF的“AFASS”程度。八个焦点小组和81名知情人提供了归纳内容分析的信息。在乌干达东部的姆巴莱区，男子和妇女分别组成了四个小组。两个研究问题出现了：如何理解和接受不同的喂养选择？男子和妇女在婴儿喂养方面的责任是什么？母亲对母乳喂养的承诺和丈夫对养家糊口的承诺都表现得很强烈。不给新生儿母乳喂养被视为危险和不可接受的，除非产妇生病。男性认为，不母乳喂养可能会受到亲属或法庭的制裁。但是，总的来说，男性和女性都认为EBF是“不够的”，甚至是“有害的”。在男性中，不给母乳补充剂与贫困和男性作为提供者的失败有关。妇女们强调，缺乏时间、疲惫、贫穷和饥饿是母乳产量有限的因素。尽管妇女参加了产前教育，但她们表示需要了解更多。大多数男子感到被排除在健康教育之外。母乳喂养是喂养婴儿的预期方式，但即使在母亲中有现有的知识，EBF通常被认为是不可能的。总的来说，紧急救济基金受到了负面的制裁。迫切需要在促进更安全的婴儿喂养方案中提高文化敏感性，特别是在艾滋病毒背景下，男性的参与势在必行。该研究是正在进行的研究PROMISE EBF的形成性研究的一部分，该研究在http://clinicaltrials.gov（NCT 00397150）上注册。
In resource-poor settings, HIV positive mothers are recommended to choose between 'Exclusive breastfeeding' (EBF) or 'Exclusive replacement feeding' (ERF). Acceptability, Feasibility, Affordability, Sustainability and Safety (AFASS) has been the World Health Organization (WHO)'s a priori criteria for ERF the last ten years. 'AFASS' has become a mere acronym among many workers in the field of prevention of mother-to-child transmission of HIV, PMTCT. Thereby, non-breastfeeding has been suggested irrespective of social norms. EBF for the first half of infancy is associated with huge health benefits for children in areas where infant mortality is high. But, even if EBF has been recommended for a decade, few mothers are practicing it. We set out to understand fathers' and mothers' infant feeding perceptions and the degree to which EBF and ERF were 'AFASS.' Eight focus groups with 81 informants provided information for inductive content analysis. Four groups were held by men among men and four groups by women among women in Mbale District, Eastern Uganda. Two study questions emerged: How are the different feeding options understood and accepted? And, what are men's and women's responsibilities related to infant feeding? A mother's commitment to breastfeed and the husband's commitment to provide for the family came out strongly. Not breastfeeding a newborn was seen as dangerous and as unacceptable, except in cases of maternal illness. Men argued that not breastfeeding could entail sanctions by kin or in court. But, in general, both men and women regarded EBF as 'not enough' or even 'harmful.' Among men, not giving supplements to breast milk was associated with poverty and men's failure as providers. Women emphasised lack of time, exhaustion, poverty and hunger as factors for limited breast milk production. Although women had attended antenatal teaching they expressed a need to know more. Most men felt left out from health education. Breastfeeding was the expected way to feed the baby, but even with existing knowledge among mothers, EBF was generally perceived as impossible. ERF was overall negatively sanctioned. Greater culture-sensitivity in programs promoting safer infant feeding in general and in HIV-contexts in particular is urgently needed, and male involvement is imperative. The study was part of formative studies for the ongoing study PROMISE EBF registered at http://clinicaltrials.gov (NCT00397150).