1. A comparison of observed feeding practices of infants and young children aged 6–23 months to national responsive feeding recommendations in Sri Lanka.
- Author
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Schwendler, Teresa R., Rowel, Dhammica, Abdulloeva, Safina, Jayawickrama, Hiranya, de Silva, Chithramalee, Romano, Olivia, Senarath, Upul, and Kodish, Stephen R.
- Subjects
CAREGIVER attitudes ,ARTIFICIAL feeding ,ATTITUDES toward breastfeeding ,CAREGIVERS ,BREASTFEEDING promotion ,RURAL conditions ,RESEARCH methodology ,INTERVIEWING ,COMPARATIVE studies ,ETHNOLOGY research ,DESCRIPTIVE statistics ,METROPOLITAN areas ,JUDGMENT sampling ,THEMATIC analysis ,DATA analysis software - Abstract
To describe the extent to which Sri Lankan caregivers follow current national responsive feeding recommendations and the factors limiting and enabling those behaviours. Study design. This ethnographic substudy was conducted using a four‐phase, mixed methods formative research design across rural, estate and urban sectors of Sri Lanka. Data collection methods. Data were collected using direct meal observations and semistructured interviews. Participants including infants and young children aged 6–23 months (n = 72), community leaders (n = 10), caregivers (n = 58) and community members (n = 37) were purposefully sampled to participate in this study. Data analysis. Observational data were summarized using descriptive statistics while textual data were analysed thematically using Dedoose. Findings were then interpreted vis‐à‐vis six national responsive feeding recommendations. During observed feeding episodes, caregivers were responsive to nearly all food requests (87.2% [34/39]) made by infants and young children. Many caregivers (61.1% [44/72]) also positively encouraged their infant and young child during feeding. Despite some responsive feeding practices being observed, 36.1% (22/61) of caregivers across sectors used forceful feeding practices if their infant or young child refused to eat. Interviews data indicated that force‐feeding practices were used because caregivers wanted their infants and young children to maintain adequate weight gain for fear of reprimand from Public Health Midwives. Despite overall high caregiver knowledge of national responsive feeding recommendations in Sri Lanka, direct observations revealed suboptimal responsive feeding practices, suggesting that other factors in the knowledge‐behaviour gap may need to be addressed. Key messages: Sri Lankan caregivers were aware of national recommendations for optimally feeding infants and young children but real‐life barriers, such as other competing household demands, limited their ability to follow them fully.Observed feeding practices that may be considered suboptimal for infants and young children, including forceful feeding, were carried out by caregivers whose intentions were to ensure their children maintain adequate weight gain.Tailored communication materials that offer caregivers specific strategies to overcome feeding challenges may benefit Public Health Midwives who are responsible for nutrition counselling during community outreach in Sri Lanka. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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