scholarly journals Psychosocial Experiences of HIV-Positive Women of African Descent in the Cultural Context of Infant Feeding: A Three-Country Comparative Analyses

2020 ◽  
Vol 17 (19) ◽  
pp. 7150
Author(s):  
Josephine Etowa ◽  
Hilary Nare ◽  
Doris M. Kakuru ◽  
Egbe B. Etowa
Keyword(s):  
Infant Feeding ◽  
African Descent ◽  
Cultural Beliefs ◽  
Feeding Practices ◽  
Black Mothers ◽  
Infant Feeding Practices ◽  
Psychosocial Experiences ◽  
Cultural Expectations ◽  
The Usa ◽  
Living With Hiv

Infant feeding among mothers of African descent living with Human Immunodeficiency Virus (HIV) is a critical practice that is influenced by policies, cultural expectations, and the resultant psychosocial state of the mother. Hence, this paper draws insights from a broader infant feeding study. It provides insights into how guidelines on infant feeding practices, cultural expectations, migration, or geographic status intersect to influence the psychosocial experiences of mothers living with HIV. We compared psychosocial experiences of Black mothers of African descent living with HIV in Nigeria versus those in high-income countries (Canada and USA), in the context of contrasting national infant feeding guidelines, cultural beliefs about breastfeeding, and geographic locations. Survey was conducted in venue-based convenience samples in two comparative groups: (Ottawa, Canada and Miami-FL, USA combined [n = 290]), and (Port Harcourt, Nigeria [n = 400]). Using independent samples t-statistics, we compared the means and distributions of six psychosocial attributes between Black mothers in two distinct: Infant feeding groups (IFGs), cultural, and geographical contexts at p < 0.05. Psychosocial attributes, such as discrimination and stigma, were greater in women who exclusively formula feed (EFF) than in women who exclusively breastfeed (EBF) at p < 0.01. Heightened vigilance, discrimination, and stigma scores were greater in women whose infant feeding practices were informed by cultural beliefs (CBs) compared to those not informed by CBs at p < 0.001. Discrimination and stigma scores were greater among mothers in Canada and the USA than in Nigeria at p < 0.001. Heightened vigilance and perceived stress scores were less among women in Canada and the USA than in Nigeria at p < 0.001. The guidelines on infant feeding practices for mothers with HIV should consider cultural expectations and migration/locational status of mothers.

scholarly journals Determinants of infant feeding practices among Black mothers living with HIV: a multinomial logistic regression analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Josephine Etowa ◽  
Jean Hannan ◽  
Egbe B. Etowa ◽  
Seye Babatunde ◽  
J. Craig Phillips
Keyword(s):  
Social Support ◽  
Infant Feeding ◽  
Perceived Stress ◽  
Multinomial Logistic Regression ◽  
Cultural Beliefs ◽  
Feeding Practices ◽  
Black Mothers ◽  
Infant Feeding Practices ◽  
Nurse Midwife ◽  
Living With Hiv

Abstract Background Infant feeding practices are imperative for babies’ and mothers’ health and emotional wellbeing. Although infant feeding may seem simple, the decisions surrounding it are complex and have far-reaching implications for women globally. This is an especially difficult concern among mothers living with HIV because breastfeeding can transmit HIV from mother to child. This is further complicated by cultural expectations in case of Black mothers living with HIV. This paper discusses determinants of infant feeding practices among Black mothers living with HIV who were on anti-retroviral therapy (ART) in two North American cites and one African city. Methods A cross-sectional, multi-country survey using venue-based convenience sampling of Black mothers living with HIV was employed. The effective response rates were 89% (n = 89) in Ottawa, Canada; 67% (n = 201) in Miami, Florida, US; and 100% (n = 400) in Port Harcourt, Nigeria, equaling a total sample size of 690. Data were collected in Qualtrics and managed in Excel and SPSS. Multinomial logistic regression analyses were used to determine the factors influencing the mothers’ infant feeding practices (Exclusive Formula Feeding [EFF] = 1; Mixed Feeding [MF] = 2; and Exclusive Breastfeeding [EBF while on ART] =3). Results The results highlight socio-demographics, EFF determinants, and EBF determinants. The statistically significant determinants of infant feeding practices included national guideline on infant feeding, cultural beliefs and practices, healthcare systems, healthcare personnel, infant feeding attitudes, social support, and perceived stress. Mothers’ mean ages were Ottawa (36.6 ± 6.4), Miami (32.4 ± 5.8), and Port Harcourt (34.7 ± 5.7). All sampled women gave birth to least one infant after their HIV diagnoses. Statistically significant (p < .05) determinants of EFF relative to MF were the national guideline of EFF (relative risk [RR] = 218.19), cultural beliefs (RR = .15), received healthcare (RR = 21.17), received healthcare through a nurse/midwife (RR = 3.1), and perceived stress (RR = .9). Statistically significant determinants of EBF relative to MF were received healthcare (RR = 20.26), received healthcare through a nurse/midwife (RR = 2.31), functional social support (RR = 1.07), and perceived stress (RR = .9). Conclusion While cultural beliefs and perceived stress favoured MF over EFF, advice of healthcare workers, and the care received from a nurse/midwife improved EFF over MF. Also while the mothers’ perceived stress favoured MF over EBF, advice of their nurses or midwife and the social support improved EBF over MF. The providers advice was congruent with WHO and national guidelines for infant feeding among mothers living with HIV. These results have implications for nursing, healthcare practice, and policies on infant feeding practices for mothers living with HIV.

For Shame: Feminism, Breastfeeding Advocacy, and Maternal Guilt

Hypatia ◽  
2012 ◽  
Vol 27 (1) ◽  
pp. 76-98 ◽  
Author(s):  
Erin N. Taylor ◽  
Lora Ebert Wallace
Keyword(s):  
Infant Feeding ◽  
Sense Of Self ◽  
Feeding Practices ◽  
Formula Feeding ◽  
Infant Feeding Practices ◽  
Self Assessment ◽  
Cultural Expectations ◽  
New Framework

In this paper, we provide a new framework for understanding infant‐feeding‐related maternal guilt and shame, placing these in the context of feminist theoretical and psychological accounts of the emotions of self‐assessment. Whereas breastfeeding advocacy has been critiqued for its perceived role in inducing maternal guilt, we argue that the emotion women often feel surrounding infant feeding may be better conceptualized as shame in its tendency to involve a negative self‐assessment—a failure to achieve an idealized notion of good motherhood. Further, we suggest, both formula‐feeding and breastfeeding mothers experience shame: the former report feeling that they fail to live up to ideals of womanhood and motherhood, and the latter transgress cultural expectations regarding feminine modesty. The problem, then, is the degree to which mothers are vulnerable to shame generally, regardless of infant feeding practices. As an emotion that is less adaptive and potentially more damaging than guilt, shame ought to be the focus of resistance for both feminists and breastfeeding advocates, who need to work in conjunction with women to oppose this shame by assisting them in constructing their own ideals of good motherhood that incorporate a sense of self‐concern.

A BIOCULTURAL INVESTIGATION OF THE WEANLING’S DILEMMA IN KATHMANDU, NEPAL: DO UNIVERSAL RECOMMENDATIONS FOR WEANING PRACTICES MAKE SENSE?

2001 ◽  
Vol 33 (3) ◽  
pp. 321-338 ◽  
Author(s):  
TINA MOFFAT
Keyword(s):  
Breast Milk ◽  
Infant Feeding ◽  
Breast Feeding ◽  
Cultural Beliefs ◽  
Feeding Practices ◽  
Primary Objective ◽  
Infant Feeding Practices ◽  
Urban District ◽  
Feeding Method ◽  
Exclusive Breast Feeding

The primary objective of this report is to use data from a study of infant growth and weaning practices in Kathmandu, Nepal, to investigate universal recommendations about exclusive breast-feeding up to 6 months postpartum. A secondary objective is to demonstrate the complexity of the biocultural nature of infant feeding practices. A sample of 283 children under 5 years of age and their 228 mothers living in a peri-urban district of Kathmandu participated in this study. The children’s height/length and weight were measured three times over 9 months. At each session, a demographic, child health and infant feeding survey was administered; between sessions, in-depth interviews were conducted with mothers regarding infant feeding practices. While a few of the infants under 2 months were receiving non-breast milk foods, at 3 months of age half of the sample had been introduced to non-breast milk foods and by 7 months all infants were eating non-breast milk foods. A comparison of growth indices and velocities between exclusively and partially breast-fed infants from birth to 7 months of age shows no evidence for a difference in nutritional status between the two groups. Although there are cultural rules about breast-feeding that vary by ethnic group, all mothers followed a feeding method that depended on their assessment of whether the child was getting enough breast milk. The conclusion is that exclusive breast-feeding up to 6 months may not be appropriate for all infants. In this sample, breast-feeding duration is not shortened by the early introduction of non-breast milk foods, as the median age of breast-feeding cessation is 36 months. One of the main reasons for severance was the onset of another pregnancy. Investigation of infant feeding practices must be contextualized in the local ecology of the population. While cultural beliefs about breast-feeding are relevant, mothers’ individual assessments of their children’s nutritional needs and demographic events in parents’ lives must also be considered.

scholarly journals Determinants of Adherence to National Infant Feeding Guidelines by Black Mothers Living with HIV

2021 ◽  
Vol 31 (1) ◽  
pp. 31-40
Author(s):  
Jean Hannan ◽  
Josephine B. Etowa ◽  
Seye Babatunde ◽  
Colleen Stephens ◽  
Latisha Barfield ◽  
...  
Keyword(s):  
Psychosocial Factors ◽  
Infant Feeding ◽  
Cultural Beliefs ◽  
Binary Logistic Regression ◽  
Policy Formulation ◽  
Black Mothers ◽  
National Guidelines ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Living With Hiv

Objective: Worldwide, 160,000 children were newly infected with HIV in 2018; half of these were infected through breastfeed­ing. Infant feeding guidelines are distinct depending on each country’s resources and national or sub-national guidelines. Because of divergent guidelines, the best infant feeding approach to prevent mother-to-child transmission can become unclear. The purpose of this study was to examine the so­ciocultural and psychosocial factors related to adherence to infant feeding guidelines through a city-level, North-South com­parison of Black mothers living with HIV in Nigeria, Canada, and the United States.Design: Using a cross-sectional multi-country survey, a convenience sample of 690 mothers were recruited from June 2016 - December 2019. Socio-cultural and psychosocial factors influencing infant feed­ing practices were measured.Results: Using binary logistic regression, infant feeding attitudes (OR = 1.10), motherhood experiences (OR = 1.08), low hyper-vigilance score (OR = .935), paternal support (OR = 1.10) and percep­tion that the health care provider supported adherence to infant feeding guidelines (OR = 2.43) were associated with guideline ad­herence. Mothers who had cultural beliefs that were inconsistent with infant feeding guidelines and mothers with low incomes (OR = 2.62) were less likely adherent with their country’s guidelines.Conclusion: City-level factors were not found to influence adherence to infant feeding guidelines; however, socio-cultural and psychosocial factors at community, family and individual levels were significant. Policy formulation and targeted interven­tions must be cognizant of cultural expecta­tions of motherhood and mindful of psycho­social determinants of adherence to infant feeding guidelines.Ethn Dis. 2021;31(1):31- 40; doi:10.18865/ed.31.1.31

scholarly journals Determinants of infant feeding practices among mothers living with HIV attending prevention of mother to child transmission Clinic at Kiambu Level 4 hospital, Kenya: a cross-sectional study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Naureen Andare ◽  
Sophie Ochola ◽  
Peter Chege
Keyword(s):  
Infant Feeding ◽  
Exclusive Breastfeeding ◽  
Feeding Practices ◽  
Feeding Practice ◽  
Infant Feeding Practices ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Breastfeeding Rate ◽  
Living With Hiv ◽  
Mother To Child

Abstract Background Human immunodeficiency virus infection and acquired immune deficiency syndrome is global pandemic with around 150,000 children infected with HIV in 2015. In Kenya, it is estimated that 11,000 children who are under 15 years old were infected. Safe infant feeding practices are the major important determinants of the prevention of mother to child transmission. The decision to breastfeed or not is considered a very tough choice for mothers living with HIV. This study assessed the infant feeding practices and its determinants among mothers living with HIV with infants 0–12 months old. Methods This was a mixed methods cross-sectional study adopting qualitative and quantitative data collection procedures. A sample of 180 systematically selected mothers living with HIV with infants 0–12 months old attending prevention of mother to child transmission clinic participated in the study. Results Exclusive breastfeeding rate was 71.4%, mixed feeding (18.2%) and replacement feeding (10.4%). Complementary feeding with continued breastfeeding rate was 63.1%. Similarly, qualitative results showed that exclusive breastfeeding was the most preferred feeding method by mothers living with HIV. Age (Adjusted Odds Ratio (AOR) 0.19; (95% Confidence Interval (CI) 0.41, 0.85; p = 0.030) and infant feeding practice knowledge (AOR 0.20; 95% CI 0.06, 0.64; p = 0.007) were determinants of exclusive breastfeeding. Education AOR 0.17; 95% CI 0.03, 0.85; p = 0.002) and occupation (AOR 3.91; 95% CI 1.24, 12.32; p = 0.020) were determinants of complementary feeding with continued breastfeeding. Conclusion Exclusive breastfeeding is attainable in this population. However, poor infant feeding practice knowledge led to non-adherence to safe infant feeding practices such as exclusive breastfeeding. Socio-demographic factors such as age, education and occupation were established as determinants of infant feeding practices among mothers living with HIV. Ministry of Health should come up with strategies on infant feeding counseling that are aligned to a local context, to allow mothers to understand the importance of recommended infant feeding options for HIV-exposed infants.

scholarly journals Reported infant feeding practices and contextual influences on breastfeeding: qualitative interviews with women registered to MomConnect in three South African provinces

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zara Trafford ◽  
Sara Jewett ◽  
Alison Swartz ◽  
Amnesty E. LeFevre ◽  
Peter J. Winch ◽  
...  
Keyword(s):  
Health System ◽  
South African ◽  
Infant Feeding ◽  
Qualitative Interviews ◽  
Feeding Practices ◽  
Policy Support ◽  
Infant Feeding Practices ◽  
Local Policy ◽  
Framework Analysis ◽  
Younger Women

Abstract Background Global guidelines recommend exclusive breastfeeding (EBF) for the first 6 months of life. South African EBF rates have steadily increased but still only average 32% for infants below 6 months of age. Malnutrition and developmental delays continue to contribute substantially to the morbidity and mortality of South African children. MomConnect, a national mHealth messaging system used to send infant and maternal health messages during and after pregnancy, has a specific focus on improving rates of breastfeeding and has achieved high rates of population coverage. Methods For this qualitative study, we interviewed women who were registered to MomConnect to investigate their breastfeeding and other infant feeding practices, decision-making pre- and post-delivery, and the role of the health system, family members and the wider community in supporting or detracting from breastfeeding intentions. Data were collected from February–March 2018 in South Africa’s KwaZulu-Natal, Free State and Gauteng provinces. Framework analysis was conducted to identify common themes. Results Most women interviewed had breastfed, including HIV-positive women. Even when women had delivered by caesarean section, they had usually been able to initiate breastfeeding a few hours after birth. Understandings of EBF varied in thoroughness and there was some confusion about the best way to cease breastfeeding. Most women felt well-equipped to make infant feeding decisions and to stick to their intentions, but returning to work or school sometimes prevented 6 months of EBF. Advice from the health system (both via clinics and MomConnect) was considered helpful and supportive in encouraging EBF to 6 months, although family influences could thwart these intentions, especially for younger women. Mothers reported a range of breastfeeding information sources that influenced their choices, including social media. Conclusions Efforts to improve EBF rates must include consideration of the social and economic environment surrounding women. Interventions that focus only on improving women’s knowledge are valuable but insufficient on their own. Attention should also be paid to infant behaviors, and how these affect women’s breastfeeding choices. Finally, although there is strong local policy support for EBF, more rigorous implementation of these and other broader changes to create a more enabling structural environment ought to be prioritized.

scholarly journals An Assessment of the Breastfeeding Practices and Infant Feeding Pattern among Mothers in Mauritius

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Ashmika Motee ◽  
Deerajen Ramasawmy ◽  
Prity Pugo-Gunsam ◽  
Rajesh Jeewon
Keyword(s):  
Infant Feeding ◽  
Infant Nutrition ◽  
Feeding Practices ◽  
Feeding Pattern ◽  
Infant Feeding Practices ◽  
Chi Square ◽  
Breastfeeding Practices ◽  
Childhood Morbidity ◽  
The Mean ◽  
Type Of Delivery

Proper breastfeeding practices are effective ways for reducing childhood morbidity and mortality. While many mothers understand the importance of breastfeeding, others are less knowledgeable on the benefits of breastfeeding and weaning. The aim in here is to assess breastfeeding pattern, infant formula feeding pattern, and weaning introduction in Mauritius and to investigate the factors that influence infant nutrition. 500 mothers were interviewed using a questionnaire which was designed to elicit information on infant feeding practices. Statistical analyses were done using SPSS (version 13.0), whereby chi-square tests were used to evaluate relationships between different selected variables. The prevalence of breastfeeding practice in Mauritius has risen from 72% in 1991 to 93.4% as found in this study, while only 17.9% breastfed their children exclusively for the first 6 months, and the mean duration of EBF (exclusive breastfeeding) is 2.10 months. Complementary feeding was more commonly initiated around 4–6 months (75.2%). Despite the fact that 60.6% of mothers initiate breastfeeding and 26.1% of mothers are found to breastfeed up to 2 years, the practice of EBF for the first 6 months is low (17.9%). Factors found to influence infant feeding practices are type of delivery, parity, alcohol consumption, occupation, education, and breast problems.

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