Social circumstances that drive early introduction of formula milk: an exploratory qualitative study in a peri‐urban South African community

摘要

Breastfeeding is widely endorsed as the optimal strategy for feeding newborns and young infants, as well as improving child survival and achieving illennium evelopment oal 4. Exclusive breastfeeding ( ) for the first 6 months of life is rarely practised in outh frica. Following the 2010 World Health Organization ( ) infant feeding recommendations ( for ‐positive mothers with maternal or infant antiretroviral treatment), outh frica adopted breastfeeding promotion as a ational nfant eeding trategy and removed free formula milk from the revention of other‐to‐ hild ransmission of programme. This study aimed to explore the perceptions of mothers and household members at community level regarding the value they placed on formula feeding and circumstances that drive the practice in a peri‐urban community. We conducted in‐depth interviews with ‐positive and ‐negative mothers in a community‐randomised trial ( ood tart ). Focus group discussions were held with grandmothers, fathers and teenage mothers. Data were analysed using thematic analysis. The following themes were identified; inadequate involvement of teenage mothers; grandmothers who become replacement mothers; fear of failing to practise for 6 months; partners as formula providers and costly formula milk leading to risky feeding practices. The new outh frican Infant Feeding Strategy needs to address the gaps in key health messages and develop community‐orientated programmes with a focus on teenage mothers. These should encourage the involvement of grandmothers and fathers in decision‐making about infant feeding so that they can support for optimal child survival.