Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households
| Autor: | Robert H. Gilman, Jessica Pachas, Peter J. Winch, Lilia Cabrera, Mayra Ochoa, Laura E. Caulfield, Jessica D. Rothstein |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Breastfeeding
0302 clinical medicine Breast milk substitutes Peru Medicine 030212 general & internal medicine Child physiological stress clinical article child lcsh:Public aspects of medicine lcsh:RJ1-570 article Obstetrics and Gynecology vignette Infant Formula Breast Feeding female counseling child health breast milk Female artificial milk Qualitative medicine.medical_specialty health care personnel body weight gain Self-concept Mothers Infant health Breast milk decision making 03 medical and health sciences 030225 pediatrics Humans case report human purl.org/pe-repo/ocde/ford#3.02.03 [https] purl.org/pe-repo/ocde/ford#3.02.02 [https] Milk Human business.industry Research Infant feeding genetic transcription Infant interview lcsh:Pediatrics lcsh:RA1-1270 infant Purchasing breast feeding education household purchasing audio recording self concept Vignette Infant formula Family medicine Pediatrics Perinatology and Child Health business Qualitative research Decision-making |
| Zdroj: | International Breastfeeding Journal International Breastfeeding Journal, Vol 16, Iss 1, Pp 1-15 (2021) |
| Popis: | Background Substantial evidence exists surrounding the health risks of breast milk substitutes (BMS) in place of exclusive breastfeeding among infants < 6 months of age in resource-poor settings. Yet, mothers’ experiences of selecting and purchasing BMS brands have not been well studied to date. This qualitative study explored the factors influencing BMS purchasing practices, along with the consequences of those decisions, in peri-urban Lima, Peru. Methods We conducted in-depth interviews (IDIs) with 29 mothers who had begun mixed-feeding their infants during the first 6 months of life. Interviews explored participants’ reasons for initiating infant formula use and their experiences of selecting, purchasing, and providing BMS to their children. Audio recordings were transcribed, coded, and key themes and illustrative vignettes were identified. Results The primary reported reasons for initiating infant formula use included having received a recommendation for infant formula from a healthcare provider, concerns about an infant’s weight gain, and the perception of insufficient breast milk. Mothers tended to initially purchase the BMS brand that had been recommended by a doctor, which was often more expensive than the alternatives. The costs of BMS, which escalated as infants grew, often disrupted the household economy and generated significant stress. While some mothers identified alternatives allowing them to continue purchasing the same brand, others chose to switch to less expensive products. Several mothers began to feed their infants follow-on formula or commercial milk, despite their awareness that such practices were not recommended for infants under 6 months of age. The approval of family members and the absence of an infant’s immediate adverse reaction influenced mothers’ decisions to continue purchasing these products. Conclusions The high costs of BMS may deepen existing socio-economic vulnerabilities and generate new risks for infant health. The continued dedication of resources towards breastfeeding education and support is critical, and strategies would benefit from underscoring the long-term financial and health consequences of infant formula use, and from strengthening women’s self-efficacy to refuse to initiate infant formula when recommended. In addition, health providers should be trained in counseling to help women to relactate or return to exclusive breastfeeding after cessation. |
| Databáze: | OpenAIRE |
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