Nutrition News for Africa

Abstract - September 30, 2007

An article entitled “Breastfeeding and mixed feeding practices in Malawi : Timing, reasons, decision makers, and child health consequences” was published by Rachel Bezner Kerr et al. in the Food and Nutrition Bulletin 2007;28 (1): 90-99

 Introduction
Current WHO/UNICEF nutrition policy guidelines encourages mothers to exclusively breastfeed their children for the first 6 months of life providing the infant with a nutritionally sufficient, clean, and safe diet. The main objective of the research presented in this paper was to characterize early infant-feeding practices in a rural Malawi setting. Specifically, the researchers set to document the foods that are introduced early to children, determine who the decision makers are for these practices, their motivation for providing certain foods, and the consequences on child growth.

Methods
The research was conducted in a rural area of northern Malawi near the town of Ekwendeni in Mzimba District. The subjects of this study were children 6 to 48   months of age and their primary caregivers from two sets of households: those in intervention villages and those in control villages. In 160 households with a child under 4 years of age, the primary caregiver was interviewed in the home about the child’s consumption of 19 specific early infant foods and was asked if the child consumed other foods.

 Results
While caregivers felt that the first milk (colostrum) and breastmilk was good for babies, exclusive breastfeeding was not widely practiced. Sixty-five percent of the children are given some type of food in the first month of life. By 6 months of age, 96% of the children had been given some type of food. There are three notable patterns in the introduction of foods. First, mzuwula the most common one (an infusion made with the leaves of a local tree), is introduced to 50% of the children in the first month. The two others are respectively plain water or water with Dawale (another kind of root water) and porridge with “chinthipu” (thin porridge with white maize). A commonly reported reason for introducing many foods was that the child was hungry or crying. Most often the caregiver was the decision maker, but the mother in-law and occasionally the father-in-law were also important decision makers. In 78% of cases when mzuwula was introduced, the mother in- law made the decision and it was given to protect the child from disease.

Conclusion
The authors concluded that promoters of exclusive breastfeeding should target their messages to appropriate decision makers.  They suggest that messages should address discouraging feeding practices having negative impacts on child growth .