Feeding practices of mothers with children attending early childhood development centres in the Xhariep District

Thumbnail Image
Carson-Porter, Angelique Celeste
Journal Title
Journal ISSN
Volume Title
University of the Free State
Background and motivation: The nutritional status and health of under five year olds are considered indicators of social progress, development and access to resources within communities. In developing countries, undernutrition is a major contributing factor to children failing to achieve their developmental potential. The prevention of malnutrition requires, among others, safe, nutritious, and diverse foods in early childhood. Young children become vulnerable to malnutrition when complementary foods are introduced, and breastfeeding is discontinued. The 2016 South African Demographic and Health Survey reported that 27% of children younger than five years were stunted. Complementary feeding practices are, therefore, a priority matter that needs to be addressed in South Africa. The Assuring Health For All in the Free State (AHA-FS) study in 2007 already identified malnutrition in the Xhariep District. Also, while rendering health services during community-based education and interprofessional training to the communities in the Xhariep District, the Department of Nutrition and Dietetics of the University of the Free State identified that mothers face many barriers to feeding their young children an appropriate diet. Therefore, this study aimed to explore the perspectives of mothers of children who attend ECD centres in the Xhariep District to gain a nuanced understanding of the driving factors of malnutrition in the area. Methods: This was a qualitative, exploratory study in which the researcher had a constructive paradigm. Twelve participants who met the inclusion criteria were conveniently sampled. Semi-structured interviews were used to determine the mothers' choices and motivation for foods they fed their children until data saturation was reached. The interviews were audio-recorded after informed consent was obtained. Content analysis was used to analyse the data and identify themes, while descriptive statistics described the participants. Results: The participants had a median age of 31 years (IQR: 26.8-41.8; range: 20-71 years), with 1-3 children in their care. Five of the participants finished grade 11 or 12, while six only had some primary school education, and one never went to school. Nine of the participants relied on social grants as a source of income, 11 were unemployed, and only two had a spouse or partner who was employed. The following themes were identified from the interviews: infant and young child feeding practices, social support for child feeding practices, financial restraints to feeding practices, concern for the nutrition wellbeing of the children and household amenities. The participants mostly fed their children cooked maize meal porridge (pap), milk, cordial mixed with water, and vegetables and meat were mostly fed only once a week. When the participants had no meat, they fed the children pap with oil. Fruits were fed to the children only at the beginning of the month and were considered as treats. All the participants reported that they skipped meals so that their young children could have food to eat. Other coping strategies included borrowing money, mostly from loan sharks, and using store credit to purchase electricity and food when they had none. However, these practices, in turn, were detrimental to the overall available household funds because of the interest incurred. The availability of water, and the amount of money spent on electricity, also influenced food choices. The participants reported that they did not have vegetable gardens because they lacked seeds, space, and water. Participants reported that they had received nutrition advice from neighbours, nearby grandmothers, and the staff at their local clinics. They reported that they tend to implement the advice from grandmothers and neighbours because they had raised children before. However, they did not always implement the advice from the clinic staff due to lack of access to the foods they recommended. Conclusion and recommendations: The participants experienced similar challenges that contributed to household food insecurity. The main challenge identified was the lack of employment opportunities in their communities. In conclusion, the effects of unemployment and the level of education of mothers should be acknowledged when policymakers recommend feeding practices for young children. The staff at the local clinics were unaware of the mothers' lived experiences, so the nutritional advice was not adapted to the circumstances of the mothers. Although the mothers received support from the government through social care grants, they still experienced frequent periods of insufficient funds to purchase food and electricity for their households. Thus, it would be worthwhile to teach recipients of social grants to budget their money and thus discourage the use of loan sharks and store credit as coping strategies. Furthermore, empowering women to generate an income through communal agricultural practices, cooking, and sewing skills could help improve their food access.
Dissertation (M.Sc. (Nutrition and Dietetics))--University of the Free State, 2021, Child health, Complementary feeding, Breastfeeding, Rural, South Africa, Qualitative research, Lived experiences, Mothers, Poverty