Little is known about the nutritional status of urban refugees. This study assesses the prevalence of malnutrition in a sample of refugee children in Cairo and analyses associations between growth indicators and their determinants. This cross-sectional study surveyed a sample of African refugee children (n=201) under two years of age. In home interviews, height and weight were measured and maternal and household characteristics, handwashing and breastfeeding practices and recent child illness were assessed. In this sample, 13% of refugee children were stunted, 4% were underweight and 8% were wasted. Multivariate analysis revealed that growth was independently and positively associated with having a flush toilet, good handwashing practices, and not recently having fever. Older children were significantly smaller than reference children of the same age, but child age was not associated with malnutrition. Further monitoring and assessment of long-term growth and development of refugee children in Cairo is required. Good child care practices should be promoted in the community.

A take-home milk supplementation programme consisting of 2 kg dry powdered milk offered monthly for 12 months to children 6--24 months of age in participating primary health care clinics was evaluated by assessing weight changes in supplemented and control children. Growth charts of supplemented (n = 362) and control (n = 410) children were summarized by the intercept and slope from the regression of individual weight measurements on age. The 2 groups were stratified by gender, ethnicity (Indo-Guyanese and Afro-Guyanese), and age intervals 0--6, 6--24, and 24--30 months which corresponded to pre, during, and post supplementation periods, respectively. Supplemented Indo-Guyanese girls gained significantly (p < 0.001) more weight than their controls: the difference being approximately 40 grams per month. No other differences were observed in the other gender/ethnic groups. Contextual information collected in a sub-sample of 60 mothers/caregivers of beneficiaries revealed that the supplement was mainly consumed with porridge, and tended to be shared more in the Afro-Guyanese than in Indo-Guyanese households. Over 90% of the beneficiaries were satisfied with the programme and wanted it to continue while 74% stated that it was of financial benefit. For future programmes, the use of locally produced infant cereal was recommended.

The value of post-infancy breast feeding for growth and nutrition has been the subject of debate and controversy. We followed a cohort of 264 western Kenyan children for six months prospectively (mean age 14 months at baseline) to investigate the influence of breast. feeding on growth. Only 14 (5%) children had been weaned by enrolment, and 173 (66%) were still breast feeding at follow-up. For analysis, children were classified into three groups of breast feeding duration as a proportion of the study: 0--49% (n = 42), 50--99% (n = 49), and 100% (n = 173). General Linear Models procedures were used for multivariate analysis. Adjusted means showed that children in the longest breast feeding group gained 3.4 cm (p < 0.001) and 360 g (p < 0.01) more than those in the shortest breast feeding group, and 0.7 cm and 230 g (p < 0.05) more than children in the intermediate group. The greatest benefits of breast feeding for linear growth were observed in households that had no latrine and whose water consumption was below 10 L/person/day. Our results support the recommendation that children in developing countries be breast-fed for at least two years.

Submitted in full compliance with the requirements for a Master’s Degree in Technology: Nursing, Department of Community Health Studies at the Durban University of Technology, 2009. / Purpose: Breastfeeding is a key child survival strategy important for the long-term health of both the mother and child. The number of women in paid employment has increased exponentially, yet very few of these women continue breastfeeding as recommended by the World Health Organisation. The purpose of this qualitative study was to identify the factors affecting breastfeeding practices in the workplace. Objectives of the study are to: 1: Describe managers’ attitudes to and knowledge about providing breastfeeding support. 2: Identify mothers’ attitudes towards breastfeeding and the workplace environment. 3: Describe the practices of the breastfeeding mothers in the workplace. 4: Identify factors that influence breastfeeding practices within the workplace environment Method The theoretical frameworks adopted were the Situation- Specific Theory of Breastfeeding and the BASNEF model. The frameworks together with the literature review provided the background which informed this study. The research was a case study of two multi -national companies in Durban, KwaZulu Natal; participants were mothers and managers in the companies. Purposive sampling was used for selecting eight women who participated in the focus groups, two follow up interviews were conducted and five managers were interviewed. Data collection techniques also included a reflexive journal and field observation. After a thorough review of the data, the main themes which emerged were used to guide the discussion and answer the objectives of the study. Results The two companies reflected a scenario of pressures in the workplace environment affecting women’s choices regarding combining work and breastfeeding; societal pressures were dictating acceptable behaviour. Breastfeeding was not a priority for employers, no breastfeeding policy existed. Breastfeeding mothers were isolated and employers and employees were not engaging on the issue. Conclusions and Recommendations Simple enabling factors within the workplace would allow mothers, their infants and employers to enjoy the benefits of supporting breastfeeding in the workplace; this would be a win-win situation. Government, non-governmental organisations and society have a responsibility to overtly protect, support and promote breastfeeding in society and in the workplace.

Background: Breastfeeding is known to have benefits both for maternal and child health. Some questions around the benefits and risks of breastfeeding in the presence of HIV infection still remain unclear. Aims: To study the effects of infant feeding mode by HIV-positive mothers, on maternal and child health. In addition, to assess the effect of nutritional supplementation to HIV-positive lactating mothers on nutritional and health status of mothers and their infants and on the quality of breastmilk. Methods: The study had 2 components; a prospective study to examine the impact of infant feeding mode on nutritional and health indices in mothers and their infants and within it a nested randomized controlled clinical trial to study the impact of a daily 50 g soya/peanut based supplement during breastfeeding on the above parameters. The measurements included anthropometry; body composition indicators (using both deuterium dilution and BIA); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. Breastmilk was analysed for both macro and micronutrients. Cervical screening was offered to all the women. Results: AFASS criteria were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (p=0.043). Longer duration of breastfeeding was observed to be significantly associated with a mean increase in CD4 count (74 cells/μL) and better health outcomes. The supplement made no significant impact on any maternal or child outcomes except for a limited effect on mothers with low BMI, where it was significantly associated with preventing loss of lean body mass (p=0.026). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months (p=0.006 and 0.014 respectively). Both breastfeeding and longer duration of breastfeeding was significantly associated with better development scores and growth parameters. Supplementation made no impact on breastmilk composition. Of the 86 mothers who agreed for cervical screening, 27.6% had human papilloma virus infection. Conclusions: Breastfeeding is not harmful to the mother despite the presence of HIV infection. On the contrary we observed both breastfeeding and longer breastfeeding duration to be associated with better maternal and child outcomes. Mothers are still choosing formula feeding inappropriately presumably because of the availability of free formula and/or sub-optimal counseling. The new (2010) local PMTCT guidelines based on WHO recommendations should reverse this. Food insecurity was prevalent amongst 32% of our study population, highlighting the need to include sustainable and empowering solutions to encounter this problem. Less sustainable solutions such as nutritional supplementation should be targeted to the malnourished and in emergency situations. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2012.

The purpose of this study was to examine maternal and infant factors associated with body mass index (e.g., maternal weight gain, infant birth weight, infant feeding methods, and motor coordination) among obese pre-adolescents and adolescents aged 8-18 years enrolled in the Pediatric OverWeight Education and Research (POWER) program operated by Riley Hospital for Children in Indianapolis, IN, between October 2008 and September 2011. POWER, a three-phase, 12-month multi-disciplinary program to reduce childhood obesity funded by Indiana University Health, enrolls obese children (Body Mass Index [BMI] greater than the 95th percentile for age and gender) through referrals from pediatricians throughout Indiana. Prior to the child’s initial visit, each family completes a comprehensive background and family history profile, approved by the Indiana University-Purdue University (IUPUI) Institutional Review Board, that includes questions related to the obese child’s motor skill development, infant feeding methods, maternal prenatal weight gain, and infant birth weight. Data related to these four categories collected during Phase 1 (12 weeks) was examined using date from 253 pre-adolescents (8-12 years of age), and 285 adolescents (13-18 years of age), to determine their impact on the subjects’ BMI. No relationship between a mother’s prenatal weight gain and the child’s BMI was seen. There was a significant correlation between infant birth weight and BMI in the pre-adolescent group. Breastfed subjects entered the POWER program at a lower BMI than non-breast fed subjects and had consistently lower BMIs throughout the program compared to the non-breastfed subjects. Differences in physical activity were observed between adolescents and pre-adolescents. Paired analysis indicated the POWER program was associated with a significant reduction in BMI overall, and among both age groups throughout Phase 1 of the program. Adolescents were especially successful in reducing their BMI compared to preadolescents. Further research is needed to identify the association of maternal and infant factors and BMI among obese children. / Department of Family and Consumer Sciences

African-American women are associated with having the lowest incidence of breast-feeding among ethnic groups. The purpose of this study was to examine attitudes toward infant feeding, feeding intentions, and previous breast-feeding exposure among African-American women. Leininger's Culture Care theory provided the framework. A convenience sample of 98 gravid, adult African-American women receiving care at community health centers was administered a 42-item questionnaire on infant feeding attitudes, intentions, and exposure. Findings indicated that mothers choosing breast-feeding agreed more with the benefits of breast-feeding, and were likely to have previous breastfeeding exposure. Formula feeding mothers agreed more with inconveniences of breast-feeding and advantages of formula feeding, and were more likely not to have had previous exposure. These findings suggest that providing culturally congruent education on the benefits of breast-feeding, information on skills to overcome barriers, and positive breast-feeding exposures could positively effect the incidence of breast-feeding in the African-American population. / School of Nursing

Thesis (Mnutr)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: INTRODUCTION: Malnutrition is a silent emergency. WHO estimates that 55% of all child deaths in developing countries are associated with malnutrition. Inadequate dietary intake and disease are the two immediate causes of malnutrition. The underlying causes are household food insecurity, inadequate maternal and child-care and poor water/ sanitation and inadequate health services. Stunting is a major problem in pre-school children in South Africa. This indicates a long term inadequate dietary intake. Furthermore, the initiation of breastfeeding in South Africa is about 90%, and the duration thereof tends to be less than 3 months after birth. A great majority of children in this country consume a diet deficient in energy and of poor nutrient density to meet their micronutrient requirements. The aim of this study was to identify feeding practices of infants that could contribute to the development of malnutrition. METHOD: This was a cohort study with a prospective experimental design. Forty-four of the original 73 mother-infant pairs that were recruited, were interviewed monthly on feeding practices of the infants. Anthropometric measurements (weight and height of the infants) were measured monthly. RESULTS: Weight-for-age Z-scores dropped significantly with age from around 4 months, when weaning had started. Inadequate dietary intake, more specifically weaning practices and breastfeeding practices, were identified as the immediate cause that could contribute to the development of malnutrition in this community. Except for the positive relationship between the level of education of the father and an increase in HAZ over time, growth was not affected by socio-economic and demographic factors in this community. This is probably because of the fact that there were very small differences in socio-economic and demographic factors. CONCLUSION: Weaning and breastfeeding practices should be addressed in all nutrition education programmes. / AFRIKAANSE OPSOMMING: INLEIDING: Wanvoeding is 'n stil gevaar. Die WGO skat dat daar 'n verband is tussen wanvoeding en ongeveer 55% van alle kindersterftes in ontwikkelende lande. 'n Onvoldoende dieetinname en siekte is die twee onmiddellike oorsake van wanvoeding. Onvoldoende huishoudelike voedselsekuriteit, onvoldoende moeder- en kindsorg en swak sanitasie en watervoorsiening asook onvoldoende gesondheidsorg is die onderliggende oorsake. Dwerggroei is 'n groot probleem in Suid-Afrika onder voorskoolse kinders. Dit dui op 'n langdurige onvoldoende dieetinname. Bydraend hiertoe, is die aanvang van borsvoeding in Suid-Afrika ongeveer 90%, maar die duurte van borsvoeding is minder as 3 maande na geboorte. Die meerderheid van alle kinders in Suid-Afrika se dieet het 'n tekort aan energie en die nutriëntdigtheid van hulle diëte voldoen nie aan hulle daaglikse behoeftes ten opsigte van mikronutriënte nie. Die doel van hierdie studie was om voedingspraktyke te identifiseer wat kan bydra tot die ontwikkeling van wanvoeding. METODE: Dit was 'n kohortstudie met 'n prospektiewe eksperimentele ontwerp. Vier-en-veertig van die oorspronklike aanvanklike moeder-babapare wat gewerf is, is maandeliks ondervra met betrekking tot die voedingspraktyke van die baba en antropometriese metimgs (gewig en lengte van die baba) is maandeliks geneem. RESULTATE: Z waardes van gewig vir ouderdom het beduidend gedaal namate die kinders ouer geword het, veral vanaf 4 maande, toe spening begin het. 'n Onvoldoende dieetinname, meer spesifiek spenings- en borsvoedingspraktyke, is geïdentifiseer as die onmiddellike oorsake wat tot die ontwikkeleing van wanvoeding kan bydra in hierdie gemeenskap. Daar was 'n positiewe verband tussen lengtegroei (Z waardes van lengte vir ouderdom) en die vlak van opvoeding van die vader. Groei is nie deur die ander sosio-ekonomiese en demografiese faktore beïnvloed nie, moontlik as gevolg van die klein verskille in sosio-ekonomiese en demografiese eienskappe van die studie populasie. GEVOLGTREKKING: Spenings- en borsvoedingpraktyke behoort aandag te geniet in alle voedingsvoorligtings-programme.

Thesis (MNutr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background: A number of observational studies where information was obtained retrospectively have been used in the past to inform guidelines regarding allergy prevention. Studies looking at the causative/protective properties of infant dietary factors on diseases that occur later in life also rely on maternal recall many years later. It is unclear however what the effect of the recall bias was on the accuracy/quality of the information obtained. Objectives: The aim of the study was to determine the impact of recall bias 10 years retrospectively on the accuracy of dietary information in relation to breast feeding, weaning age and introduction of allergenic foods. A literature review was performed into studies assessing the accuracy of data obtained retrospectively and into studies using retrospective data to draw conclusions on the protective/causative factors of infant feeding in relation to food allergy. Methodology: An infant feeding questionnaire was developed from some of the same questions that were asked by mothers recruited into the FAIR study, a prospective birth cohort on the Isle of Wight. Families had been recruited and followed up since 2001/2002 and data has been gathered when the mothers were 36 weeks pregnant, and then when their child was 3, 6, 9 months and 1 and 2 years old. Mothers were asked in 2012, when their children were 10 years of age, to complete this questionnaire. Agreement of answers was computed using Kappa coefficients, Spearman’s correlation and percentage agreement. Results: One hundred and twenty five mothers completed the questionnaire. There was substantial agreement for recall of whether mothers breast fed, the duration of EBF and breast feeding 10 years earlier (k = 0.79, r = 0.70 and r = 0.84 respectively). Seven per cent (n = 9) of mothers however who did breast feed reported not to have. Eighty four per cent (n = 103) of mothers recorded correctly whether their child had a bottle of formula milk in hospital. Ninety four per cent (n = 116) of mothers recalled accurately that their child had received formula milk at some stage of their infancy. The exact age at which formula milk was first given to their child was answered accurately (r = 0.63). The brand of formula milk provided was poorly recalled. Answers to when mothers first introduced solid foods into their child’s diet were not accurate (r = 0.16). The age of introduction of peanuts was the only food allergen that mothers recalled accurately for when they first introduced this into their child’s diet (86% correct answers). Recall of whether peanuts were consumed during pregnancy was accurate after two years (k = 0.64) but not after 8 years (k = 0.39). Conclusion: The study highlights the importance of possible recall bias of infant feeding practices by mothers over a period of 10 years. Recall related to breast feeding and formula feeding were accurately recorded for, but not for age of introduction of solid foods and introduction of allergenic foods. Studies relying on maternal recall of weaning questions need to be cautious. / AFRIKAANSE OPSOMMING: Agtergrond: ’n Aantal waarnemingstudies waarin inligting op retrospektiewe wyse of terugwerkend bekom is, is in die verlede gebruik om riglyne oor die voorkoming van allergie neer te lê. Studies oor die veroorsakende/beskermende kenmerke wat kindervoedingsfaktore op latere siektes het, steun verder op die herinneringe wat die moeder baie jare later kan oproep. Dit is egter onduidelik watter uitwerking hierdie oproepvooroordeel op die akkuraatheid/gehalte van die versamelde inligting het. Oogmerke: Die oogmerk met die studie was om die impak te bepaal wat oproepvooroordeel met terugwerkende effek van 10 jaar op die akkuraatheid van voedingsinligting oor borsvoeding, speenouderdom en die insluiting van allergeniese voedselsoorte uitoefen. ’n Literatuuroorsig was onderneem van studies wat die akkuraatheid evalueer van data wat retrospektief bekom is, asook studies wat retrospektiewe data gebruik om gevolgtrekkings oor die beskermende/veroorsakende kenmerke van kindervoeding met betrekking tot voedselallergie te maak. Metodologie: ’n Kindervoedingsvraelys is saamgestel vanaf sommige van die vrae wat aan gewerfde moeders voorheen in die FAIR-studie, ’n voornemende geboortekohort op die eiland Wight, gestel is. Gesinne is in 2001/2002 gewerf en opgevolg, en data is versamel toe die moeders 36 weke swanger was; en weer toe hulle kinders die ouderdom van 3, 6, 9 maande en 1 en 2 jaar bereik het. In 2012, toe hulle kinders 10 jaar oud was, is die moeders weer versoek om hierdie vraelys in te vul. Ooreenstemming tussen antwoorde is bepaal deur Kappa koeffisiënte, Spearman korrelasies en persentasie ooreenstemming. Resultate: Eenhonderd vyf-en-twintig moeders het die vraelys ingevul. Daar was beduidende ooreenkoms in die moeders se oproep oor die vraag of hulle borsvoeding gegee het, hoe lank eksklusiewe borsvoeding (EBV) geduur het, asook borsvoeding 10 jaar vantevore (k = 0.79, r = 0.70 en r = 0.84 onderskeidelik). Sewe persent (n = 9) van die moeders wat wel borsvoeding gegee het, het egter geantwoord dat hulle dit nie gegee het nie. Vier-en-tagtig persent (n = 103) van die moeders het akkuraat geantwoord op die vraag of hulle kinders bottelvoeding met ’n melkformule in die hospitaal ontvang het. Vier-en-negentig persent (n =116) van die moeders kon akkuraat oproep dat hulle kinders in ’n sekere stadium van hulle kindertyd melkformule ontvang het. Die vraag oor presies hoe oud die kinders was toe hulle die eerste maal melkformule ontvang het, is akkuraat beantwoord (r = 0.63). Die handelsnaam van die melkformule kon nie goed herroep word nie. Antwoorde oor wanneer moeders die eerste maal vaste voedsel by hulle kinders se dieet ingesluit het, was nie baie akkuraat nie (r = 0.16). Die ouderdom waarop grondboontjies ingesluit is, was die enigste antwoord wat moeders akkuraat kon oproep (86% korrekte antwoorde) op die vraag wanneer hulle die eerste maal ’n voedselallergeen by hulle kinders se dieet ingesluit het. Die antwoord op die vraag of hulle tydens hul swangerskap grondboontjies geëet het, was akkuraat na twee jaar (k = 0.64), maar nie na agt jaar (k = 0.39) nie. Gevolgtrekking: Die studie onderstreep die belang van moontlike oproepvooroordeel rakende kindervoedingspraktyke by moeders oor ’n tydperk van 10 jaar. Die oproep oor borsvoeding en formulevoeding is korrek aangedui, maar nie vir die ouderdom waarop vaste voedselsoorte en allergeniese voedselsoorte ingesluit is nie. Studies wat op moederoproep oor speningsvrae staatmaak, moet omsigtig gedoen word.

Thesis (Mnutr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Inappropriate feeding practices are a major cause of malnutrition in young children. Within this context, it has been well documented that the incidence of malnutrition rises sharply during the period from six to 18 months of age in most countries. Complementary feeding typically covers the period from six to 24 months of age. Renewed focus has been placed on the promotion of breastfeeding. Similar attention should be paid to complementary feeding. Six percent of deaths per year are preventable through good complementary feeding practises. To improve infant nutrition it is important to know the local infant and young child feeding practises present in communities but also to identify and understand the underlying factors that influence these practises. Aim The study aimed to describe the various factors that influence complementary feeding practices of infants aged 6 – 12 months in 2 communities (Avian Park and Zweletemba) in the Breede Valley district of the Western Cape. Methods The study was conducted from May – July 2012. A descriptive study design was used. A qualitative approach was followed with the use of focus group discussions with mothers / primary caregivers, fathers and grandmothers of infants aged 6 – 12 months. Results The findings of this study provide insight into different aspects regarding early cessation of breastfeeding that could lead to early introduction of complementary foods. In both Avian Park and Zweletemba the age of introduction of liquids and solids ranged from birth to 12 months. Various liquids such as water, over the counter medicine, high concentrated sugar beverages and low nutrient beverages were given to infants from as young as two days post-partum by means of a feeding bottle. Cow’s milk was also introduced before six months of age for reasons such as affordability, availability and because cow’s milk does not need boiling water for reconstitution like formula milk, especially when access to electricity is inadequate. Infants from both communities also received meelbol (flour and water beverage) fed either via feeding bottles (as a beverage) or as porridge fed to the infant with a spoon. Porridge (especially rice cereal and maize meal porridge) was introduced to infants from one week post-partum and infants from both areas also received family “food from the pot” before the age of 6 months. In this study it was found that it was most often a female (either the mother or the grandmother) in the household who was responsible for buying and preparing food and for feeding the infant. Health care workers, members of the mothers’ household as well as community members were identified as key role players in conveying information regarding breastfeeding and complementary feeding from birth to 1 year. Various factors were identified in this study that influenced suboptimal infant feeding practises in Avian Park and Zweletemba. The main factors identified were i) health, ii) physiological, iii) nutritional, iv) educational, v) behavioural, vi) financial and vii) social factors. Other aspects mentioned were viii) demographic and x) commercial factors. Conclusion Results indicated that the current practices and factors influencing the feeding practices in Avian Park and Zweletemba were similar there was very little to no cultural differences between the two communities in terms of current practices and influencing factors. The findings of this study have highlighted the importance of involving all household members in interventions, as well as the larger community in a public nutrition approach. Factors influencing current feeding practises should be considered carefully when planning future interventions to improve infant feeding practises. / AFRIKAANSE OPSOMMING: Onvanpaste voedingspraktyke is ‘n groot oorsaak van wanvoeding in jong kinders. Binne hierdie konteks is dit goed gedokumenteer dat die voorkoms van wanvoeding skerp styg gedurende die tydperk vanaf ses tot 18 maande ouderdom in die meeste lande. Komplimentêre voeding dek tipies die tydperk van ses tot 24 maande oud. Hernude fokus word geplaas op die bevordering van borsvoeding. Komplimentêre voeding behoort soortgelyke aandag te kry. Ses persent van sterftes per jaar is voorkombaar deur goeie komplimentêree voedingpraktyke. Om kindervoeding te verbeter is dit belangrik om bekend te wees met plaaslike baba- en jong kind praktyke in gemeenskappe, en ook om die onderliggende faktore wat hierdie praktyke beïnvloed te identifiseer en verstaan. Doelwit Hierdie studie het gepoog om die verskillende faktore ten opsigte van die komplimentêre voeding praktyke van babas tussen 6 – 12 maande te beskryf in 2 gemeenskappe (Avian Park en Zweletemba) in die Breede Vallei distrik van die Wes-Kaap. Metodes Die studie is uitgevoer vanaf Mei – Julie 2012. ‘n Beskrywende studie ontwerp is gebruik. ‘n Kwalitatiewe benadering is gevolg met die gebruik van fokusgroepbesprekings met moeders / primêre versorgers, vaders en oumas van babas tussen 6 – 12 maande. Resultate Die bevindinge van hierdie studie voorsien insae in die verskillende aspekte van die vroeë beëindiging van borsvoeding wat kan lei tot vroeë bekendstelling van komplimentêre voeding. In beide Avian Park en Zweletemba het die ouderdomme van insluiting van vloeistowwe en vaste stowwe gewissel van geboorte tot 12 maande.Verskeie vloeistowwe soos water, oor-die-toonbank-medisyne, hoë konsentrasie suiker drankies en lae voedingswaarde drankies was aan babas gegee so vroeg as twee dae post-partum deur middel van ‘n voedingsbottel. Koeimelk was ook gegee voor 6 maande, om redes soos bekostigbaarheid, beskikbaarheid en omdat koeimelk nie kookwater benodig vir hersamestelling soos formule melk nie, veral in situasies waar toegang tot elektrisiteit onvoldoende is. Babas van beide gemeenskappe was ook meelbol (meel en water drankie) gevoer óf via voedingsbottels (as ‘n vloeistof) of as ‘n pap wat gevoer word met ‘n lepel. Pap (veral ryspap en mieliemeelpap) was gegee vanaf een week post-partum en babas van beide gebiede het ook familie kookkos ontvang “vanuit die pot” voor 6 maande. In hierdie studie is bevind dat dit heel dikwels ‘n vrou (óf die moeder of ouma) in die huishouding is wat verantwoordelik is vir die koop en voorbereiding van voedsel asook die voer van die baba. Gesondheidswerkers, lede van die moeder se huishouding sowel as lede van die gemeenskap is geïdentifiseer as belangrike rolspelers in die oordrag van inligting oor borsvoeding en komplimentêre voeding vanaf geboorte tot een jaar. Die belangrikste faktore geïdentifiseer was verwant aan: i) gesondheid, ii) fisiologie, iii) voedingswaarde , iv) opvoedkunde, v) gedrag, vi) finansies en vii) sosiale faktore. Ander aspekte genoem is: vii) demografiese en x) kommersiële faktore. Gevolgtrekking Resultate het aangedui dat die huidige voedingpraktyke soortgelyk was in Avian Park en Zweletemba en dat daar baie min kulturele verskille tussen die twee gemeenskappe was in soverre huidige praktyke en faktore wat dit beïnvloed. Die bevindinge van hierdie studie het die belangrikheid daarvan uitgelig om al die lede van die huishouding, sowel as die breër gemeenskap in te sluit in intervensies met ‘n openbare voeding benadering. Faktore wat die huidige babavoeding praktyke beïnvloed moet versigtig oorweeg word tydens die beplanning van toekomstige intervensies om babavoeding praktyke te verbeter.