The purpose of the study was to determine if mothers who breast-feed their babies for nine months and longer experience problems when weaning. This research also determines the type of problems and weaning practices used by those mothers. In this descriptive study, data was collected from 150 mothers by means of questionnaires and interviews. The subjects were mothers who breast-fed their children for nine months or longer, who attended antenatal and postnatal clinics at Coronation Hospital. Reasons for weaning were inter alia the belief that the baby was old enough to be weaned. The results revealed that 42 (31,34%) of the respondents experienced problems during weaning. The problems included, among others, guilt feelings in the mother. Mothers use harsh methods of weaning such as sending a child away to a relative. There is minimal involvement of health workers in the health education of mothers on weaning. / Health Studies / M.A. (Nursing Science)

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The impact of infant feeding practices in the prevention of mother-to-childtransmission of HIV raised concerns in the field of health services. Breast feeding adds an additional 15-30% risk of HIV transmission to the infant; therefore, mothers who are HIV-positive are in need of information regarding safe infant feeding. A descriptive design for this particular study was applied with a primary quantitative approach. A convenient sample of sixty (n=60) participants between the ages of 15 – 37 were taken from subjects that enrolled in the prevention of mother-to-child transmission (PMTCT) programme in Onandjokwe district. The sample formed 85% of the target population (N=71). A structured questionnaire with closed and openended questions was used and completed by the researcher. Ethical approval for the study was obtained from the Ethics Committee at the Faculty of Health Sciences, University of Stellenbosch. Permission to conduct the research was obtained from the Ministry of Health and Social Services, Namibia, and the Onandjokwe district Hospital. A pilot study was conducted that constituted 25% of the sample. Validity and reliability was insured by the pilot study and the consultation of an expert in HIV research and an expert in nursing research. The presentation of results was mostly descriptive in nature by using frequency tables and a pie chart. The results showed that all participants (n=60/100%) were offered HIV counselling and testing during antenatal care. Mothers who were HIV positive knew that there is a possibility that the baby might be infected through breast milk. Furthermore, the study found that 70% (n=42) of participants used breast feeding exclusively, 20% (n=12) used replacement feeding and 10% (n=6) used mixed feeding practices. It was concluded that pregnant women and mothers known to be HIV-infected should be informed of the infant feeding practice recommended by the national or subnational authority to improve HIV-free survival of HIV-exposed infants. This includes information about the risks and benefits of various infant feeding options based on local assessments and guidance in selecting the most suitable option for their own situation. / AFRIKAANSE OPSOMMING: Die invloed van voedingspraktyke vir babas by die voorkoming van moeder-na-kindoordrag van die menslike immuungebrekvirus (MIV) het kommer op die gebied van gesondheidsdienste laat ontstaan. Borsvoeding dra ’n addisionele 15–30% risiko van MIV-oordrag tot die baba by en daarom benodig moeders wat MIV-positief is inligting ten opsigte van veilige voeding van hulle babas. 'n Beskrywende ontwerp vir hierdie besondere studie is gebruik tesame met 'n primêr kwantitatiewe benadering. 'n Gerieflikheidsteekproef van sestig (n=60) deelnemers tussen die ouderdomme 15–37 jaar is gekies uit persone wat ingeskryf het vir die voorkoming van moeder-na-kind-oordrag (VMNKO) program in Onandjokwe-distrik. Die steekproef het 85% van die teikenpopulasie (N=71) uitgemaak. 'n Gestruktureerde vraelys met geslote en oop vrae is gebruik en deur die navorser voltooi. Etiese goedkeuring vir die studie is verkry van die Etiese Kommitee van die Fakulteit Gesondheidswetenskappe, Universiteit Stellenbosch. Toestemming om die navorsing te doen, is verkry van die Ministerie van Gesondheid en Maatskaplike Dienste, Namibië, en die Onandjokwe Distrikshospitaal. 'n Loodsstudie is onderneem wat 25% van die steekproef behels het. Geldigheid en betroubaarheid is verseker deur die loodsstudie en oorlegpleging met 'n kundige op die gebied van MIV-navorsing en 'n kundige in verpleegnavorsing. Die aanbieding van resultate was meestal deskriptief van aard deur van frekwensietabelle en 'n sektordiagram gebruik te maak. Die resultate het getoon dat MIV-berading en -toetsing gedurende voorgeboortesorg aan alle deelnemers (n=60/100%) aangebied is. Moeders wat MIV-positief is, het geweet dat daar 'n moontlikheid bestaan dat die baba moontlik deur moedersmelk geïnfekteer kan word. Verder het die studie bevind dat 70% (n=42) van deelnemers uitsluitlik borsvoeding gebruik, 20% (n=12) gebruik ’n vervanging vir moedersmelk en 10% (n=6) gebruik gemengde voedingspraktyke. Daar is tot die slotsom gekom dat swanger vroue en moeders van wie bekend is dat hulle MIV-geïnfekteer is, ingelig behoort te word oor die babavoedingspraktyk aanbeveel deur die nasionale of subnasionale owerheid vir die verbetering van MIVvrye oorlewing van babas wat aan die MIV blootgestel is. Dit sluit in inligting oor die risiko’s en voordele van verskeie babavoedingsopsies gebaseer op plaaslike assesserings en leiding ten opsigte van die kies van die geskikste opsie vir hulle eie situasie.

No description available.

Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Consumer Sciences: Food and Nutrition in the Faculty of Applied Sciences at the Cape Peninsula University of Technology 2013 / Child undernutrition is the outcome of numerous complex and interrelated factors. It is considered a worldwide health concern, also in Botswana. Undernourished infants are especially vulnerable to develop nutritional deficiencies and diseases. Tsabana was developed as a weaning food to improve the diet quality of undernourished infants in Botswana but also as a dietary intervention product for the four-month- to five-year-old age group to improve the nutritional status of Batswana children. The study undertook a theoretical nutritional appraisal of Tsabana and assessed its acceptance and use in rural districts of Botswana. A quantitative approach that incorporated a survey was used as the research design for the study. A pre-tested questionnaire consisting of close-ended questions in the multiple choice format was used to collect the data on the field acceptance and use of Tsabana. The questionnaire was completed by 105 caregivers of infants aged six to 36 months old visiting the selected clinics with the research sites the Ngamiland, North East, Central and Kweneng rural districts. The energy, macro- and micronutrient content adequacy of Tsabana was compared to the Codex Alimentarius Standard for Processed Cereal-based Foods for Infants and Young Children (Codex Standard 074) and the Proposed Nutrient Composition for Fortified Complementary Foods (PNCFCF). Sorghum and soya are the two major ingredients of Tsabana which contribute to its protein and energy provision. The nutrient appraisal revealed that the level of energy provided by Tsabana is more than the specified Codex Alimentarius Standard composition but slightly less than the PNCFCF specified range, whereas the protein level is within the specified ranges as put forward by both the Codex composition and the PNCFCF, respectively. The results further revealed that in comparison to the PNCFCF the content of vitamins A, E, C and pyridoxine, zinc, iodine and iron were less than the specified ranges. The content of vitamins A and D met the compositional guidelines of the Codex Alimentarius Standard. The micronutrient provision of Tsabana in relation to the World Health Organization (WHO) recommended nutrient intakes was mostly adequate except for pyridoxine which was inadequately provided for both seven- to 18-month-old (33% provision) and one- to three-year-old (52% provision) infants at the daily rations of 75 gram (g) and 200 g powder respectively. Some minerals also were provided at inadequate amounts, e.g. iodine at a daily provision of 42% as well as iron at 26% for seven- to 12-month-old and 12- to 18-month-old infants both provided at a daily ration of 75 g Tsabana powder. Zinc was only provided at 19% of the WHO recommended intake for seven- to 12-month-old and 14.8% for 12- to 18-month-old infants. As with the absence of omega-3 and omega-6 fatty acids, the minerals selenium and copper are not provided by Tsabana. The micronutrient fortification compounds used in Tsabana for the mineral and vitamin additions as vitamin A palmitate, cholecalciferol, vitamin E acetate, calcium pantothenate, carbonate and tri-calcium phosphate (ratio 1:18:482), zinc sulphate and potassium iodate are readily bioavailable, but not the vitamin A and vitamin E compounds used. The iron fortificant used is not stipulated on the Tsabana package. The field survey results revealed that Tsabana was well accepted by the infants as perceived by their caregivers as the majority indicated that Tsabana was enjoyed (80%) and that it tasted nice (71.4%). The majority (78.1%) of the caregivers also indicated that the wellbeing of the infants improved on receiving Tsabana. Most (51.4%) of them also knew that Tsabana is more nutritious than other cooked porridges. Tsabana though was not used properly as most of the caregivers fed Tsabana to the infant only once a day (60.9%) instead of two to three times (for infants six- to 18-month-olds) and did not use enough water (3½ cups) (76.2%) to cook one feeding of Tsabana as stipulated on the Tsabana package. The product use factors, which include the number of daily Tsabana feedings provided, the addition of sugar to the cooked Tsabana, the amount of water used to cook one feeding of Tsabana and the cooking period of one feeding were the factors significantly (p < 0.05) linked to the perceived infant acceptance of Tsabana. The number of daily Tsabana feedings was linked to the perceived enjoyment of Tsabana (p < 0.05) and its perceived texture (p < 0.05) and colour (p < 0.05) acceptance. While the addition of sugar to the cooked Tsabana was linked to its perceived enjoyment (p < 0.05), the amount of water used to its perceived taste acceptance (p < 0.05) and the cooking period of one feeding to its perceived colour acceptance (p < 0.05). For instance, more caregivers in relation to the enjoyment of Tsabana and its colour and texture acceptance who perceived it not to be enjoyed and not having a nice colour or texture, indicated not to feed it daily in comparison to caregivers who perceived that Tsabana was enjoyed by the infants and that it had a nice colour and texture. The caregiver perceived infant wellbeing improvement through the provision of Tsabana and the perceived difference between Tsabana and other cooked porridges were the only two clinic-related factors which significantly (p < 0.05) influenced the infant acceptance of Tsabana as perceived by the caregivers. For instance, while the majority (86.2%, 84.8% and 80%, respectively) of the caregivers who perceived the infant taste acceptance of Tsabana as very nice, nice or acceptable indicated that providing Tsabana to the infant improved the infant’s wellbeing, the majority (80%) who perceived it as not tasting nice indicated that providing Tsabana to the infant had not improved the infant’s wellbeing. More than half of the caregivers who perceived the infant texture acceptance of Tsabana as acceptable (59.4%) or nice (56.8%) indicated that Tsabana provides more nutrition to the infant. However, less than half (46.2%) of the caregivers who perceived the texture of Tsabana as not nice indicated that it provides more nutrition to the infant. The caregiver education level was the only demographic factor that significantly (p < 0.05) influenced the acceptance of Tsabana. The majority (90.3%) of the caregivers who attained a secondary education level (form 1 to form 4) and higher, perceived the infant texture acceptance of Tsabana as nice, acceptable or not nice. In contrast, the majority who perceived the texture acceptance as very nice attained either no schooling/standard one to seven (73.9%) and not a secondary level or higher (26.1%). It could be speculated that caregivers who attained a higher education level may be more critical of such attributes such as the texture acceptance of Tsabana. Most (59%) of the caregivers indicated that they did not receive any information regarding Tsabana from the clinic personnel. Caregiver education on Tsabana and infant nutrition will impart sufficient knowledge and skills to prepare, store and adequately feed Tsabana to their infants as well as provide a variety of foods in adequate amounts to contribute to their optimal growth and development. This is a vital undertaking as it was evident from the study that most of the factors that influenced the acceptance of Tsabana were the product use factors. The study additionally found that foods such as meat, poultry and fish, as well as fruit and vegetables, which should be included in the daily dietary provision, were provided to most of the study infants on a weekly basis only.

Breastfeeding is the optimal form of infant feeding. It appears to protect children from certain childhood diseases that are over represented in the Aboriginal population. Although breastfeeding rates in the general Canadian population have increased over the past two decades, they remain lower than recommended. Rates in the Canadian Aboriginal population are even lower. Breastfeeding literature among Aboriginals is largely demographic and statistical in nature and focuses primarily on First Nations women living on reserves. The purpose of this study was to investigate the factors influencing the infant feeding decisions of Aboriginal women living in Saskatoon. Data were collected using qualitative methods, including face-to-face interviews and prolonged observation. Between October 2003 and May 2004, interviews were conducted with a total of eight participants recruited from the Food for Thought program in Saskatoon. A semi-structured prenatal interview was followed by two unstructured, in-depth interviews at approximately one month postpartum. The researcher's participation in two weekly Food for Thought sessions over the same time period allowed for prolonged observation. Observations were recorded using field notes and interviews were tape-recorded and transcribed verbatim. Observation and interview data from each participant were analyzed separately for dominant themes and then integrated to establish collective influencing factors. Results indicated influencing factors are numerous and varied in nature. Contextual (sociocultural and environmental), attitudinal, cognitive (knowledge, information and beliefs), experiential (previous infant feeding experiences), and psychological influences were revealed. The principle implication of this study for those involved with the protection, support, and promotion of breastfeeding in this population is that there are many factors capable of influencing feeding decisions. Feeding decisions are not static; they are dynamic and result from the complex interplay between influencing factors. The importance or significance of any single factor is a reflection of the circumstances surrounding the particular feeding decision.

Breastfeeding is the optimal form of infant feeding. It appears to protect children from certain childhood diseases that are over represented in the Aboriginal population. Although breastfeeding rates in the general Canadian population have increased over the past two decades, they remain lower than recommended. Rates in the Canadian Aboriginal population are even lower. Breastfeeding literature among Aboriginals is largely demographic and statistical in nature and focuses primarily on First Nations women living on reserves. The purpose of this study was to investigate the factors influencing the infant feeding decisions of Aboriginal women living in Saskatoon. Data were collected using qualitative methods, including face-to-face interviews and prolonged observation. Between October 2003 and May 2004, interviews were conducted with a total of eight participants recruited from the Food for Thought program in Saskatoon. A semi-structured prenatal interview was followed by two unstructured, in-depth interviews at approximately one month postpartum. The researcher's participation in two weekly Food for Thought sessions over the same time period allowed for prolonged observation. Observations were recorded using field notes and interviews were tape-recorded and transcribed verbatim. Observation and interview data from each participant were analyzed separately for dominant themes and then integrated to establish collective influencing factors. Results indicated influencing factors are numerous and varied in nature. Contextual (sociocultural and environmental), attitudinal, cognitive (knowledge, information and beliefs), experiential (previous infant feeding experiences), and psychological influences were revealed. The principle implication of this study for those involved with the protection, support, and promotion of breastfeeding in this population is that there are many factors capable of influencing feeding decisions. Feeding decisions are not static; they are dynamic and result from the complex interplay between influencing factors. The importance or significance of any single factor is a reflection of the circumstances surrounding the particular feeding decision.

No abstract available. / Thesis (M.A.)-University of Natal, Durban, 2003.

Thesis (MVoeding)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Objectives and scope of investigation Following the 1996 recommendations of a FAO/WHO expert panel for the development of food-based dietary guidelines (FBDGs) unique and specific to the needs of the populations of different countries, a South African FBDG Working Group was formed and ultimately also a Paediatric FBDG (PFBDG) Working Group with the task of the latter being the development of FBDGs for children younger than 7 years. A set of preliminary PFBDGs, chosen to address the most pressing paediatric public health issues, namely protein-energy malnutrition, micronutrient deficiencies and infectious diseases, were formulated for each age group sub-category (0-6 months, 6-12 months and 1-7 years). The following set of preliminary PFBDGs for the age group 6-12 months were approved by the Working Group to be subjected to consumer testing: • Enjoy time with your baby • From six months start giving your baby small amounts of solid foods • Gradually increase your baby’s meals to five times a day • Keep breast feeding your baby • Offer your baby clean, safe water regularly • Teach your baby to drink from a cup • Take your baby to the clinic every month Assessment of the consumer’s comprehension, interpretation of the proposed guidelines, and ability to apply them, was considered essential before the PFBDGs could be finalised, disseminated to the consumer, and implemented as an educational tool for health professionals and community workers. This study was also the first in which PFBDGs were tested, and was intended to be a pilot study for further testing of PFBDGs for this age category in other parts of the country, adapted for different circumstances. The investigation was conducted among women who were mothers or caregivers to infants 6-12 months of age in the Afrikaans-, English- and Xhosa-speaking communities of the greater Oudtshoorn area, including Bongulethu, Bridgeton and Toekomsrus and its adjacent rural areas of Dysselsdorp, Calitzdorp, Uniondale, Ladismith and Zoar. Methodology The study was designed to be an observational, descriptive and cross-sectional study. Qualitative data was collected from a sample of 64 volunteers who took part in ten focus group discussions each attended by between 3 and 11 participants. Group discussions were recorded on videotape and quantitative and qualitative questionnaires measured pre-discussion knowledge and comprehension of guidelines, perceived hindrances to compliance with guidelines and perceived importance of guidelines as well as socio-demographic data. Results and conclusions With this study, useful and enlightening information was obtained which met the research objectives. Participants discussed the guidelines in depth and information obtained from the questionnaires were found to support what was said during the discussions. Body language or non-verbal communication as observed, and recorded on videotape, also complemented the information gained from the discussions. Summarily it can be said that the guidelines were well-received and perceived as important by the majority of respondents, although some of the guidelines were initially not well-understood without explanation. Furthermore, the fact that the applicability of the guideline on prolonged breast feeding seems to be the most problematic, is a cause for concern. In view of the results obtained in this study, it can be concluded that PFBDGs will have to be supported by extensive and appropriate educational material to be effective when introduced to the public. The findings of this study will be submitted to the PFBDG Working group for consideration before finalisation of the guidelines for the age group 6-12 months. / AFRIKAANSE OPSOMMING: Doelwitte en omvang van die studie Na aanleiding van die 1996 aanbevelings van ‘n VLO/WGO paneel van kenners vir die ontwikkeling van voedselgebaseerde dieetriglyne (VGDR) wat uniek en spesifiek gerig is tot die behoeftes van die bevolkings van verskillende lande, is ‘n Suid-Afrikaanse VGDR Werkgroep gevorm en uiteindelik ook ‘n Pediatriese VGDR (PVGDR) Werkgroep met die opdrag van laasgenoemde om VGDRe te ontwikkel vir kinders jonger as 7 jaar. ‘n Stel voorlopige Pediatriese VGDRe, gekies om die mees dringende pediatriese publieke gesondheidsvraagstukke, naamlik proteïn-energie wanvoeding, mikronutriënttekorte en infektiewe siektetoestande aan te spreek, is geformuleer vir elke ouderdomsgroep subkategorie (0-6 maande, 6-12 maande en 1-7 jaar). Die volgende stel voorlopige PVGDRe vir die ouderdomsgroep 6-12 maande is deur die Werkgroep goedgekeur om aan verbruikerstoetsing te onderwerp: • Geniet tyd saam met jou baba • Begin vanaf ses maande om jou baba klein hoeveelhede vaste kos te gee • Vermeerder jou baba se maaltye geleidelik na vyf keer per dag • Hou aan om jou baba te borsvoed • Bied gereeld vir jou baba skoon, veilige drinkwater aan • Leer jou baba om uit ‘n koppie te drink • Neem jou baba elke maand kliniek toe Evaluering van die verbruiker se begrip, interpretasie van die riglyne en die vermoë om die riglyne te implementeer, is as noodsaaklik beskou voordat die PVGDRe gefinaliseer kon word, vrygestel kon word aan die publiek, en aan professionele- en gemeenskapsgesondheidswerkers beskikbaar gestel kon word as ‘n onderrighulpmiddel. Hierdie studie was die eerste waarin PVGDRe getoets is en dit is bedoel as ‘n voorloperstudie vir verdere toetsing van PVGDRe vir hierdie ouderdomskategorie in ander dele van die land en aangepas vir ander omstandighede. Die ondersoek is gedoen onder vroue wat moeders of versorgers van babas van 6-12 maande was in die Afrikaans- Engels- en Xhosasprekende gemeenskappe van die groter Oudtshoorn area wat Bongulethu, Bridgton en Toekomsrus insluit asook die nabygeleë plattelandse gemeenskappe van Dysselsdorp, Calitzdorp, Uniondale, Ladismith en Zoar. Metodiek Die studie is ontwerp om ‘n waarnemende en beskrywende analise van ‘n deursnee van die studiepopulasie moontlik te maak. Kwalitatiewe data is verkry van ‘n proefmonster van 64 vrywilligers wat deelgeneem het aan tien fokusgroep besprekings wat elk deur 3 tot 11 persone bygewoon is. Groepbesprekings is op videoband opgeneem en kwantitatiewe en kwalitatiewe vraelyste het voorbesprekings kennis en begrip van die voorgestelde riglyne, vermeende verhindering tot uitvoering van die riglyne en vermeende belangrikheid van riglyne sowel as sosio-demografiese inligting gemeet. Resultate en gevolgtrekkings Met hierdie studie is bruikbare en verhelderende inligting verkry wat beantwoord het aan die doelwitte van die studie. Deelnemers het die riglyne in diepte bespreek en dit is bevind dat inligting wat van die vraelyste verkry is, ook dit bevestig het wat gedurende die sessies bespreek is. Lyftaal en nie-verbale kommunikasie soos waargeneem en soos op videoband vasgelê, het ook die inligting ondersteun wat van die besprekingsessies verkry is. Opsommend kan gesê word dat die riglyne goed ontvang is en as belangrik beskou is deur die meerderheid van respondente. Sommige van die riglyne was nie vir deelnemers goed verstaanbaar sonder meegaande verduideliking nie. Verder is die feit dat die toepasbaarheid van die riglyn met betrekking tot ‘n verlengde tydperk van borsvoeding voorgekom het as die mees problematiese, ‘n rede tot kommer In die lig van die resultate van hierdie studie, kan daar tot die slotsom gekom word dat PVGDRE ondersteun sal moet word deur omvattende en gepaste onderrigmateriaal om effektief te kan wees wanneer dit aan die publiek bekend bekend gestel word. Die bevindings van hierdie studie sal aan die Pediatriese VGDR Werkgroep voorgelê word vir oorweging voordat riglyne vir die ouderdomsgroep 6-12 maande gefinaliseer word.

The purpose of the study was to determine if mothers who breast-feed their babies for nine months and longer experience problems when weaning. This research also determines the type of problems and weaning practices used by those mothers. In this descriptive study, data was collected from 150 mothers by means of questionnaires and interviews. The subjects were mothers who breast-fed their children for nine months or longer, who attended antenatal and postnatal clinics at Coronation Hospital. Reasons for weaning were inter alia the belief that the baby was old enough to be weaned. The results revealed that 42 (31,34%) of the respondents experienced problems during weaning. The problems included, among others, guilt feelings in the mother. Mothers use harsh methods of weaning such as sending a child away to a relative. There is minimal involvement of health workers in the health education of mothers on weaning. / Health Studies / M.A. (Nursing Science)

No description available.