Fish and Complementary Feeding Practices for Young Children: Qualitative Research Findings From Coastal Kenya

Abstract

ObjectivesTo assess the potential barriers and facilitators to fish consumption during the complementary feeding period in two coastal counties of Kenya with high rates of child malnutrition. MethodsThis qualitative study was part of a mixed-methods formative research investigation to examine the role of sustainable fish production and access to fish foods in coastal communities in Kenya. Twenty in-depth interviews were conducted with primary caregivers of children less than five years (n = 12) and community health workers and nutritionists (n = 8) in Kilifi County and Kwale County. Interviews were transcribed, translated and analyzed. A conceptual framework was developed based on the analysis to illustrate major factors and pathways influencing decisions to feed fish in the complementary feeding period. ResultsComplementary feeding practices reported by caregivers showed a low level of fish consumption in young children and delayed introduction of fish to the diet. Findings indicate that fish consumption was impacted by factors related to accessibility, food preferences, and caregiver’s knowledge and beliefs. Access to fish was driven primarily by cost, proximity to locations where different fish types were sold, gendered purchasing behavior and the seasonal availability of fish foods. In some cases, the high cost of fish outweighed positive associations or perceived nutritional benefits when deciding whether to feed fish to children. Caregivers’ knowledge, beliefs, and food preferences also impacted consumption, with mixed perceptions regarding the importance of fish as a source of protein and other nutrients. These direct factors were influenced by prominent community figures such as elder women and health workers, whose own beliefs and understandings were impacted by underlying cultural norms, potentially limiting fish consumption. ConclusionsUnderstanding current attitudes and beliefs toward fish consumption during the complementary feeding phase is a critical first step towards the creation of more effective policies and interventions that incorporate sustainable fish foods to address significant nutritional disparities that exist in the study population. Funding SourcesThis study was supported by the United States Agency for International Development (USAID) Feed the Future Innovation Lab for Fish.