Infant and Young Child Feeding Perceptions and Practices Among Caregivers Living in Three Districts in the Central Region of Ghana

Abstract

ObjectivesThis qualitative study sought to understand caregiver practices related to exclusive breastfeeding (EBF), meal frequency, diet diversity, and responsive feeding in rural communities in Ghana. MethodsFifty-two audio-taped in-depth interviews were conducted in local dialects with caregivers (teen and adult mothers, fathers, and grandmothers) of children younger than 1-year-old living in three districts in Ghana’s Central Region. Recordings were translated, transcribed into English, then read and coded independently by two authors. Consensus was reached on emerging domains and themes, and a final codebook was developed. ResultsCaregivers were knowledgeable about EBF and complementary feeding recommendations. However, preliminary findings showed that non-adherence to EBF was common. Water was fed to address perceived thirst and/or to soothe persistent crying. Perceived readiness for complementary foods was tied to the belief that, by 3–6 months, breastmilk could not satisfy hunger. From the sixth month, infants were fed at least three times, including night feeds, and perceived to be capable of eating any family foods if home prepared soft and not spicy. Caregivers understood that local proteins such as pounded dried fish could be added to soups and stews while egg yolk could be added to porridge. Responsive and non-responsive feeding practices emerged. Meals were fed using spoons, cups, and bowls, and caregivers constantly engaged and interacted with the child (cooing) to encourage eating. Caregivers were aware that introducing new foods may require several tries before acceptance and recommended patience and encouragement when offering new foods. Caregivers typically used time of day and incessant crying to recognize hunger, not knowing how to identify subtle hunger cues. Some misperceptions about early foods centered around illness, especially stomach aches and diarrhea, and how those might be a result of late night feeding or sugary foods/snacks. ConclusionsGaps were seen between caregiver knowledge of feeding recommendations and some infant and young child (IYCF) perceptions/practice. Caregivers in this population may benefit from targeted IYCF counseling to facilitate optimal caregiver practices. Funding SourcesThis study was funded by UNICEF-Ghana.