"The battle of feeding": Awareness and practices of responsive complementary feeding in Anuradhapura, Sri Lanka-a qualitative study

Abstract

Background: Responsive feeding (RF) is an evidence-based behaviour in complementary feeding. Although included in the infant feeding guidelines of Sri Lanka, it is doubtful whether knowledge and practices entailed to RF is established in the Sri Lankan community. Objectives: To explore the knowledge and practices of RF among mothers having nine month old infants and to explore attitudes of public health midwives (PHMs) towards the concept. Method: A qualitative study was conducted using in-depth interviews in caregivers of 9 month old infants and focused group discussions in PHMs of Nuwaragam Palatha Central area in Anuradhapura district. Interviews were tape recorded, transcribed and thematic analysis performed. Results: None of the mothers effectively practised the full concept of RF. Only a few mothers have prepared a separate feeding place. Although signals of hunger and satiety were identified, most mothers did not use them in an appropriate manner in feeding. Letting the child watch television and taking the child round the garden were common suboptimal practices. Mothers stated the difficulty in introducing new food to their children indicating lack of reciprocity between them and children. The public health midwives also had poor understanding on total concept of RF. Conclusions: PHMs and mothers having nine month old infants have poor understanding and practices on the concept of RF.