Development and Field-Testing of Proposed Food-Based Dietary Guideline Messages and Images amongst Consumers in Tanzania

In this paper we report on the development and field-testing of proposed food-based dietary guideline (FBDG) messages among Tanzanian consumers. The messages were tested for cultural appropriateness, consumer understanding, acceptability, and feasibility. In addition, comprehension of the messages was assessed using culturally representative images for low literacy audiences. Focus group discussions were used as method for data collection. Results indicate that the core meaning of the proposed FBDG messages and images were understood and acceptable to the general population. However, participants felt that nutrition education would be required for improved comprehension. Feasibility was affected by some cultural differences, lack of nutrition knowledge, time constraints, and poverty. Suggestions were made for some rewording of certain messages and editing of certain images. It is recommended that the field-tested messages and images, incorporating the suggested changes, should be adopted. Once adopted, the FBDGs can be used to inform and engage various stakeholders, including parents, caregivers, healthcare providers and educators on appropriate nutritional practices for children and adults. They can also be used to guide implementation of relevant policies and programmes to contribute towards the achievement of sustainable healthy diets and healthy dietary patterns

Let’s work together to make breastfeeding work

CITATION: Du Plessis, L. M. 2015. Let’s work together to make breastfeeding work. South African Journal of Clinical Nutrition, 28(3):103-104.The original publication is available at http://www.sajcn.co.zaENGLISH SUMMARY : The global recommendation on the early initiation of breastfeeding, exclusive breastfeeding (EBF) for six months, and continued breastfeeding for up to two years of age and beyond,1 remains uncontested.2-4 However, the translation of this recommendation into successful practice continues to fall short.http://www.sajcn.co.za/index.php/SAJCN/article/view/1043Publisher's versio

Commitment and capacity for the support of breastfeeding in South Africa : a paediatric food-based dietary guideline

CITATION: Du Plessis, L. M. & Pereira, C. 2013. Commitment and capacity for the support of breastfeeding in South Africa : a paediatric food-based dietary guideline. South African Journal of Clinical Nutrition, 26(3)(Suppl):S120-S128.The original publication is available at http://www.sajcn.co.zaThis paper aims to summarise current evidence and highlight best practices, in order to propose a paediatric food-based dietary guideline (FBDG) on exclusive breastfeeding for South Africa. A literature search was conducted to profile the current nutritional status of children and breastfeeding practices in South Africa, reflect on the commitment and capacity that has been pledged and built for exclusive and continued breastfeeding over the past five years, and highlight the action needed to improve infant and young child feeding practices in the country. From the review, it was clear that the nutritional status of children and breastfeeding practices in South Africa remain unsatisfactory. The evidence base supporting the importance of exclusive and continued breastfeeding on a global and local level has been broadened. There are comprehensive and practical international guidelines to guide the protection, promotion of, and support for breastfeeding. Comprehensive and sound national and provincial policies and guidelines have also been developed in South Africa. The political will to address infant and young child feeding has been advanced and demonstrated, and a supportive environment created through commitment and capacity building. There is a need for focused action addressing adequate monitoring and evaluation of processes during all stages of the implementation of evidence-based and theoretical planning. These actions should drastically improve exclusive and continued breastfeeding and advance the health and survival of children in South Africa. The recent momentum gained in support of improving infant and young child feeding could further be enhanced by the process of reviewing the preliminary South African paediatric FBDG and field testing the following proposed message: “Give only breast milk, and no other foods or liquids, to your baby for the first six months of life”.http://www.sajcn.co.za/index.php/SAJCN/article/view/756Publisher's versio

Complementary feeding : a critical window of opportunity from six months onwards

CITATION: Du Plessis, L. M., Kruger, H. S. & Sweet, L. 2013. Complementary feeding : a critical window of opportunity from six months onwards. South African Journal Clinical Nutrition, 26(3)(Supplement):S129-S140.The original publication is available at http://www.sajcn.co.zaThis paper aims to propose evidence-based, paediatric food-based dietary guidelines on the complementary feeding period, from six to 24 months, of South Africa. A growing body of evidence supports the World Health Organization recommendation that, following six months of exclusive breastfeeding, appropriate and adequate complementary foods should be introduced, with continued breastfeeding for up to two years of age and beyond. A literature search was done by searching electronic databases (PubMed, the Cochrane Library and Sabinet) and hand searching key reference lists from January 2004 to April 2012, including studies published prior to 2004. Relevant international and national documents from normative bodies, global health and infant feeding authorities, professional and scientific societies and government were identified. It has been established that, in South Africa, high levels of stunting, growing concerns about overweight and obesity and the poor intake of certain micronutrients in the critical six- to 24-month period are, in part, a consequence of poor breastfeeding and complementary feeding practices, as well as the poor quality of the complementary diet. The introduction of semi-solid foods before four months of age is a common practice. The typical maize-based feeding pattern is low in food sourced from animals, vegetables and fruit and omega-3 fatty acids. Efforts by mothers to improve the quality of their children’s diets by adding energy-rich food to maize meal improves energy intake, but not micronutrient intake. Low nutrient-dense liquid, such as tea and coffee, energy-dense sugar-sweetened drinks, an excessive intake of fruit juice and high-fat and salty snacks exacerbate poor nutrient intake and displace nutrient-dense food in the diet. Healthcare workers should provide consistent, evidence-based messages and guidelines to caregivers of future generations. Interventions must be implemented and strengthened at a programme level. These could include nutrition education to improve caregiver practices, the use of high-quality, locally available foods, the use of enriched complementary foods, and exceptional support of food-insecure populations.http://www.sajcn.co.za/index.php/SAJCN/article/view/757Publisher's versio