Background: Childhood malnutrition has been a longstanding crisis in
Mumbai, India. Despite national IYCF (Infant Young Child Feeding)
guidelines to promote best practices for infant/toddler feeding, nearly
one-third of children under age five are stunted or underweight. To
improve child nutrition, interventions should address the cultural,
social, and environmental influences on infant feeding practices. This
study is an in-depth qualitative assessment of family barriers and
facilitators to implementing recommended nutrition practices in two
Mumbai slum communities, within the context of an existing nutrition
education-based intervention by a local non-governmental non-profit
organization. Methods: The population was purposively sampled to
represent a variety of household demographics. Data were collected
through 33 in-depth semi-structured interviews with caregivers (mothers
and paternal grandmothers) of children age 0\u20132 years. Transcripts
were translated and transcribed, and analyzed using qualitative
analysis procedures and software. Results: A complex set of barriers
and facilitators influence mothers\u2019/caregivers\u2019
infant-toddler feeding practices. Most infants were fed complementary
foods and non-nutritious processed snacks, counter to IYCF
recommendations. Key barriers included: lack of nutrition knowledge and
experience, receiving conflicting messages from different sources,
limited social support, and poor self-efficacy for maternal
decision-making. Key facilitators included: professional nutrition
guidance, personal self-efficacy and empowerment, and family support.
Interventions to improve child nutrition should address
mothers\u2019/caregivers\u2019 key barriers and facilitators to
recommended infant-toddler feeding practices. Conclusions: Nutrition
interventions should prioritize standard messaging across healthcare
providers, engage all family members, target prevention of early
introduction of sugary and non-nutritious processed foods, and
strengthen maternal self-efficacy for following IYCF recommended
guidelines