'International Mountain Society (IMS) and United Nations University'
Abstract
Scientific paper based on IDRC projectBackground. In order to effectively promote exclusive
breastfeeding, it is important to first understand who
makes child-care and child-feeding decisions, and why
those decisions are made; as in most parts of the world,
exclusive breastfeeding until 6 months of age is uncommon
in Malawi.
Objective. To characterize early infant foods in rural
northern Malawi, who the decision-makers are, their
motivation, and the consequences for child growth, in
order to design a more effective program for improved
child health and nutrition.
Methods. In a rural area of northern Malawi, 160
caregivers of children 6 to 48 months of age were asked
to recall the child’s age at introduction of 19 common
early infant foods, who decided to introduce the food,
and why. The heights and weights of the 160 children
were measured.
Results. Sixty-five percent of the children were given
food in their first month, and only 4% of the children
were exclusively breastfed for 6 months. Mzuwula and
dawale (two herbal infusions), water, and porridge were
common early foods. Grandmothers introduced mzuwula
to protect the children from illness; other foods were usually
introduced by mothers or grandmothers in response
to perceived hunger. The early introduction of porridge
and dawale, but not mzuwula, was associated with
worse anthropometric status. Mzuwula, which is not
associated with poor growth, is usually made with boiled water and given in small amounts. Conversely, porridge,
which is associated with poor child growth, is potentially
contaminated and is served in larger amounts, which
would displace breastmilk.
Conclusions. Promoters of exclusive breastfeeding
should target their messages to appropriate decision
makers and consider targeting foods that are most harmful
to child growth