|Beitragstitel||Breastfeeding and childhood diarrhoeal diseases in the rural Peruvian Andes. An exploratory assessment using mixed methods.|
Breastfeeding (BF) has protective health effects for both children and nursing women. Sixty-three per cent of children younger than 6 months in low-income and middle-income countries are not exclusively breastfed. This percentage is about halved to 37% for children between 6-23 months in the same regions. In Peru, 78.2% of infants, aged 6 to 8 months, received the minimum meal required for their age. Furthermore, 75.8% of children are continually breastfed at one year while only 43.4% received maternal milk at the age of two albeit BF is nationally recommended up to that age.
We describe and explain BF practices and dynamics and local explanatory models for childhood illnesses in a sub-set of 40 rural Andean families participating in a randomised controlled trial.
Mixed methods data collection (questionnaires, interviews and participant observations) was done with 40 participant mothers and with 10 medical practitioners. Materials were adapted from the Process for the Promotion of Child Feeding (ProPAN) guidelines. Participant observations consisted in accompanying families in their daily activities. .
Ninety-two percent of children were breastfed during the first six months, but in 69% BF was ceased before the recommended age of 24mths. Reasons for BF cessation include balancing childcare and domestic tasks, the perception that breast milk becomes ‘blood’ after the sixth month or BF can cause child diarrhoea. Mothers identified totally six childhood diseases that are directly provoked by breast milk. They originate in psychosocial and environmental factors and the ‘hot and cold’ theory associated with objects, plants, foods and body states. These pathologies can be associated with other childhood diseases with similar symptoms (‘fright sickness’ and ‘infection’), which constitute the body of diarrheal childhood diseases within the folk health model.
Local explanatory models identify BF as a cause for child diarrhoea and can lead to BF cessation. ‘Infection’ is the only diarrhoea mothers linked to hygiene and the germ-disease concept. This diarrhoea is seen as drug-treatable contradicting cultural beliefs that the majority of diarrhoeal episodes cannot be treated in the formal public health sector. This leads to increased home treatment also of severe diarrhoeal episodes. Local explanatory models of disease should be considered in national child diarrhoea disease control and BF recommendations.