Exploring the infant feeding experiences of mothers living in selected Tshwane informal settlements: a qualitative study

Figures & data

Table 1: Demographic profile of study participants

Characteristics	Value
Mean age (years ± SD)	29 ± 6
Age distribution:	(n, %)
> 20	1 (3.6%)
20–24	6 (21.4)
25–34	14 (50%)
35–44	7 (25%)
Education level:	(n, %)
Primary school	1 (3.6)
Grades 8–11	17 (60.7)
Grade 12	9 (32.1)
College diploma	1 (3.6)
Employment status:	(n, %)
Unemployed	16 (57.1)
Day-to-day jobs	5 (17.9)
Temporary/seasonal work	4 (14.3)
Permanent work	3 (10.7)
Marital status:	(n, %)
Married	9 (32.1)
Living with a partner	11 (39.3)
Single	8 (26.6)
Number of children per mother:	(n, %)
1	7 (25)
2–3	17 (60.7)
≥ 4	4 (14.3)
Age of youngest child (months):	(n, %)
3–5	4 (14.3)
6–11	10 (35.7)
12–17	9 (32.1)
18–24	5 (17.9)

Table 2: Main and sub-themes that emerged as mothers’ experiences of infant feeding

Theme	Sub-theme	Supporting quotes
Experience of infant feeding	Exclusive breastfeeding	‘I know that breast milk is divided into three, the one that quenches the baby’s thirst, the one that gives food to the baby and the milk that builds muscles … . From birth until six months’ (FG5P3, 22 years old, UE, mother of 1 infant aged 5 months) ‘According to me six months is too much for the baby because even as an adult you eat three times a day. In the morning you eat, midday you eat and in the evening, you eat. But you want the baby to survive by breastfeeding him only? You see, so according to me six months is too much’ (FG1P2, 28 years, UE, mother of 2; youngest aged 12 months) ‘Also think about yourself … can you survive three days without eating? When you are pregnant, they tell you that the baby eats any food that you eat … . This child was obviously eating while in the womb. So after birth he is no longer eating? He must eat’ (FG5P7, 31 years old, E, mother of 4; youngest aged 17 months)
	Introduction of complementary food	‘I started feeding my baby solids at 1 month and 2 weeks [of age] because when I exclusively breastfed him, he only slept for a short while, the next thing he woke up and cried. I breastfed him, I breastfed non-stop, and he cried non-stop … . My mother prepared food for him … . After that he never gave me a problem again … . He was able to sleep for a long time in the daytime after eating’ (FG5P2, 26 years old, UE, mother of 2; youngest aged 11 months) ‘Sometimes you will leave your baby at the creche, he is not the only baby at the creche there are other children … . So, you must teach the baby from home. My baby started creche at the age of two months because I was going back to work. I had already taught him at home that you must eat and suck the bottle. I also gave him water so that when he came to the creche it would not be difficult’ (FG5P7, 31 years old, E, mother of 4; youngest aged 17 months)
Support received for infant feeding	Support by the elders based on common beliefs	‘With my first born I was a student. I used to breastfeed before and after going to school. When I returned, I first expressed the dirty milk, when I was done I gave him (the breast) with fresh milk … that is how they taught us, the older people … . They tell us that it becomes dirty because I spent most of the time at school … . (FG1P2, 28 years, UE, mother of 2; youngest aged 12 months) ‘I was given 3 months of [maternity] leave after giving birth. After 3 months I was going to work and coming back home with my breasts full of milk. When the breasts are full of milk, they are painful, the milk changes and is not good for the baby because you spend the whole day with that milk in your breasts’ (FG2P4, 34 years old, E, mother of 2; youngest aged 24 months) ‘My baby was premature just like FG3P4, so the first few days she was just drinking 8 ml, then as time went on, I gave more breast milk. When I came back home, my grandmother taught me how to feed the baby. I then started to give her the porridge and my baby was growing’ (FG3P2, 22 years old, UE, mother of 1 infant aged 9 months) ‘When I came from the hospital, my mother said we must feed my baby bottled baby food … . Our mothers say that a baby must eat on the first day when they come from the hospital because the baby is hungry’ (FG6P1, 32 years old, E, mothers of 3 children, youngest aged 6 months)
	Support by the healthcare workers not always perceived positively	‘After giving birth to my second baby, the nurses taught me about breastfeeding. On the first day they said we must give the baby the first milk because it is more important for the baby. I was supposed to give the baby breast milk every two hours until he was three months old … .. I just did what the nurse said … my baby was born prematurely, but he gained weight every day because of the many things I learned at the hospital’ (FG3P4, 35 years old, UE, mother of 2; youngest aged 15 months) ‘At the clinic, they tell you how to feed your baby and the kind of food you must give … . I feed my baby the foods I was told about such as butternut, mashed potato and others … (FG1P2, 28 years, UE, mother of 2; youngest aged 12 months) ‘I also attend the clinic but they haven’t told me anything. I read about what a 9-month-old baby eats from the pamphlets that were placed there … . I only received advice when I was told not to feed [solids] the baby until he is six months old’ (FG1P3,25 years, UE, mother of 2; youngest aged 9 months) ‘At the clinic they only asked me about what I fed my baby when he was sick, but if he is not sick, they don’t ask or tell you anything. (FG2P1, 35 years old, E, mother of 4; youngest aged 9 months) ‘We were also advised to give Rooibos tea at the clinic … a mother who doesn’t have money to buy milk [formula] should rather give Rooibos tea to her baby instead of giving both formula milk and breastfeeding … so I don’t know what I must do. I am confused’ (FG2P1, 35 years old, E, mother of 4; youngest aged 9 months) ‘Nurses said we must give our children food from six months. When your child is one year old, they complain again saying your child must be seen by the dietitian because he doesn’t eat meat. When you start feeding bottled baby food at six months, when will he start eating meat? I cannot start with both pap and meat at six months’ (FG5P5, 26 years old, E, mother of 2; youngest aged 15 months)
Factors in the setting that affect infant feeding	Household food security affected both maternal and infant nutrition	‘There is a difference in breast milk … . when you have eaten enough food, it becomes white … but if you haven’t eaten it becomes like water … (FG1P3, 25 years, UE, mother of 2; youngest aged 9 months) ‘The amount of milk that you make is also affected by how much food you eat. If you have enough food and are eating enough then your body can make milk regardless of the size of your breast’ (FG2P1, 35 years old, E, mother of 4; youngest aged 9 months) ‘I breastfed my baby for only four months then I gave porridge. I cannot eat enough because I don’t have enough money for food … . So, it is better to feed my baby porridge so that he can sleep. I know that is not right, but I don’t want my baby to cry for a long time’ (FG3P1, 35 years, UE, mother of 4; youngest aged 5 months) ‘When we talk about vegetables like butternut, we don’t eat them every day. If I buy a butternut, I cook it once or twice a month only … (FG1P1, 22 years, UE, mother of 1 child aged 6 months) ‘Most of the time I give my baby pap and soup … ’ (FG2P2, 27 years old, E, mother of 3; youngest aged 9 months)
	Environmental and household factors affecting food storage and preparation	‘I made porridge for the baby, then took my older child to creche. Leaving the porridge to cool down. When I returned, I found that the rat had eaten it … ’ (FG6P5, 28 years old, UE, mother of 2; youngest aged 4 months) ‘I once bought potatoes, planning to make some mash for the baby. I placed them in a bowl to cook the next day. I felt so powerless when I returned to find that a rat had eaten the potatoes … ’ (FG6P1, 32 years old, E, mother of 3; youngest aged 6 months) ‘I believe paraffin is more expensive than all the baby food including bottled baby food. This is why I make sure that I have the instant sorghum meal which I can prepare whenever I don’t have paraffin, so that my child can still eat’ (FG1P3, 25 years, UE, mother of 2; youngest aged 9 months) ‘Money is also a problem, it is not only an issue of access to electricity, because even if you have electricity, you might not have money to buy the food’ (FG2P1, 35 years old, E, mother of 4; youngest aged 9 months) ‘I think that it is good to express your breast milk and leave it for the baby. But in our situation here, I don’t believe that it will work because there is no electricity and a refrigerator at the crèche, so there is no space to store the milk. There is also no microwave that can be used to warm up the milk … (FG2P1, 35 years old, E, mother of 4; youngest aged 9 months) ‘I can try to cook rice and make a treat for him but now it is summer, the food becomes rotten because the shacks are hot and there are no refrigerators’ (FG1P1, 22 years, UE, mother of 1 aged 6 months)