Dear Lactnet Friends:

I wondered with whom I could share this fascinating abstract; then, I
remembered 3,000+ international breastfeeding workers. Bless you all!

BMC Public Health. 2013 Dec 13;13:1172. doi: 10.1186/1471-2458-13-1172.

Spoiled breast milk and bad water; local understandings of diarrhea causes
and prevention in rural Sierra Leone.

McMahon SA1, George AS, Yumkella F, Diaz T.

Abstract

BACKGROUND:
Globally, diarrhea remains a leading killer of young children. In Sierra
Leone, one in seven children die before their fifth birthday and diarrhea
is a leading cause. Studies that emphasize the demand-side of health
interventions -- how caregivers understand causation and prevention of
diarrhea -- have been neglected in research and programming.

METHODS:
We undertook applied qualitative research including 68 in-depth interviews
and 36 focus group discussions with mothers, fathers and older female
caretakers to examine the causes and prevention of childhood diarrhea in
villages near and far from health facilities across four rural districts.
Verbal consent was obtained.

RESULTS:
Respondents reported multiple, co-existing descriptions of causation
including: contaminated water and difficulties accessing clean water;
exposure to an unclean environment and poor food hygiene; contaminated
breast milk due to sexual intercourse, overheated breast milk or bodily
maternal conditions such as menstruation or pregnancy; and dietary
imbalances and curses. Respondents rarely discussed the role of open
defecation or the importance of handwashing with soap in preventing
diarrhea.

CONCLUSIONS:
Categorizing behaviors as beneficial, harmful, non-existent or benign
enables tailored programmatic recommendations. For example, respondents
recognized the value of clean water and we correspondingly recommend
interventions that reinforce consumption of and access to clean water.
Second, respondents report denying "contaminated" breast milk to
breastfeeding children. This is a harmful practice that merits attention.
Third, the role of open defecation and poor hygiene in causing diarrhea is
less understood and warrants introduction or clarification. Finally, the
role of exposed feet or curses in causing diarrhea is relatively benign and
does not necessitate programmatic attention. Further research supportive of
communication and social mobilization strategies building on these findings
is required to ensure that improved understanding regarding diarrhea
causation translates into improved diarrhea prevention.
-- 
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
Author:* Complementary and Alternative Medicine in Breastfeeding Therapy*
www.nikkileehealth.com
https://www.facebook.com/nikkileehealth

*Get my FREE webinar series*

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