Cargando…

Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households

BACKGROUND: Substantial evidence exists surrounding the health risks of breast milk substitutes (BMS) in place of exclusive breastfeeding among infants < 6 months of age in resource-poor settings. Yet, mothers’ experiences of selecting and purchasing BMS brands have not been well studied to date....

Descripción completa

Detalles Bibliográficos
Autores principales: Rothstein, Jessica D., Winch, Peter J., Pachas, Jessica, Cabrera, Lilia Z., Ochoa, Mayra, Gilman, Robert H., Caulfield, Laura E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816440/
https://www.ncbi.nlm.nih.gov/pubmed/33468169
http://dx.doi.org/10.1186/s13006-021-00356-6
_version_ 1783638442841735168
author Rothstein, Jessica D.
Winch, Peter J.
Pachas, Jessica
Cabrera, Lilia Z.
Ochoa, Mayra
Gilman, Robert H.
Caulfield, Laura E.
author_facet Rothstein, Jessica D.
Winch, Peter J.
Pachas, Jessica
Cabrera, Lilia Z.
Ochoa, Mayra
Gilman, Robert H.
Caulfield, Laura E.
author_sort Rothstein, Jessica D.
collection PubMed
description BACKGROUND: Substantial evidence exists surrounding the health risks of breast milk substitutes (BMS) in place of exclusive breastfeeding among infants < 6 months of age in resource-poor settings. Yet, mothers’ experiences of selecting and purchasing BMS brands have not been well studied to date. This qualitative study explored the factors influencing BMS purchasing practices, along with the consequences of those decisions, in peri-urban Lima, Peru. METHODS: We conducted in-depth interviews (IDIs) with 29 mothers who had begun mixed-feeding their infants during the first 6 months of life. Interviews explored participants’ reasons for initiating infant formula use and their experiences of selecting, purchasing, and providing BMS to their children. Audio recordings were transcribed, coded, and key themes and illustrative vignettes were identified. RESULTS: The primary reported reasons for initiating infant formula use included having received a recommendation for infant formula from a healthcare provider, concerns about an infant’s weight gain, and the perception of insufficient breast milk. Mothers tended to initially purchase the BMS brand that had been recommended by a doctor, which was often more expensive than the alternatives. The costs of BMS, which escalated as infants grew, often disrupted the household economy and generated significant stress. While some mothers identified alternatives allowing them to continue purchasing the same brand, others chose to switch to less expensive products. Several mothers began to feed their infants follow-on formula or commercial milk, despite their awareness that such practices were not recommended for infants under 6 months of age. The approval of family members and the absence of an infant’s immediate adverse reaction influenced mothers’ decisions to continue purchasing these products. CONCLUSIONS: The high costs of BMS may deepen existing socio-economic vulnerabilities and generate new risks for infant health. The continued dedication of resources towards breastfeeding education and support is critical, and strategies would benefit from underscoring the long-term financial and health consequences of infant formula use, and from strengthening women’s self-efficacy to refuse to initiate infant formula when recommended. In addition, health providers should be trained in counseling to help women to relactate or return to exclusive breastfeeding after cessation.
format Online
Article
Text
id pubmed-7816440
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-78164402021-01-22 Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households Rothstein, Jessica D. Winch, Peter J. Pachas, Jessica Cabrera, Lilia Z. Ochoa, Mayra Gilman, Robert H. Caulfield, Laura E. Int Breastfeed J Research BACKGROUND: Substantial evidence exists surrounding the health risks of breast milk substitutes (BMS) in place of exclusive breastfeeding among infants < 6 months of age in resource-poor settings. Yet, mothers’ experiences of selecting and purchasing BMS brands have not been well studied to date. This qualitative study explored the factors influencing BMS purchasing practices, along with the consequences of those decisions, in peri-urban Lima, Peru. METHODS: We conducted in-depth interviews (IDIs) with 29 mothers who had begun mixed-feeding their infants during the first 6 months of life. Interviews explored participants’ reasons for initiating infant formula use and their experiences of selecting, purchasing, and providing BMS to their children. Audio recordings were transcribed, coded, and key themes and illustrative vignettes were identified. RESULTS: The primary reported reasons for initiating infant formula use included having received a recommendation for infant formula from a healthcare provider, concerns about an infant’s weight gain, and the perception of insufficient breast milk. Mothers tended to initially purchase the BMS brand that had been recommended by a doctor, which was often more expensive than the alternatives. The costs of BMS, which escalated as infants grew, often disrupted the household economy and generated significant stress. While some mothers identified alternatives allowing them to continue purchasing the same brand, others chose to switch to less expensive products. Several mothers began to feed their infants follow-on formula or commercial milk, despite their awareness that such practices were not recommended for infants under 6 months of age. The approval of family members and the absence of an infant’s immediate adverse reaction influenced mothers’ decisions to continue purchasing these products. CONCLUSIONS: The high costs of BMS may deepen existing socio-economic vulnerabilities and generate new risks for infant health. The continued dedication of resources towards breastfeeding education and support is critical, and strategies would benefit from underscoring the long-term financial and health consequences of infant formula use, and from strengthening women’s self-efficacy to refuse to initiate infant formula when recommended. In addition, health providers should be trained in counseling to help women to relactate or return to exclusive breastfeeding after cessation. BioMed Central 2021-01-19 /pmc/articles/PMC7816440/ /pubmed/33468169 http://dx.doi.org/10.1186/s13006-021-00356-6 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Rothstein, Jessica D.
Winch, Peter J.
Pachas, Jessica
Cabrera, Lilia Z.
Ochoa, Mayra
Gilman, Robert H.
Caulfield, Laura E.
Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households
title Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households
title_full Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households
title_fullStr Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households
title_full_unstemmed Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households
title_short Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households
title_sort vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban peruvian households
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816440/
https://www.ncbi.nlm.nih.gov/pubmed/33468169
http://dx.doi.org/10.1186/s13006-021-00356-6
work_keys_str_mv AT rothsteinjessicad vulnerablefamiliesandcostlyformulaaqualitativeexplorationofinfantformulapurchasingamongperiurbanperuvianhouseholds
AT winchpeterj vulnerablefamiliesandcostlyformulaaqualitativeexplorationofinfantformulapurchasingamongperiurbanperuvianhouseholds
AT pachasjessica vulnerablefamiliesandcostlyformulaaqualitativeexplorationofinfantformulapurchasingamongperiurbanperuvianhouseholds
AT cabreraliliaz vulnerablefamiliesandcostlyformulaaqualitativeexplorationofinfantformulapurchasingamongperiurbanperuvianhouseholds
AT ochoamayra vulnerablefamiliesandcostlyformulaaqualitativeexplorationofinfantformulapurchasingamongperiurbanperuvianhouseholds
AT gilmanroberth vulnerablefamiliesandcostlyformulaaqualitativeexplorationofinfantformulapurchasingamongperiurbanperuvianhouseholds
AT caulfieldlaurae vulnerablefamiliesandcostlyformulaaqualitativeexplorationofinfantformulapurchasingamongperiurbanperuvianhouseholds