Universidad Peruana Cayetano Heredia

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

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dc.contributor.author Rothstein, Jessica D.
dc.contributor.author Winch, Peter J.
dc.contributor.author Pachas, Jessica
dc.contributor.author Cabrera, Lilia Z.
dc.contributor.author Ochoa, Mayra
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Caulfield, Laura E.
dc.date.accessioned 2021-04-13T20:51:01Z
dc.date.available 2021-04-13T20:51:01Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9171
dc.description.abstract 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. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries International Breastfeeding Journal
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject female en_US
dc.subject human en_US
dc.subject Peru en_US
dc.subject clinical article en_US
dc.subject child en_US
dc.subject article en_US
dc.subject child health en_US
dc.subject infant en_US
dc.subject artificial milk en_US
dc.subject audio recording en_US
dc.subject body weight gain en_US
dc.subject breast feeding education en_US
dc.subject breast milk en_US
dc.subject Breast milk substitutes en_US
dc.subject case report en_US
dc.subject counseling en_US
dc.subject decision making en_US
dc.subject Decision-making en_US
dc.subject genetic transcription en_US
dc.subject health care personnel en_US
dc.subject household en_US
dc.subject Infant feeding en_US
dc.subject interview en_US
dc.subject physiological stress en_US
dc.subject purchasing en_US
dc.subject Qualitative en_US
dc.subject self concept en_US
dc.subject vignette en_US
dc.title Vulnerable families and costly formula: a qualitative exploration of infant formula purchasing among peri-urban Peruvian households en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s13006-021-00356-6
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.02
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.03
dc.relation.issn 1746-4358


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