Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive study
Objective To determine caregiver knowledge of, attitudes towards, and perceptions of feeding practices for infants admitted to a tertiary referral hospital with severe pneumonia, and to identify community feelings about nasogastric tube feeding in Malawi.Setting The paediatric ward of a government t...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e094793.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850137428936884224 |
|---|---|
| author | Eric D McCollum Tisungane Mvalo Mercy Tsidya Marieke Van der Zalm Agatha Bula Nadia E Hoekstra Dalton M Craven Annie Thom |
| author_facet | Eric D McCollum Tisungane Mvalo Mercy Tsidya Marieke Van der Zalm Agatha Bula Nadia E Hoekstra Dalton M Craven Annie Thom |
| author_sort | Eric D McCollum |
| collection | DOAJ |
| description | Objective To determine caregiver knowledge of, attitudes towards, and perceptions of feeding practices for infants admitted to a tertiary referral hospital with severe pneumonia, and to identify community feelings about nasogastric tube feeding in Malawi.Setting The paediatric ward of a government tertiary referral hospital in Lilongwe, Malawi.Methods From March through April 2023, we conducted in-depth interviews with 14 mothers of infants 0–12 months of age hospitalised with severe pneumonia who had been enrolled in an observational study evaluating feeding and swallowing in breastfed infants. In-depth interviews assessed mothers’ attitudes towards hospital feeding practices including nasogastric tube feeding, along with community perceptions of nasogastric tubes. Data were analysed using a thematic analysis approach to assess themes and subthemes of transcripts.Results Mothers understood that children with pneumonia are at risk of ‘choking’ during oral feeding; however, they had substantial worries about both withholding breastfeeding and providing nasogastric feeds to their infants through a nasogastric tube. Community perceptions of nasogastric tubes were widely negative and included beliefs that nasogastric tubes cause children to ‘choke’ and die and that medical providers want to harm children. Mothers held strong beliefs about the benefits of breastfeeding.Conclusion There are alarming misconceptions in the community around nasogastric tubes and the intentions of medical providers. This leads to maternal concerns about this hospital feeding practice, poor adherence to medical recommendations, and mistrust in the broader healthcare system. To improve hospital outcomes of children with severe pneumonia, caregiver and community education is needed. |
| format | Article |
| id | doaj-art-cc5ec9a16d8f4e12aef3bd9f7ed82480 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-cc5ec9a16d8f4e12aef3bd9f7ed824802025-08-20T02:30:50ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-094793Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive studyEric D McCollum0Tisungane Mvalo1Mercy Tsidya2Marieke Van der Zalm3Agatha Bula4Nadia E Hoekstra5Dalton M Craven6Annie Thom7Global Program in Pediatric Respiratory Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USAUNC Project-Malawi, Lilongwe, Central Region, MalawiUNC Project-Malawi, Lilongwe, Central Region, MalawiDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Desmond Tutu TB Centre, Cape Town, South AfricaUNC Project-Malawi, Lilongwe, Central Region, MalawiUNC Project-Malawi, Lilongwe, Central Region, MalawiUNC Project-Malawi, Lilongwe, Central Region, MalawiUNC Project-Malawi, Lilongwe, Central Region, MalawiObjective To determine caregiver knowledge of, attitudes towards, and perceptions of feeding practices for infants admitted to a tertiary referral hospital with severe pneumonia, and to identify community feelings about nasogastric tube feeding in Malawi.Setting The paediatric ward of a government tertiary referral hospital in Lilongwe, Malawi.Methods From March through April 2023, we conducted in-depth interviews with 14 mothers of infants 0–12 months of age hospitalised with severe pneumonia who had been enrolled in an observational study evaluating feeding and swallowing in breastfed infants. In-depth interviews assessed mothers’ attitudes towards hospital feeding practices including nasogastric tube feeding, along with community perceptions of nasogastric tubes. Data were analysed using a thematic analysis approach to assess themes and subthemes of transcripts.Results Mothers understood that children with pneumonia are at risk of ‘choking’ during oral feeding; however, they had substantial worries about both withholding breastfeeding and providing nasogastric feeds to their infants through a nasogastric tube. Community perceptions of nasogastric tubes were widely negative and included beliefs that nasogastric tubes cause children to ‘choke’ and die and that medical providers want to harm children. Mothers held strong beliefs about the benefits of breastfeeding.Conclusion There are alarming misconceptions in the community around nasogastric tubes and the intentions of medical providers. This leads to maternal concerns about this hospital feeding practice, poor adherence to medical recommendations, and mistrust in the broader healthcare system. To improve hospital outcomes of children with severe pneumonia, caregiver and community education is needed.https://bmjopen.bmj.com/content/15/6/e094793.full |
| spellingShingle | Eric D McCollum Tisungane Mvalo Mercy Tsidya Marieke Van der Zalm Agatha Bula Nadia E Hoekstra Dalton M Craven Annie Thom Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive study BMJ Open |
| title | Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive study |
| title_full | Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive study |
| title_fullStr | Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive study |
| title_full_unstemmed | Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive study |
| title_short | Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive study |
| title_sort | perceptions of hospital feeding practices among mothers of infants with severe pneumonia in malawi a qualitative descriptive study |
| url | https://bmjopen.bmj.com/content/15/6/e094793.full |
| work_keys_str_mv | AT ericdmccollum perceptionsofhospitalfeedingpracticesamongmothersofinfantswithseverepneumoniainmalawiaqualitativedescriptivestudy AT tisunganemvalo perceptionsofhospitalfeedingpracticesamongmothersofinfantswithseverepneumoniainmalawiaqualitativedescriptivestudy AT mercytsidya perceptionsofhospitalfeedingpracticesamongmothersofinfantswithseverepneumoniainmalawiaqualitativedescriptivestudy AT mariekevanderzalm perceptionsofhospitalfeedingpracticesamongmothersofinfantswithseverepneumoniainmalawiaqualitativedescriptivestudy AT agathabula perceptionsofhospitalfeedingpracticesamongmothersofinfantswithseverepneumoniainmalawiaqualitativedescriptivestudy AT nadiaehoekstra perceptionsofhospitalfeedingpracticesamongmothersofinfantswithseverepneumoniainmalawiaqualitativedescriptivestudy AT daltonmcraven perceptionsofhospitalfeedingpracticesamongmothersofinfantswithseverepneumoniainmalawiaqualitativedescriptivestudy AT anniethom perceptionsofhospitalfeedingpracticesamongmothersofinfantswithseverepneumoniainmalawiaqualitativedescriptivestudy |