title: Sociocultural influences on newborn health in the first 6 weeks of life: qualitative study in a fishing village in Karachi, Pakistan.
abstract: BACKGROUND
  Given regional variability and minimal improvement in infant mortality rates in Pakistan, this study aimed to explicate sociocultural influences impacting mothers' efforts to maintain or improve newborn health.
  
  
  METHODS
  We used a qualitative phenomenological approach. A total of 10 mothers and 8 fathers from a fishing village in Karachi, Pakistan were purposefully sampled and interviewed individually. A focus group was undertaken with four grandmothers (primary decision makers). Transcripts were independently reviewed using interpretive thematic analysis.
  
  
  RESULTS
  A multigenerational approach was used in infant care, but mothers did not have a voice in decision-making. Parents connected breast milk to infant health, and crying was used as cue to initiate feeding. Participants perceived that newborns required early supplementation, given poor milk supply and to improve health. There were tensions between traditional (i.e., home) remedies and current medical practices. Equal importance was given to sons and daughters.
  
  
  CONCLUSIONS
  Findings suggest that social and cultural influences within families and the community must be considered in developing interventions to improve newborn health. Introducing non-breast milk substances into newborn diets may reduce the duration of exclusive or partial breastfeeding and increase risks to infant health.
authors.affiliation: Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada. premjis@ucalgary.ca.
authors.forename: Shahirose
authors.initials: S
authors.lastname: Premji
authors.forename: Shaneela
authors.initials: S
authors.lastname: Khowaja
authors.forename: Salima
authors.initials: S
authors.lastname: Meherali
authors.forename: Rachelle
authors.initials: R
authors.lastname: Forgeron
mesh_terms: D000328:Adult; D001942:Breast Feeding; D003469:Culture; D003657:Decision Making; D005191:Family Characteristics / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D005502:Food; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007223:Infant; D007224:Infant Care; D007231:Infant, Newborn; D016901:Intergenerational Relations / Q000208:ethnology; D007407:Interviews as Topic; D008297:Male; D008519:Medicine, Traditional; D009035:Mothers; D010154:Pakistan; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D011203:Poverty; D036301:Qualitative Research; D012931:Social Environment