title: A qualitative study exploring perceived barriers to infant feeding and caregiving among adolescent girls and young women in rural Bangladesh.
abstract: BACKGROUND
  Infant feeding and caregiving by adolescent girls and young women in rural Bangladesh remains relatively understudied despite high potential vulnerability of younger mothers and their children due to poverty and high rates of early marriage and childbearing. This key knowledge gap may hamper the effectiveness of maternal, infant and child health interventions not specifically tailored to teenage mothers. This study aimed to narrow this gap by documenting key barriers to optimal infant and young child feeding and caregiving perceived by adolescent girls and young women in rural Bangladesh.
  
  
  METHODS
  Focus group discussions and in-depth semi-structured interviews were conducted with 70 adolescent girls and young women participating in a community-based adolescent empowerment program in two rural regions of northwestern Bangladesh. Participants were stratified into three groups: unmarried, married without child, and married with child(ren). Thematic analysis was performed to elucidate dominant ideas regarding challenges with child feeding and caregiving across participant strata.
  
  
  RESULTS
  Participants in all three strata and in both geographical regions attributed actual and anticipated caregiving difficulties to five major contextual factors: early marriage, maternal time allocation conflicts, rural life, short birth intervals, and poverty. Indications are that many girls and young women anticipate difficulties in feeding and caring for their future children from an early age, and often prior to motherhood. Participants articulated both perceived need and unmet demand for additional education in infant and young child feeding, childcare, and family planning techniques.
  
  
  CONCLUSIONS
  Provision during adolescence of appropriate education, services and financial aid to support best practices for infant feeding and childcare could significantly improve maternal self-efficacy, mental health, nutrition security and young childcare, nutrition and health in rural Bangladesh. Lessons learned can be applied in future programs aimed at supporting adolescent women along a continuum of care.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada. kristy.hackett@mail.utoronto.ca.
authors.forename: Kristy M
authors.initials: KM
authors.lastname: Hackett
authors.affiliation: Research and Evaluation Division, BRAC, Dhaka, Bangladesh. salma.mukta@gmail.com.
authors.forename: Umme S
authors.initials: US
authors.lastname: Mukta
authors.affiliation: Micronutrient Initiative, Ottawa, Canada. cjalal@MICRONUTRIENT.ORG.
authors.forename: Chowdhury S B
authors.initials: CS
authors.lastname: Jalal
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada. dan.sellen@utoronto.ca.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Sellen
mesh_terms: D000293:Adolescent; D001459:Bangladesh / Q000453:epidemiology; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000706:statistics & numerical data*; D007227:Infant Nutritional Physiological Phenomena; D060127:Kangaroo-Mother Care Method; D009035:Mothers / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012424:Rural Population / Q000706:statistics & numerical data; D055815:Young Adult