title: Perceptions related to breastfeeding and the early introduction of complementary foods amongst migrants in Cape Town, South Africa.
abstract: BACKGROUND
  Infant feeding recommendations are of health importance, yet the extent to which migrant communities in low- and middle-income countries know or implement these recommendations is poorly understood. This study explores the perspectives of infant feeding amongst cross-border migrants in Cape Town, South Africa.
  
  
  METHODS
  Between February and October 2013, semi-structured in-depth interviews (n= 23) were conducted face-to-face with Congolese, Somali and Zimbabwean mothers living in Cape Town. To assess commonly identified narratives of infant feeding, nine focus group discussions (three with men and six with women) were conducted with migrant Somalis, Congolese, and Zimbabweans.
  
  
  RESULTS
  Three dominant themes framed infant feeding. 1) Pragmatism in feeding choices drove responses to baby's cues, including cries, sleeping patterns, and weight gain (2). Formula feeding was normative in the South African context, whereas lack of commercial infant milk back home was described in terms of expense (3). Low rates of breastfeeding were explained in terms of work responsibilities including household work and lack of breastmilk supply resulting from stress and poor diet. However, women participants typically did not consider their feeding choices to negatively affect their baby's health.
  
  
  CONCLUSIONS
  The reasons for early introduction of both commercial infant milk and solid foods were complex. Breastfeeding was not prioritized despite an awareness of medical recommendations. Rather than emphasizing specific breastfeeding intentions, participants favoured an approach that reacted to their baby's perceived changing needs. The practical challenges of breastfeeding described by cross-border migrant women reflect one way in which socio-economic and health inequalities may currently be perpetuated for marginalised populations.
authors: Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town Observatory, Cape Town, 7925 South Africa.
authors: Jo
authors: J
authors: Hunter-Adams
authors: Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town Observatory, Cape Town, 7925 South Africa.
authors: Landon
authors: L
authors: Myer
authors: Environmental Health Division, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town Observatory, Cape Town, 7925 South Africa.
authors: Hanna-Andrea
authors: HA
authors: Rother
keywords: Breastfeeding; Complementary feeding; Infant nutrition; Refugee and immigrant health; South Africa