An interesting finding

The workshop I taught in Ethiopia was participatory, and in the middle of it we went to the field to collect data for 2 days. We interviewed mothers of positive deviant (PD) children (WAZ>-1 for you nutrition techies out there!) and mothers of children that were at least moderately malnourished (WAZ<-2). A positive "deviant" child is a child that for some "unexplained" reason is growing well, or relatively well, in the midst of a village of malnourished children. Our research interviews were focused on discovering those "unexplained" reasons, at least as they pertain to child feeding practices, child care and health seeking practices, and psychosocial factors. One of our most surprising findings was that children that were currently breastfeeding were MORE LIKELY to be MALNOURISHED! WHAT! Isn't breastfeeding supposed to be good for babies?

But when we looked at this result in the context of the families we interviewed and the breastfeeding practices of the area it made more sense. The international recommendations are for children to breastfeed until age 2 (unless the mother is HIV+ and then recommended to exclusively BF only until the baby is 6 months). The average age of our subjects was 33 months (range 12-59m), and 78% of the malnourished kids were BF, while only 47% of the PD kids were BF. So that's alot of older toddlers nursing. As we discussed this phenomenon we discovered that there were also several "older" kids that were ONLY nursing, and not eating any solid foods or hardly any solids! OK, now that's a major problem! Our assessment was that there was a severe mismanagement of breastfeeding going on, for reasons we could only guess why (lack of knowledge, lack of foods to offer for complementary feeding, believing breastmilk was enough, etc). So the plan of action is to start with getting correct information about breastfeeding and introduction of complementary foods out there. Whew! What a crazy situation!