How do Andean mothers’ infant feeding beliefs relate to public health advice?

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Childhood undernutrition persists in low-income countries despite long-standing efforts by local governments and international development agencies. To address it, Peru’s Ministry of Health has focused on access to primary healthcare and maternal and child health monitoring and education. Current maternal-child health policies in Peru offer recommendations that differ in some respects from those of Indigenous highland communities.

The study compared public health and mothers’ infant feeding recommendations and examined what persisted or changed among women who were mothers before and after current policies were introduced. Researchers conducted semi-structured interviews with 18 older mothers, 15 mothers currently breastfeeding, and 15 public health staff in rural highland communities of Peru. They used thematic codes and text passages in an iterative analysis to document emerging themes.

The findings described a traditional body of infant feeding and care beliefs consistent with Andean ethnomedical beliefs. Mothers spoke of maintaining a dietary balance of fluids and semi-fluids and harmony with elements of the natural environment. They also incorporated public health recommendations they found useful, including starting breastfeeding immediately after birth and exclusive breastfeeding until 6 months.

Tensions between the systems included different understandings of breastfeeding and infant food, the coercive imposition of public health services, and negative stereotyping of rural Andean diets and mothers. The authors concluded that identifying similarities and differences between the systems could inform effective intercultural health policies, and that sources of tension should be carefully assessed to improve those policies. They called for cultural humility: healthcare professionals should exchange ideas and converse with patients and communities while acknowledging the assumptions and beliefs embedded in their own understanding. The process should also recognize and value Andean mothers’ knowledge and practices and their role as primary caretakers.