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Program considerations for integration of nutrition and family planning: Beliefs around maternal diet and breastfeeding within the context of the nutrition transition in Egypt
Authors:Justine A Kavle  Sohair Mehanna  Ghada Khan  Mohamed Hassan  Gulsen Saleh  Cyril Engmann
Institution:1. Maternal and Child Survival Program (MCSP), Washington, DC, USA;2. Maternal, Newborn, Child Health and Nutrition, PATH, Washington, DC, USA;3. Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA;4. Social Research Center, American University in Cairo, Cairo, Egypt;5. National Nutrition Institute of Egypt, Cairo, Egypt;6. SMART Project Maternal and Child Health Integrated Program (MCHIP), Cairo, Egypt;7. School of Public Health Global Health, University of Washington, Seattle, Washington, USA;8. School of Medicine Pediatrics, University of Washington, Seattle, Washington, USA;9. Maternal, Newborn, Child Health and Nutrition, PATH, Seattle, WA, USA
Abstract:In Egypt, rising maternal overweight and obesity is consistent with the transition to westernized diets and a growing reliance on energy‐dense, low nutrient foods. Although the first 1,000 days of life are the focus of many programmes designed to prevent many forms of malnutrition, little attention has been paid to maternal dietary practices and weight gain during pregnancy. This study used in‐depth interviews with pregnant women (N = 40), lactating women (N = 40), and nonlactating women (N = 40) to gain an understanding of behaviours, perceptions, and cultural beliefs in relation to maternal dietary intake during pregnancy, lactation, and nonlactation; weight gain during pregnancy; birth spacing; and family planning. Study findings reveal that food choice was driven by affordability, favoured foods, or foods considered appropriate for a specific life stage (pregnant, lactating, and nonlactating). Knowledge of weight gain during pregnancy is limited, especially with regards to excessive weight gain during pregnancy. Diet is often modified during lactation to support breast milk production, and a normal diet resumed when breastfeeding ceases. Within the context of breastfeeding, the lactational amenorrhea method provides an opportunity to improve exclusive breastfeeding practices, maternal diet during lactation, and the transition to other family planning methods by 6 months postpartum. Health care providers should discuss limiting maternal consumption of low nutrient foods such as junk foods, soda, and teas during pregnancy and postpartum. Dietary counselling should accompany information on appropriate weight gain during pregnancy and exercise to prevent excessive weight gain, in the context of the nutrition transition.
Keywords:breastfeeding  family planning  infant and child nutrition  maternal nutrition  nutrition transition  weight gain during pregnancy
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