Field-testing of the revised, draft South African Paediatric Food-Based Dietary Guidelines amongst mothers/caregivers of children aged 0-12 months in the Breede Valley sub-district, Western Cape province, South Africa

Objectives: To assess the appropriateness and understanding of the revised, draft South African Paediatric Food-Based Dietary Guidelines (SA-PFBDGs) amongst mothers/caregivers of children aged 0-12 months. Exposure to guidelines with similar messages, barriers and enablers to following of the guidelines were also assessed. Design: Qualitative data were collected from 14 focus-group discussions (FGDs), conducted in isiXhosa (n = 5), English (n = 4) and Afrikaans (n = 5), totalling 73 mother/caregiver participants. Setting: Worcester, Breede Valley sub-district, Western Cape province. Subjects: The study population included mothers/caregivers who were older than 18 years. Results: The majority of participants had previous exposure to variations of messages similar to the revised, draft SA-PFBDGs. Health platforms and practitioners (community health centres, antenatal classes, nurses, doctors) and social networks and platforms (family, magazines, radio) were mentioned as primary sources of information. Barriers to following the messages included: inconsistent messages (mainly communicated by healthcare workers), contrasting beliefs and cultural/family practices, limited physical and financial access to resources, poor social support structures and the psycho-social and physical demands of raising a child. Conclusion: The revised, draft SA-PFBDGs for the age range 0-12 months have been field-tested in English, Afrikaans and isiXhosa. The messages in some of the revised, draft SA-PFBDGs were not understood by the participants, indicating that a degree of rewording should be considered to facilitate understanding of the guidelines by the public. The National Department of Health should consider the findings of this study, and use these standardised messages to optimise infant and young child feeding.