There is an increasing immigration to Norway. The fifth largest immigrant group is the Iraqis. Immigrants constitute about 13 % of the total population in Norway. It has been further reported that Iraqi women are among the immigrant groups with the highest number of births compared to ethnic Norwegian women. Although infant feeding practices of Norwegian mothers has been well documented, no previous studies have reported infant feeding practices among Iraqi mothers in Norway.
The Norwegian recommendations on infant nutrition are in line with WHOs recommendation on breastfeeding and complementary feeding. Exclusive breastfeeding is advised to be maintained until the infant is six months old, and gradually introduce complementary food at this age. The breastfeeding should be maintained up to one year of age. Breastfeeding in Iraq is a common infant feeding practice. A majority of Iraqis are Muslims, and the Quran recommends mothers to breastfeed for two years if possible.
Studies have suggested that the breastfeeding practice may be influenced by the immigration to a new country. This has been referred as acculturation of breastfeeding practices. The breastfeeding prevalence may have increased or reduced in the new country. Several factors may influence the mother’s infant feeding decision. In order to investigate and describe the Iraqi mothers infant feeding practices of their six months old infant, the InnBaKost study was developed. The experience and potential barriers to their choice of infant feeding practice have also been explored, and how they perceive the information given to them by the Iraqi network and health clinic.
This thesis is based on the results from qualitative in-depth interviews with 14 Iraqi mothers with the help of a semi-structured interview guide, and an interpreter when necessary. The qualitative approach of the data collection and analysis was conducted according to the Grounded Theory. The mothers were recruited from various places such as “Folkeregisteret”, health clinics and the snow-ball method. All the interviews were digitally recorded. The interviews were further transcribed verbatim in Norwegian and transferred to the software program OpenCode, where the transcripts were coded. The relevant codes were further clustered and transformed to categories, and further attempted to be connected to each other.
The main findings in the study were that the mothers practiced predominant breastfeeding, and introduced liquids (milk formula, water, sugar water) before the infant’s first month of age. Milk formula was perceived as an easy option, when challenges occurred. The main challenges mentioned were that the mothers felt their milk was not enough, breastfeeding in public and plans to go back to school or work. According to the mothers water was a necessity for the infant and sugar water was perceived as a pain relief for stomach ache. The advices on water and sugar water were given by their mothers and mothers-in-law. The mothers perceived their own mothers and mothers-in-law as trustworthy persons because of their previous experience with children. Some mothers also mentioned language and their mothers or mothers-in-law to be more available than the health clinic as the reasons for why they trusted them more. The recommendations on complementary food from the health clinic were also followed by the mothers. They introduced typical Norwegian infant foods such as porridge and mashed vegetables. They also added the Iraqi soup to the infant meals, which consisted of vegetables, some added rice and sometimes meat and seasoning.
The majority of the mothers had a positive experience with the health clinic. The mothers who felt they did not have enough milk were advised to use milk formula at the hospital and/or at the health clinic. A few of the mothers mentioned that there was a stressful environment in the health clinic. This could have made the mothers hesitant to ask questions at the health clinic, because it seemed like they had limited time for each mother.
Their own mothers, mothers-in-law and the health clinic seem to be important information sources for the Iraqi mothers. However, information from different sources may be confusing for the mothers. The Iraqi mothers seem to need more information on sugar water, water and exclusive breastfeeding. Information from this study can be valuable in improving counseling of Iraqi mothers at the health clinic. In this way the public health nurse will have a better knowledge what they should emphasize when giving advice or inquire the Iraqi mothers about at the health clinic. The findings in this study, can be helpful in knowing which areas should be targeted, in advice-giving to the Iraqi mothers. In addition, develop relevant strategies to improve the knowledge on liquids during the first six months of the infant.