Maternal acceptability of iron supplementation in young breastfed rural Gambian infants

Isabella Stelle*, Mamadou Bah, M. Saidykhan, Hans Verhoef, Andrew M Prentice, Carla Cerami, Sergio A. Silverio, Sophie Moore

*Corresponding author for this work

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A recent analysis of Gambian infants showed plasma iron concentrations decline rapidly from birth to levels below the 95% reference range within five months of age. To address this issue, a trial was initiated to assess the efficacy of early iron supplementation in breastfed infants under six months of age. To understand if such an intervention is feasible for scaleup, the acceptability, through the lens of local stakeholders and caregivers (mothers), must be considered. An embedded qualitative study therefore explored acceptability through focus group discussions with local stakeholders and interviews with mothers. Four focus group discussions with local stakeholders (n=19) and individual interviews (n=14) with mothers whose infants were enrolled in the clinical trial were conducted. Qualitative data were analysed with respect to an implementation acceptability framework using Template Analysis. From the focus group discussions there was a general sense of enthusiasm for the intervention, but also concern due to confusion around nutritional messaging. The intervention was acceptable to mothers with limited mention of side effects and enthusiasm for participating in clinical trials on iron supplementation. However, when looking at scaleup there were mixed opinions on the practicality of daily supplementation, as well as concerns around costs. In addition, it was suggested that proper dissemination of information and inclusion of all family members in decision making, especially fathers, is key to acceptability. There was no indication that stakeholders or mothers were resistant to iron supplementation of breastfed infants.
Original languageEnglish
JournalReproductive, Female and Child Health
Early online date20 Mar 2023
Publication statusPublished - 1 Jun 2023


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