Question

Imagine you are a healthcare provider who has a Somali patient whose baby refuses to eat because he/she is overfed. Explain in detail how you will appeal to the values held by your Somali patient in order to implement the clinically effective interventions mentioned at the end of the article. Which values will you attempt to appeal to? How will you do this? Be specific. Give examples.

Answer 1

Ans) When overfeeding is occurring, infants with a strong appetite drive tend to become overweight. Infants without such a strong appetite drive, or those who have a more independent temperament, can develop refusal to feed and an oral aversion. This can lead to weight faltering or frank failure to thrive.

- Careful attention to the history of frequency and timing of feedings and identifying all foods offered, combined with an open-ended and sympathetic exploration of maternal anxiety about her child’s weight, allows providers to identify this problem. Interventions that we have found clinically to be effective include:

• Promotion and support of exclusive breast feeding for the first 6 months of life including providing education and equipment to pump and store breast milk.
• Using the analogy of breast milk equals gold while formula is silver – both precious metals but one is more valuable than the other.
• Helping mothers identify infant cues for real hunger and satiety and feed based on demand rather than on time periods.
• Role playing with mothers how infants and toddlers react to overfeeding and how it makes feeding time a negative experience for both mother and infant.
• Discussing and mother scope with peer pressure that they receive to have a “fat” baby.

Providing mothers with goals for healthy weight gain between well child or WIC visits.