Evidence map›Paper›PMID 40484434›Full record

Observational studyBMJ open2025

Perceptions of hospital feeding practices among mothers of infants with severe pneumonia in Malawi: a qualitative descriptive study.

Nadia E Hoekstra, Dalton M Craven, Mercy Tsidya, Annie Thom, Agatha Bula, Marieke van der Zalm, Tisungane Mvalo, Eric D McCollum

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nadia E HoekstraUNC Project-Malawi, Lilongwe, Central Region, Malawi Nadia_Hoekstra@med.unc.edu.ORCID http://orcid.org/0000-0002-4432-4029
Dalton M CravenUNC Project-Malawi, Lilongwe, Central Region, Malawi.
Mercy TsidyaUNC Project-Malawi, Lilongwe, Central Region, Malawi.
Annie ThomUNC Project-Malawi, Lilongwe, Central Region, Malawi.
Agatha BulaUNC Project-Malawi, Lilongwe, Central Region, Malawi.
Marieke van der ZalmDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Desmond Tutu TB Centre, Cape Town, South Africa.
Tisungane MvaloUNC Project-Malawi, Lilongwe, Central Region, Malawi.
Eric D McCollumGlobal Program in Pediatric Respiratory Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID http://orcid.org/0000-0002-1872-5566

Funding

UJMT – ORWH – Gazzetta, Issa-BoubeD43TW009340 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI William Checkley, Benjamin H. Chi · 2017 to 2026
$14.8M
The long-term consequences of pulmonary tuberculosis and respiratory viruses on lung health in young South African childrenK43TW011028 · FIC · STELLENBOSCH UNIVERSITY · PI VAN DER ZALM, MARIEKE MARGREET · 2020 to 2024
$647k
FIC NIH HHS D43 TW009340FIC NIH HHS K43 TW011028
6 · The paper itself

Abstract

objectiveTo determine caregiver knowledge of, attitudes towards, and perceptions of feeding practices for infants admitted to a tertiary referral hospital with severe pneumonia, and to identify community feelings about nasogastric tube feeding in Malawi.

settingThe paediatric ward of a government tertiary referral hospital in Lilongwe, Malawi.

methodsFrom March through April 2023, we conducted in-depth interviews with 14 mothers of infants 0-12 months of age hospitalised with severe pneumonia who had been enrolled in an observational study evaluating feeding and swallowing in breastfed infants. In-depth interviews assessed mothers' attitudes towards hospital feeding practices including nasogastric tube feeding, along with community perceptions of nasogastric tubes. Data were analysed using a thematic analysis approach to assess themes and subthemes of transcripts.

resultsMothers understood that children with pneumonia are at risk of 'choking' during oral feeding; however, they had substantial worries about both withholding breastfeeding and providing nasogastric feeds to their infants through a nasogastric tube. Community perceptions of nasogastric tubes were widely negative and included beliefs that nasogastric tubes cause children to 'choke' and die and that medical providers want to harm children. Mothers held strong beliefs about the benefits of breastfeeding.

conclusionThere are alarming misconceptions in the community around nasogastric tubes and the intentions of medical providers. This leads to maternal concerns about this hospital feeding practice, poor adherence to medical recommendations, and mistrust in the broader healthcare system. To improve hospital outcomes of children with severe pneumonia, caregiver and community education is needed.

Indexed as

Breast FeedingEnteral NutritionHealth Knowledge, Attitudes, PracticeIntubation, GastrointestinalMothersPneumoniaAdultFemaleHospitalizationHumansInfantInfant, NewbornMalawiMaleQualitative ResearchChildNutritionPaediatric thoracic medicineQUALITATIVE RESEARCHRespiratory infectionsTropical medicine

Identifiers

PMID40484434
PMCPMC12161392

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.