Re-establishment and maintenance of exclusive breastfeeding (EBF) is recommended by the World Health Organization for the nutritional rehabilitation of malnourished infants under 6 months; however, there is no explicit guidance on how this should be achieved. The IBAMI study-a pilot study conducted in Kilifi, Kenya-implemented these recommendations using an intervention for hospitalized infants and their mothers that included ward-based breastfeeding peer supporters. This paper explores how the challenges of maintaining EBF are recontextualized after infant hospitalization for malnutrition. Four weeks after discharge, semistructured interviews on experiences of trying to maintain EBF in a postdischarge home setting were conducted with a total of 20 mothers. Although most stated the aspiration of maintaining EBF for 6 months, a range of challenges were reported and not all had successfully maintained EBF post discharge. Reported challenges include the stress of household chores, food insecurity, technical difficulties and social stigma of expressing breast milk, pressure from neighbours and family members to introduce mixed feeding, and needing more community-based awareness and support. Most of these challenges were specific to the home setting and were not easily surmountable, despite the breastfeeding practices mothers had learned in the ward. Indeed, in some cases, challenges were exacerbated by the overmedicalized nature of the breastfeeding practices taught in the ward. In order to aid the transition from ward to home, there may be a need to further translate ward-based education and promotional messaging for EBF into a community setting, targeting other caregivers as well.

中文翻译：

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母亲在出院后家庭环境中进行纯母乳喂养的经历。

世界卫生组织建议重新建立和维持纯母乳喂养 (EBF)，以促进 6 个月以下营养不良婴儿的营养康复；但是，对于如何实现这一点，没有明确的指导。IBAMI 研究——一项在肯尼亚基利菲进行的试点研究——通过对住院婴儿及其母亲的干预来实施这些建议，其中包括基于病房的母乳喂养同伴支持者。本文探讨了婴儿因营养不良住院后如何重新考虑维持 EBF 的挑战。出院 4 周后，对总共 20 位母亲进行了半结构式访谈，内容涉及在出院后家庭环境中尝试维持 EBF 的经历。尽管大多数人表示希望维持 EBF 6 个月，报告了一系列挑战，但并非所有挑战都在出院后成功维持 EBF。报告的挑战包括家务压力、粮食不安全、技术困难和挤奶的社会污名、邻居和家庭成员引入混合喂养的压力，以及需要更多基于社区的认识和支持。尽管母亲们在病房里学到了母乳喂养的做法，但大多数这些挑战都是针对家庭环境的，并不容易克服。事实上，在某些情况下，病房教授的母乳喂养实践的过度医疗性质加剧了挑战。为了帮助从病房过渡到家，可能需要进一步将 EBF 的病房教育和宣传信息转化为社区环境，