{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:10:40Z","timestamp":1784308240626,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,6,25]],"date-time":"2013-06-25T00:00:00Z","timestamp":1372118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100000690","name":"Research Councils UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000690","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Severe acute malnutrition (<jats:styled-content style=\"fixed-case\">SAM<\/jats:styled-content>) in infants aged &lt;6 months is a major global health problem. Supplementary suckling (<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>) is widely recommended as an inpatient treatment technique for infant &lt;6 months <jats:styled-content style=\"fixed-case\">SAM<\/jats:styled-content>. Its aim is to re\u2010establish effective exclusive breastfeeding. Despite widespread support in guidelines, research suggests that field use of SS is limited in many settings. In this study, we aimed therefore to describe and understand the barriers and facilitating factors to <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> as a treatment technique for infant <jats:styled-content style=\"fixed-case\">SAM<\/jats:styled-content>. We conducted qualitative interviews and focus group discussions in a hospital setting in <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>lantyre, <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>alawi, with ward staff and caregivers of infants &lt;2 years. We created a conceptual framework based on five major themes identified from the data: (1) motivation; (2) breastfeeding views; (3) practicalities; (4) understanding; and (5) perceptions of hospital\u2010based medicine. Within each major theme, more setting\u2010specific subthemes can also be developed. Other health facilities considering <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> roll\u2010out could consider their own barriers and facilitators using our framework; this will facilitate the implementation of <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>, improve staff confidence and therefore give <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> a better chance of success. Used to shape and guide discussions and inform action plans for implementing <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>, the framework has the potential to facilitate SS roll\u2010out in settings other than Malawi, where this study was conducted. We hope that it will help pave the way to more widespread <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>, more research into its use and effectiveness, and a stronger evidence\u2010base on malnutrition in infants aged &lt;6 months.<\/jats:p>","DOI":"10.1111\/mcn.12064","type":"journal-article","created":{"date-parts":[[2013,6,25]],"date-time":"2013-06-25T07:38:49Z","timestamp":1372145929000},"page":"593-603","source":"Crossref","is-referenced-by-count":7,"title":["Carer and staff perspectives on supplementary suckling for treating infant malnutrition: qualitative findings from <scp>M<\/scp>alawi"],"prefix":"10.1111","volume":"10","author":[{"given":"Natasha","family":"Lelijveld","sequence":"first","affiliation":[{"name":"UCL Centre for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chawanangwa","family":"Mahebere\u2010Chirambo","sequence":"additional","affiliation":[{"name":"College of Medicine  Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Kerac","sequence":"additional","affiliation":[{"name":"Leonard Cheshire Disability and Inclusive Development Centre, Department of Epidemiology and Public Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.84.2.191"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2007.00100.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61690-0"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.6999.251"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265060273S304"},{"key":"e_1_2_10_7_1","unstructured":"CorbettM.(2000)Infant Feeding in a TFP. 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