Integration of infant feeding in clinical undergraduate education: a case study of one South African university faculty

Abstract

Background Healthcare workers (HCW) have a significant influence on the infant feeding practices that parents choose to undertake, with options varying between breastfeeding and other alternative forms of feeding like formula milk or homemade foods. It is, therefore, important to know what and how healthcare workers are taught and trained on infant feeding. In South Africa, there is a paucity of data on how infant feeding education (IFE) is included in the undergraduate curricula for clinical health science students who are being trained for direct involvement in patient care. This study explored how infant feeding education was included in the curriculum of undergraduate clinical health science students at one university faculty. The study also explored what influenced how this education was structured and delivered, including the potential influence of commercial milk formula (CMF) companies. Methods This qualitative study comprised 13 in-depth key informant interviews with staff members involved in either teaching, developing, or curating the curriculum of undergraduate students in Medicine, Nursing, Clinical Medical Practice, and Dentistry at the University of the Witwatersrand, Johannesburg, South Africa. A smaller record review was embedded as part of the study to characterize the timing, duration, and delivery methods of the infant feeding education. The study was conducted between June and July 2024. We used thematic analysis to analyse the qualitative data. Results IFE is being included at varying levels across the degrees, with distinct reasons for inclusion and exclusion. Nursing students were receiving more in-depth lessons compared to the other degrees as there was a notion that infant feeding was meant to be a nurse’s job. However, the lessons that were delivered across all degrees are based on the clinical evidence of the benefits of breastfeeding. Other influences of how IFE is structured were the coordinator’s attributes, timetabling constraints, and the lack of prioritisation for IFE. Conclusion This study reveals gaps in IFE at Wits University’s Faculty of Health Sciences across the different degrees, where nursing students receive thorough training, while other clinical degrees offer minimal, unstructured IFE. Most programs emphasise breastfeeding’s biological benefits over a holistic biopsychosocial approach, limiting practical application. Though CMF companies did not directly influence the curriculum, their presence in faculty awards subtly shapes perceptions.