Maternal acceptability of iron supplementation in young breastfed rural Gambian infants

Abstract Introduction A recent analysis of Gambian infants showed that plasma iron concentrations decline rapidly from birth to levels below the 95% reference range within 5 months of age. To address this issue, a clinical trial was initiated to assess the efficacy of early iron supplementation in breastfed infants under 6 months of age (‘Iron Babies’; NCT04751994). To understand if such an intervention is feasible for scaleup, the acceptability, through the lens of local stakeholders and mothers (as the primary caregiver), must be considered. Methods An embedded qualitative study, therefore, explored acceptability through focus group discussions with local stakeholders and interviews with mothers. Four focus group discussions with local stakeholders ( n = 19) and individual interviews ( n = 14) with mothers whose infants were enrolled in the clinical trial were conducted. Qualitative data were analysed with respect to an implementation acceptability framework using Template Analysis. Results From the focus group discussions, there was a general sense of enthusiasm for the intervention, but also a concern due to confusion around nutritional messaging. The intervention was acceptable to mothers with limited mention of side effects and enthusiasm for participating in clinical trials on iron supplementation. However, when looking at scaleup, there were mixed opinions on the practicality of daily supplementation, as well as concerns around costs. In addition, it was suggested that proper dissemination of information and inclusion of all family members in decision‐making, especially fathers, is key to acceptability. Conclusion There was no indication that stakeholders or mothers were resistant to iron supplementation of breastfed infants.