• Exclusive breastfeeding;
  • infants;
  • Lesotho;
  • water supplementation

This study was designed to obtain policy-and programme-relevant data on exclusive breastfeeding in Lesotho at a time when global recommendations for exclusive breastfeeding were new. During both phases of field research, conducted in 1991 and 1992, qualitative information was obtained through focus groups and individual interviews with mothers, grandmothers and nurses. This was complemented during the second phase with quantitative data collected through a clinic-based survey of mothers. The qualitative and the quantitative findings consistently converged, illustrating a culture of infant feeding in which breastfeeding was central, but exclusive breastfeeding was an unknown concept and not practised. Grandmothers seemed to be more in tune with the ideal of exclusive breastfeeding as they had given their young infants thin gruel only occasionally. Contemporary mothers, in contrast, were regularly giving their young infants water. Mothers and grandmothers frequently cited nurses as the source of advice for giving water. Grandmothers were adamant in pointing out that they had never given water to their own young infants and asserted that they avoided giving it to their grandchildren as they considered it unnecessary and harmful. According to the grandmothers, water supplementation was a new practice that had been introduced through the clinics.

Conclusion: Efforts to discourage water supplementation and encourage exclusive breastfeeding in this setting need to be directed both at mothers and health providers.