This study provides insight into the complex experience that mothers in the southeastern United States undergo when expressing milk for their VLBW infants.
Excessive, rapid weight gain in early infancy has been linked to risk of later overweight and obesity. Inappropriate infant feeding practices associated with this rapid weight gain are currently of great interest. Understanding the origin of these practices may increase the effectiveness of interventions. Low-income populations in the Southeastern United States are at increased risk for development of inappropriate infant feeding practices, secondary to the relatively low rates of breastfeeding reported from this region. The objective was to use grounded theory methodology (GTM) to explore interactions between mothers and infants that may influence development of feeding practices, and to do so among low-income, primiparous, Southeastern United States mothers. Analysis of 15 in-depth phone interviews resulted in development of a theoretical model in which Mother-Infant Communication Dynamic emerged as the central concept. The central concept suggests a communication pattern developed over the first year of life, based on a positive feedback loop, which is harmonious and results in the maternal perception of mother and infant now speaking the same language. Importantly, though harmonious, this dynamic may result from inaccurate maternal interpretation of infant cues and behaviours, subsequently leading to inappropriate infant feeding practices. Future research should test this theoretical model using direct observation of mother-infant communication, to increase the understanding of maternal interpretation of infant cues. Subsequently, interventions targeting accurate maternal interpretation of and response to infant cues, and impact on rate of infant weight gain could be tested. If effective, health care providers could potentially use these concepts to attenuate excess rapid infant weight gain.
The purpose of this grounded theory study was to explore the experiences that influence infant feeding practices between first‐time mothers and their infants in a low‐income population in the Southeastern United States. Mothers were recruited, via printed flyers and social media websites, and screened for eligibility. Eligibility criteria included first‐time mothers of infants ≤ 12 months of age living in urban areas. In‐depth phone interviews were audio‐recorded, transcribed, and entered into QDA Miner text‐analysis program to facilitate coding. Using grounded theory strategies and emergent coding techniques, transcripts were coded by two independent researchers and coding agreement compared on a predetermined schedule. Interviews were conducted until reaching saturation (n=12). Major, emergent themes include: 1) actions motivated by being perceived as a “good mom” in one's circle, 2) adoption of a feeding schedule until controlled cues are exhibited by the infant (2–4 months of age), and 3) strategies driven by maternal projection that may influence feeding practices. These results will be discussed in detail and offer valuable insight for future programs targeting this population. Funds: University of Tennessee, Knoxville, Professional Development Fund.Grant Funding Source: University Professional Development Fund
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