A qualitative study of providers’ perceptions of parental feeding practices of infants and toddlers to prevent childhood obesity

Abstract

Background With a recent focus on establishing US Dietary Guidance for children ages 0 to 2 years old, the objective of this qualitative study was to determine misconceptions and barriers that prevent parents from implementing early childhood feeding and obesity prevention practices as reported by healthcare, community-based, and education providers. Methods Trained researchers conducted one-on-one qualitative phone interviews, using a semi-structured script, with early childhood health and education providers working with families of young children. Interviews were audiotaped, transcribed verbatim, and analyzed using the classic analysis approach. Transcripts were coded by researchers and analyzed for themes. Results Providers (n = 21) reported commonly observed obesogenic practices including overfeeding tendencies, early initiation of solids or less optimal feeding practices, lack of autonomy and self-regulation by child, and suboptimal dietary patterns. Sources of parental misconceptions about feeding were often related to cultural, familial, and media influences, or lack of knowledge about optimal feeding practices for infants or toddlers. Conclusions Providers indicated a need for engaging and consistent child feeding and obesity prevention education materials appropriate for diverse cultural and literacy levels of parents, with detailed information on transitioning to solid foods. Early education and community-based providers reported limited access to evidence-based educational materials more so than healthcare providers. It is an opportune time to develop reputable and evidence-based child feeding guidance that is readily available and accessible for parents of infants and toddlers to prevent early childhood obesity.

Identifying elevated child weight from 3 to 24 months: Early transitions into nonparental care and to solid foods

“…It is vital that we identify ways to support parents who rely on NPC and the caregivers who provide care. A recent qualitative study with early childhood professionals revealed that ITS is a common area where parents need more support and reported needing more nutrition education materials for educating and engaging with parents on early feeding practices, including culturally representative information 43 . Findings from the current study underscore the need for the development and accessibility of resources for those caring for and feeding infants and young children.…”

“…Less desirable infant feeding practices among nonparental caregivers have been linked to increased child weight, 30 however, providers may lack access to resources or information needed to enact more desirable infant feeding practices. 43 Third, NPC has been defined in a myriad of ways. A similar study categorized NPC groups as relative care, informal care, formal care, and combinations of those types of care; infants who were received more than one type of NPC or were in relative care demonstrated higher weight.…”

“…Second, the current study does not have access to the infant feeding practices of nonparental caregivers. Less desirable infant feeding practices among nonparental caregivers have been linked to increased child weight, 30 however, providers may lack access to resources or information needed to enact more desirable infant feeding practices 43 . Third, NPC has been defined in a myriad of ways.…”

BabyByte: Qualitative Research to Inform the Development of an App to Improve Responsive Feeding Practices in Parents of Infants and Toddlers

“…Overall, parents expressed interest in using a child-feeding mobile phone app like BabyByte for accessing feeding-related guidance for children ages 0–2 years. With current parental confusion surrounding early childhood feeding [ 14 , 24 ] and reported nutrition education needs by parents [ 33 , 34 ] for early childhood obesity prevention, an app like BabyByte may be helpful as an intervention option. This is especially true for family members who may be more difficult to reach or less willing to commit to in-person meetings or sessions [ 36 ].…”

“…Age groups were organized based on optimal developmental feeding milestones. Content for the app prototype was based on early childhood obesity prevention information and related features based on priority topics identified by the target population from prior research conducted by the corresponding author [ 32 , 33 , 34 ] and key strategies from the Robert Wood Johnson Foundation’s (RWJF) Feeding Guidelines for Infants and Young Toddlers: A Responsive Parenting Approach [ 24 ]. These topics included when and how to introduce solid foods, how to safely introduce allergenic foods, how to encourage autonomy and self-regulation, and how to increase the variety and healthy food options in a young child’s diet.…”