A qualitative study of the infant feeding beliefs and behaviours of mothers with low educational attainment

Abstract

BackgroundInfancy is an important period for the promotion of healthy eating, diet and weight. However little is known about how best to engage caregivers of infants in healthy eating programs. This is particularly true for caregivers, infants and children from socioeconomically disadvantaged backgrounds who experience greater rates of overweight and obesity yet are more challenging to reach in health programs. Behaviour change interventions targeting parent-infant feeding interactions are more likely to be effective if assumptions about what needs to change for the target behaviours to occur are identified. As such we explored the precursors of key obesity promoting infant feeding practices in mothers with low educational attainment.MethodsOne–on–one semi-structured telephone interviews were developed around the Capability Opportunity Motivation Behaviour (COM-B) framework and applied to parental feeding practices associated with infant excess or healthy weight gain. The target behaviours and their competing alternatives were (a) initiating breastfeeding/formula feeding, (b) prolonging breastfeeding/replacing breast milk with formula, (c) best practice formula preparation/sub-optimal formula preparation, (d) delaying the introduction of solid foods until around six months of age/introducing solids earlier than four months of age, and (e) introducing healthy first foods/introducing unhealthy first foods, and (f) feeding to appetite/use of non-nutritive (i.e., feeding for reasons other than hunger) feeding. The participants’ education level was used as the indicator of socioeconomic disadvantage. Two researchers independently undertook thematic analysis.ResultsParticipants were 29 mothers of infants aged 2–11 months. The COM-B elements of Social and Environmental Opportunity, Psychological Capability, and Reflective Motivation were the key elements identified as determinants of a mother’s likelihood to adopt the healthy target behaviours although the relative importance of each of the COM-B factors varied with each of the target feeding behaviours.ConclusionsInterventions targeting healthy infant feeding practices should be tailored to the unique factors that may influence mothers’ various feeding practices, taking into account motivational and social influences.

Parental experiences and perceptions of infant complementary feeding: a qualitative evidence synthesis

“…Others did not have such intentions or explicitly stated intentions to commence feeding before guidelines of 4–6 months . Irrespective of intentions, parental worries, concerns and confusion about infant feeding emerged in 10 papers . Worries included infant developmental readiness for food, particularly around choking: ‘They worried about the infant not being able to chew certain foods or swallowing them too quickly and choking’ .…”

Factors Related to the Practice of Exclusive Breastfeeding in Different Cities of the States Minas Gerais and Bahia, Brazil

“…Motivation strategies for the establishment of healthy feeding practices should be initiated from breastfeeding, as long as it is individualized for different populations, considering the social, economic, cultural and emotional influences inherent to each of them [34].…”

Healthcare professionals’ views on supporting young mothers with eating and moving during and after pregnancy: An interview study using the COM‐B framework

“…Although opportunity and capability are not linked in the COM‐B model, this study suggests that the pressure of time and cuts on healthcare professionals’ roles (physical opportunity) may stifle their capability to provide the optimum support for young women. Previous studies have (in different contexts) identified this influence of opportunity on capability (Russell et al, ).…”