Home and Videotape Intervention Delays Early Complementary Feeding Among Adolescent Mothers

Abstract

ABSTRACT. Background. The American Academy of Pediatrics, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the World Health Organization recommend that infants receive only breast milk or formula for the first 4 to 6 months of life, followed by the introduction of complementary foods. Despite these recommendations, many infants, particularly those with adolescent mothers, receive solid foods (often cereal mixed with formula in a bottle) and liquids other than formula or breast milk in the first few weeks of life. Decisions on early feeding are often guided by grandmothers and influenced by beliefs that infants need complementary food to counteract signals of hunger, reduce crying, and sleep through the night.Objective. This investigation evaluated the efficacy of an intervention to delay the early introduction of complementary feeding among first-time, black, adolescent mothers living in multigenerational households. The intervention focused on reducing the cultural barriers to the acceptance of the recommendations of the American Academy of Pediatrics, WIC, and World Health Organization on complementary feeding by highlighting 3 topics: 1) recognition of infants' cues; 2) nonfood strategies for managing infant behavior; and 3) mother-grandmother negotiation strategies. The intervention was delivered through a mentorship model in which a videotape made by an advisory group of black adolescent mothers was incorporated into a home-visiting program and evaluated through a randomized, controlled trial.Methods. One hundred eighty-one first-time, low-income, black mothers <18 years old, living in multigenerational households were recruited from 3 urban hospitals. Infants were born at term, with birth weight appropriate for gestational age and no congenital problems. Shortly after delivery, mothers and grandmothers completed a baseline assessment and mothers were randomized into an intervention or control group. Intervention group mothers received home visitation every other week for 1 year. At 3 months, a subset of 121 adolescent mothers reported on their infant's intake through a food frequency questionnaire. Mothers who fed their infant only breast milk, formula, or water were classified as optimal feeders. Mothers who provided complementary foods other than breast milk, formula, or water were classified as less optimal feeders.Results. Sixty-one percent of the infants received complementary foods before 3 months old. Multivariate hierarchical logistic regression was used to evaluate the determinants of being in the optimal versus less optimal feeders group. After controlling for infant age and family income, mothers of infants in the optimal feeders group were more likely to report accurate messages from WIC regarding the timing of complementary food and nearly 4 times more likely to be in the intervention group. The most common complementary food was cereal mixed with formula in the bottle.Conclusions. The success of this relatively brief intervention demonstrates the importan...

Home Visiting for Adolescent Mothers: Effects on Parenting, Maternal Life Course, and Primary Care Linkage

“…25 We furthermore emphasized staff training and monitoring to ensure that staff acquired and used skills to teach, promote, and model positive parenting faithfully. 20 Similar to programs that specifi cally target teenage mothers, 15 our program signifi cantly infl uenced school reentry and graduation. This effect may have been due to the home visitors' consistent messages and case management activities delivered in the context of their ongoing relationship with the teen.…”

“…The curricula were grounded in social cognitive theory and were developed by a child development psychologist and an anthropologist specifi cally for urban, African American adolescent mothers. 19,20 The parenting curriculum sessions aimed to improve teens' understanding of child development, teach and model good parenting attitudes and skills, and promote appropriate health care use. If the adolescent mother gave consent, the home visitor attempted to engage the baby's father along with the mother in parenting sessions.…”

Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps

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Competing infant feeding information in mothers’ networks: advice that supports v. undermines clinical recommendations

“…Thus, many of the interventions on breast-feeding (24)(25)(26) and early complementary feeding (27) have focused on providing education to increase knowledge among mothers and their social support providers (e.g. spouse, own mother, health professionals).…”