Native Hawaiian Complementary Feeding Practices as Told by Grandparents: A Transgenerational Experience

Abstract

Background Infancy is a significant disease prevention and health promotion stage in life. There is a need to examine factors influencing complementary feeding among Native Hawaiians through an indigenous framed lens. Objective To identify Hawaiian complementary feeding practices through in-depth interviews with kūpuna (grandparents) from across the state of Hawai‘i. Methods The chain-referral-sampling method was used to identify Native Hawaiian kūpuna knowledgeable in Hawaiian complementary feeding practices from across the 4 counties in Hawai‘i. Interview question topics included sharing about their formative years, infant health, infant feeding, transgenerational knowledge, and opportunities and barriers related to traditional food consumption. Interviews were recorded and then transcribed. 3 coders used NVivio12 to code transcripts using a priori and emergent themes. IRB approval was received prior to data collection. Results Fourteen kūpuna interviews were included in the analysis. A majority of the kūpuna were female. Most kūpuna shared that complementary feeding practices in their childhood and when their children and grandchildren were being raised reflected aspects of the traditional Hawaiian diet. Poi or steamed mashed taro root was the most common traditional Hawaiian dietary staple of infancy. However, kūpuna shared that traditional dietary practices evolved to reflect contemporary dietary practices such as the mixing of poi with infant cereal or milk. Female family members were prominent influences on kūpuna complementary feeding practices. Lifestyle and lack of knowledge were the most commonly shared reflections by kūpuna on the supports and barriers, respectively, to promoting and engaging in traditional Hawaiian complementary feeding practices. Conclusions Complementary feeding practices have evolved over generations but aspects of traditional Hawaiian feeding practices have remained. These findings are important when working with Hawaiian families as kūpuna play a prominent role in feeding infants.

A Qualitative Analysis of a Caregivers’ Experience of Complementary Feeding in a Population of Native Hawaiian, Other Pacific Islander and Filipino Infants: The Timing of the Introduction of Complementary Foods, and the Role of Transgenerational Experience

“…As was anticipated based on current research, males (fathers) were reported to have a more prominent role in cooking and feeding activities than in previous generations [46]. However, grandparents' role in cooking and feeding was much less prevalent than is traditional for families of the NHPI population [35]. Although, the small sample size in this study is acknowledged.…”

“…Similarly, most caregivers in both groups were receptive to the advice of HCPs relating to unadvised feeding practices, including pre-mastication. Pre-mastication is a transgenerational feeding practice, which holds cultural significance in the Native Hawaiian population [35]. This practice nourishes the infant's soul [51].…”

“…The research question guiding the qualitative data collection was: what influences decisionmaking on first foods of NHPI and Filipino infants? The protocol used by interviewers was adapted from research by Fialkowski et al [35]. This protocol facilitated the interviewers' ability to guide conversations in order to obtain relevant information and gave flexibility to acknowledge and respond to the matter at hand (such as emerging ideas).…”

“…Similarly, taro along with coconut were traditional first foods among Other Pacific Islanders [34]. In Filipino culture, the introduction of complementary foods occurred at 6 months, with rice offered as the first food [35]. The transgenerational experience was identified as influential in caregivers' decision-making regarding CF in several cultural groups; including the timing and types of foods [6,31].…”

Food Preparation Practices for Infants Aged From 7 to 13 Months

“…31 In addition to educational resources available, qualitative research has underscored the importance of understanding and celebrating diverse cultures and practices regarding early feeding. 32 Scoping reviews, such as the one described by Monteith et al, 33 on qualitative literature related to Indigenous infant feeding experiences, could provide even more insights to understanding the context of culture and traditions on infant feeding practices. Continued efforts by both WIC educators and health care providers to emphasize the importance of early experiences with different food textures, using a culturally competent approach, could help support the development of positive current dietary behaviors and practices and potentially influence later dietary behaviors for WIC and non-WIC participants alike.…”