Roles, perceptions and control of infant feeding among low-income fathers

"You just have to spread it thin": Perceptions and feeding experiences of Australian fathers of young children living with disadvantage

The role of fathers in feeding is an emerging field within child feeding literature. Fathers have unique contributions to make to family mealtimes and child eating behaviours. However, qualitative research on fathers' experiences is limited, especially in the context of disadvantage. This study explored fathers' perceptions of their roles and feeding practices and their lived experience of disadvantage through a symbolic interactionism lens. Twenty-five Australian fathers of children aged six months to five years who experienced socioeconomic disadvantage participated in semi-structured interviews. Five themes were constructed from reflexive thematic analysis: (i) responsibilities for foodwork are based on strengths, opportunities, and values, (ii) negotiating fatherhood identity from a place of tension to acceptance, (iii) struggling with financial and mental strain, and food insecurity, (iv) managing adversity whist prioritising feeding children, and (v) paternal feeding practices are driven by values, adversity, and emotions. The division of foodwork was contingent on family capability and employment, maternal gatekeeping, paternal attitudes and values, and intergenerational, cultural and gender norms around earning and childrearing. Economic, environmental, and emotional stressors triggered changes to fathers' feeding practices, often contradicting their ideals (e.g., providing alternative meals, using rewards and electronic devices, unstructured settings). Fathers described income and food-based strategies to protect children's food intake, which may involve caregivers forgoing meals. These findings provide insight into fathers' feeding experiences through recognising personal, interpersonal, and systemic enablers and barriers. Promoting optimal feeding practices should include targeted feeding support and broader structural interventions to address inequality. Fathers' experiences as they navigate child mealtime interactions within a context of adversity can be used to inform child feeding interventions to improve child health and development.

Parental engagement with complementary feeding information in the United Kingdom: A qualitative evidence synthesis

Complementary feeding is the process of introducing solid foods to milk-fed infants (also known as weaning). Current UK guidance states that complementary feeding should occur around 6 months but not before 4 months. This systematic review explores how parents in the UK, with an infant under 24 months of age, engage with sources of information and advice about complementary feeding. Engaging with sources of information can influence parents' feeding choices and so a better understanding of parents' information behaviours can improve service provisions. Six databases were searched, identifying 15 relevant qualitative studies with the predefined criteria. Data from each study were coded line by line allowing for a synthesis of higher analytical themes. Using thematic synthesis, four main themes were observed: (1) trust and rapport-parents valued information from a trusted source (2), accessibility-information needs were often time sensitive, and parents showed varying levels of understanding, (3) adapting feeding plans-often influenced by practicalities (4), being a good parent-feeding plans were changed to comply with societal ideas of 'good parenting'. The review concluded that parents receive information and advice about complementary feeding from multiple sources and are highly motivated to seek further information. The scope of this novel review explored the parental experience of finding, receiving and engaging with information sources and how this may or may not have influenced their feeding behaviours. The review has provided a new perspective to add to the growing body of literature that focuses on the experience of feeding an infant.

A Systematic Review of Research on Non-Maternal Caregivers' Feeding of Children 0-3 Years

Although people other than mothers participate in feeding, few interventions include non-maternal caregivers, especially those promoting healthy development among children aged 0-3 years. Understanding the role and influence of non-maternal caregivers is essential for the development and effectiveness of early childhood feeding interventions; yet, no reviews have examined non-maternal caregivers of children aged 0-3 years. This study assessed what is known about non-maternal caregivers' feeding of children aged 0-3. We systematically reviewed 38 empirical quantitative, qualitative, and mixed methods studies, cataloged in PubMed and Web of Science and published between 1/2000-6/2021. The studies showed that non-maternal caregivers engage in child feeding and their attitudes and behaviors affect child outcomes. Like mothers, non-maternal caregivers vary in the extent to which their knowledge and attitudes support recommended feeding practices and the extent to which they exhibit responsive feeding styles and practices. Children of broad ages were included in the studies; future research should include infant/toddler-only samples to allow for better assessment of age-specific feeding constructs. The studies also revealed issues specific to non-maternal caregivers that are unlikely to be addressed in interventions developed for mothers. Thus, the review highlighted features of non-maternal caregiving of children 0-3 years that could be addressed to support feeding and child outcomes.

Fathers' role in sustainability of exclusive breastfeeding practice in post-cesarean-section mothers

Background: The success of breastfeeding among post-cesarean- section mothers requires strong willingness and commitment, self-confidence, support from various professionals, and internal support (especially from their husband) and the belief and value of their family. Exclusive breastfeeding remains low in some cities such as in West Java, especially in post-cesarean-section mothers, who are influenced by certain factors. The purpose of this study is to identify husbands’ role and their support for post-cesarean-section mothers in exclusive breastfeeding.

Design and Methods: This study used a qualitative phenomenological approach. with a combination of different data collection techniques: focus group discussion and in-depth interviews. Twelve husbands of post-cesarean-section mothers participated in this study. Data were analyzed by thematic content analysis.

Results: Four themes were identified namely knowledge about exclusive breastfeeding, the role of the father during breastfeeding, the experience of the husband and the family in supporting breastfeeding, and Women’s lack of knowledge, inconvenience due to pain as the most impending factors of exclusive breastfeeding.

Conclusion: Most fathers seem eager to be involved and assist their partners to give breastfeeding to their baby. Furthermore, adequate support from family members, health care professionals, and employers can enable fathers to encourage and help their partners initiate and maintain exclusive breastfeeding. Fathers’ emotional, practical, and physical supports are also important factors that promote successful breastfeeding and enrich the experience of mothers.

Parental considerations during complementary feeding in higher income countries: a systematic review of qualitative evidence

OBJECTIVE

Worldwide data suggest a clash between parental complementary feeding practices and recommendations. Understanding the circumstances under which parents form their feeding practices is a crucial step to improve such practices. This paper aimed to systematically review the existing qualitative literature and synthesise the factors that parents take into consideration in relation to complementary feeding.

DESIGN

A systematic review was undertaken. Four electronic databases were searched for qualitative studies published after 2001 exploring parental experiences during complementary feeding. A framework that included authors' outcomes of interest was used to extract and synthesise study findings. The Standards for Reporting Qualitative Research were used to critically assess the included studies.

SETTING

Upper-middle- and high-income countries.

PARTICIPANTS

Parents with a child below the age of 3 years.

RESULTS

A total of forty-seven studies met the eligibility criteria and were included in this systematic review. The themes were organised into three main categories: (1) factors related to introduction of complementary foods; (2) factors related to the type of complementary foods and (3) factors related to both timing and type. The selected literature highlights: prevalent baby cues that prompt parents to introduce solid foods; parents' views on the recommended timing of complementary feeding; factors that drive the choice of complementary foods and perceived value in advice received from health professionals and grandmothers.

CONCLUSIONS

This systematic review indicates factors that can be barriers to complying with the complementary feeding guidelines, and therefore, its findings are pertinent to improving parental feeding practices through intervention studies and through infant feeding education in a primary care setting.

Relatively speaking? Partners' and family members' views and experiences of supporting breastfeeding: a systematic review of qualitative evidence

This review aimed to synthesize qualitative evidence of views and experiences of partners and other family members who provided breastfeeding support for a relative. The Joanna Briggs Institute (JBI) methodology for systematic reviews of qualitative evidence was followed. Seven databases: CINAHL, MEDLINE, EMBASE, PsycINFO, Scopus, Maternal and Infant Care, and Web of Science were searched. Partners and other family members (e.g. grandmothers, siblings) of women in any countries were included. Included papers were critically appraised. The JBI meta-aggregative approach was used to analyze data and form synthesized findings. Seventy-six papers from 74 studies were included. Five synthesized findings were: (i) spectrum of family members' breastfeeding knowledge, experiences and roles; (ii) the complexity of infant feeding decision making; (iii) the controversy of breastfeeding in front of others; (iv) impact of breastfeeding on family; and (v) it takes more than just family members: support for family members. Partners' and family members' views and experiences of breastfeeding support reflected multi-faceted personal, social, financial, cultural, religious, emotional, psychological, and societal factors of the support they provided (or not). Healthcare professionals should engage them in breastfeeding discussions with the woman, and offer tailored and practical guidance relevant to help them to appropriately support the woman. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Comparing Maternal and Paternal Complementary Feeding Practices: Findings From an Online Survey

OBJECTIVE

To explore differences between mothers' and fathers' complementary feeding practices.

METHODS

An online survey of UK parents with a healthy child in complementary feeding age. Timing of introducing solid foods and adherence to feeding guidelines were assessed. Dietary quality was measured using the Complementary Feeding Utility Index.

RESULTS

In a sample of 60 mothers and fathers (nondyads), there were no differences between fathers and mothers in the timing of introduction of solid foods, compliance with complementary feeding guidelines, or dietary quality. Most fathers who participated had a male child, whereas mothers had an equal number of male and female children (P < 0.001). The proportion of mothers who followed baby-led weaning was higher compared with fathers (P = 0.02).

CONCLUSIONS AND IMPLICATIONS

Study findings reveal no gender differences in parental complementary feeding practices apart from the use of baby-led weaning. Future studies with bigger male samples are warranted to explore the paternal role during complementary feeding.

Men's views and experiences of infant feeding: A qualitative systematic review

Although the advantages of breastfeeding are well documented, rates for breastfeeding often fall short of international and national targets. Increasing attention has been paid to the role of men in infant feeding, but a lot of the research about men has been elicited from women, rather than from men themselves. To explore these issues further, a systematic review of the qualitative research on infant feeding was carried out, focusing specifically on men's own views and experiences. Evidence was identified by searching electronic databases (CINAL, Cochrane, PubMed, and Scopus), manually searching citations, and by searching the grey literature. Studies were included in the review if they discussed men's views and experiences of infant feeding and if they reported primary qualitative data. Twenty research papers were included in the review, and each study was summarised and then analysed thematically to produce a synthesis. Five major analytical themes were identified: men's knowledge of infant feeding; men's perceptions of their role in infant feeding; positive views on breastfeeding; negative views on breastfeeding; and men's experiences of health promotion and support. The review concludes by highlighting that although men can play an important role in supporting women, they do not have a significant role in infant feeding decisions.

Contributions of nonmaternal caregivers to infant feeding in a low-income African-American sample

Infant feeding is a well-established topic of interest in obesity research, yet few studies have focused on contributions of nonmaternal caregivers (NMCs)-such as fathers, grandparents, and daycare providers-to infant feeding. Data from the Infant Care, Feeding and Risk of Obesity Project in North Carolina were used to investigate (a) which factors were associated with NMC feeding styles and (b) how NMCs' and mothers' feeding styles compared. Multivariate regression models utilizing random effects were used to analyse data from 108 NMCs who were identified by mothers as being heavily involved in infant feeding. Feeding styles were measured using the Infant Feeding Style Questionnaire. Several individual characteristics were important. Higher laissez faire-attention scores were reported by men and NMCs who lived in the same household as infant. Men reported higher indulgent-coax and indulgent-pamper scores. Perceptions of fussier infants, older infant age, and higher infant weight-for-length z-scores were also important. Mothers' and NMCs' feeding styles differed. Compared with mothers, grandparents reported lower laissez faire and indulgent-permissive scores. Fathers reported higher pressure-soothe and indulgent scores. Daycare providers reported higher restriction-diet quality and responsive satiety. Feeding styles were also predicted to change over time for all caregiver types. These findings highlight the importance of helping all caregivers develop skills that will promote optimal infant feeding outcomes. Given the paucity of research in this area, it is important to improve our understanding of what influences caregivers' feeding styles, especially among diverse populations, and how exposure to different feeding styles may shape children's obesity risk.

The influence of father's child feeding knowledge and practices on children's dietary diversity: a study in urban and rural districts of Northern Ethiopia, 2013

Infant and young child feeding has been recognised as an essential element to improve growth of children, especially in developing countries where malnutrition among children and its dire consequences are very prevalent. However, little attention has been paid on the influence of fathers on child feeding practices, although fathers are very important in raising well-adjusted, happy and successful children. Therefore, this study aimed to assess the influence of fathers' child feeding knowledge and practice on children's dietary diversity. A community-based comparative cross-sectional study was conducted among 850 eligible urban and rural households with children of 6-23 months. The father and mother of the child were interviewed on children's dietary diversity and fathers' knowledge and practice of child feeding. Nearly half (46%) of the children in the rural district did not meet the minimum dietary diversity, and in the urban district, the rate was even worse (72%). Grains were the common food group given to the children in both districts, whereas flesh food was the least commonly consumed food group. Additionally, low vitamin A-rich food and other fruit and vegetable consumption seem to be a problem in both districts. Almost all dimensions of fathers' knowledge and practice were significantly related to children's minimum dietary diversity; especially, fathers' knowledge of food groups was an important predictor (P-value < 0.001) in both districts. Interventions that focus on the fathers' knowledge of child feeding, especially about food groups, are recommended to improve children's dietary diversity in the study communities.

Diversity in fathers' food parenting practices: A qualitative exploration within a heterogeneous sample

BACKGROUND

Food parenting practices (FPPs) are important in shaping children's dietary behaviors. However, existing FPP knowledge is largely based on research with mothers.

PURPOSE

This study (1) identified fathers' FPPs; (2) described differences in FPP use by fathers' education and residential status.

METHODS

Semi-structured interviews were conducted with 40 fathers (39 ± 9.1 years; 37.5% non-residential; 40% ≥college education). Interviews were audio-recorded and transcribed. NVivo 10 was used for theme detection, categorization and classification using inductive and deductive approaches. FPPs were identified and their relative distribution was examined across education and residential status.

RESULTS

Twenty FPPs were identified - 13 responsive practices and 7 unresponsive practices. Having food rules was the most common responsive FPP (81.5%), followed by feeding on schedule (60%) and making healthy food accessible (60%). Common unresponsive FPPs were letting child dictate preferences (70%), incentivizing food consumption (60%) and pressuring the child to eat (35%). Compared to fathers with a college education, more fathers without a college education reported letting child dictate preferences (92% vs. 37%), educating their children about food (37% vs 12%), fewer reported feeding on schedule (50% vs. 75%), modeling healthy practices (29% vs. 50%), and using distraction to feed (4% vs. 37%). Compared to residential fathers, more non-residential fathers monitored (60% vs. 40%) or encouraged (60% vs. 36%) child food intake and let child dictate preferences (87% vs. 60%).

CONCLUSIONS

Fathers used an extensive variety of FPPs, similar to those identified in mothers. Further study on the influence of fathers' education and residential status on FPP use is warranted.

Engaging and supporting fathers to promote breast feeding: a concept analysis

OBJECTIVE

Empirical evidence demonstrates that fathers have a strong influence on a mother's decision to initiate and continue breast feeding. However, no clear delineation of what behaviours and attributes constitute father support or differentiate it from other kinds of support is provided in the current literature. The purpose of this study was to analyse the concept of 'father support' in relation to maternity services and broader health settings, thereby clarifying meaning to enable comprehension and application in practice, education, and research.

DESIGN

A concept analysis combining the evolutionary model of concept development with the inter-related theoretical, fieldwork and analytical phases of the hybrid model of concept development.

SETTING

Children's Centres in East and West Sussex in Southern England.

PARTICIPANTS

Repeated qualitative research over two phases with 16 parents of breast fed infants through seven focus groups and five telephone interviews.

MEASUREMENTS AND FINDINGS

CINAHL, PsycINFO, AMED, MEDLINE, OVID and EMBASE databases were searched for articles published in English between 1999 and 2013 using the keywords breast feeding, father, and support. Seven same-sex focus groups and five individual interviews were also conducted over two research phases with the parents of breast fed infants to expand and exemplify, and then validate the analysis of the literature search. Five main attributes of father support in relation to breast feeding were identified: (1) knowledge about breast feeding; (2) positive attitude to breast feeding; (3) involvement in the decision-making process; (4) practical support; and (5) emotional support. Multiple antecedents and consequences to these attributes were also identified.

KEY CONCLUSION

This study has contributed to clarifying the meaning of father support in relation to breast feeding and provides an important starting point for the development of a theoretical and practical model of optimal breast feeding that takes into account father support.

IMPLICATIONS FOR PRACTICE

Identification of attributes, antecedents, and consequences of father support may assist practitioners to reflect on current working practices and service delivery models, and offer important educational opportunities for the training of student midwives and other health professionals.

Transition to fatherhood: modeling the experience of fathers of breastfed infants

Transition to parenthood has long been examined from the angle of mothers' experience. When looked at this transition through fathers' lens, fathers' involvement and perceived parental efficacy appear to be landmarks of this experience. This article examines a model of the relationships among father involvement, perceived parental efficacy, events related to breastfeeding, support, stress, and income with a sample of 164 fathers of breastfed infants. This model highlights the direct and indirect contributions of support and stress to fathers' perceived parenting efficacy and involvement. Possible directions for nursing practice, education, and research are proposed to ease men's transition to fatherhood.

Fathers' beliefs about parenting and fathers' clubs to promote child health in rural Haiti

Health care providers are challenged to use culturally appropriate, low-technology approaches to improve child health in resource-poor countries. Village fathers' clubs is one approach used in rural Haiti since 1994. Fathers meet regularly for health education and community-building activities. Our aim was to investigate parenting practices and beliefs among Haitian fathers of young children and to explore their views on fathers' clubs. We conducted semistructured interviews with 18 fathers. Themes identified were fathers' involvement in routine care of their children, the close partnerships of fathers and mothers in child care, fathers' responsibilities to their communities, and fathers' clubs as an important supportive institution for the Haitian fathers and their families. Rural Haitian fathers reported taking a very active role in the lives of their families and children. Increased involvement of fathers should be explored as a strategy to improve child health and survival in other parts of Haiti and throughout the world.

Expectant fathers' and mothers' perceptions of breastfeeding and formula feeding: a focus group study in three US cities

The objective of the current study was to better understand how pregnant women and male partners conceptualize infant feeding and support for breastfeeding. Information was collected through 18 focus group interviews in 3 major US cities. There were 121 focus group participants of varying professions and income levels. Half were African American and half were Caucasian. Pregnant women and male partners had favorable attitudes toward breastfeeding, but did not articulate specific benefits to mothers or infants. Men expressed empathy for their partners' pregnancies and deferred to their partners' feeding decisions. Both groups disapproved of breastfeeding in public. Women voiced concerns about father-infant bonding more than men did. Both groups emphasized fathers' support of the infant, but not of the mother. Educators and practitioners may wish to consider expectant couples' perceptions of breastfeeding in public, knowledge of breastfeeding laws, and expectations of father-mother and father-infant relationships in their approach to breastfeeding promotion among expectant couples.