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Hässig-Wegmann A, Román S, Sánchez-Siles L, Siegrist M. Complementary feeding challenges: Insights from Swiss parents' perspectives. Appetite 2024; 202:107638. [PMID: 39168251 DOI: 10.1016/j.appet.2024.107638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 08/08/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024]
Abstract
Parents play a crucial role in deciding what foods to introduce to their infants during the transition from milk to solids. This study examined the challenges they face, including adherence to official complementary feeding recommendations and the struggles and concerns across different stages of feeding. Specifically, this study focused on the initial stage (transition from breastmilk/formula to mashed foods), middle stage (consumption of mashed foods and some fingerfoods, transitioning towards family foods) and late stage (complete transition to family diet). Findings from 22 semi-structured interviews with Swiss parents reveal that, despite being well-informed, practical obstacles such as returning to work, limited time for preparing homemade foods, managing multiple children, and food preferences often hinder adherence. Safety concerns like allergies and choking were prominent early on but decreased as infants grew older and parents gained confidence. In the middle phase, concerns shifted towards pesticides, indicating a growing awareness of food quality. Maintaining a healthy diet was a constant concern, with early reassurance from breastfeeding or formula feeding giving way to worries about balanced nutrition as solids became more prominent. Time constraints were particularly significant in the first two stages, due to the effort of preparing small amounts of mash and later cooking separate meals. Tailored support and clear communication can help parents navigate these challenges and promote healthier feeding practices.
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Affiliation(s)
- Alenica Hässig-Wegmann
- ETH Zurich, Department Health Science and Technology (D-HEST), Consumer Behaviour, Switzerland.
| | - Sergio Román
- Marketing Department, Facultad de Economía y Empresa, Universidad de Murcia, 30100 Murcia, Spain
| | - Luisma Sánchez-Siles
- Institute for Research and Nutrition, Hero Group, 5600, Lenzburg, Switzerland; Research and Development Department, Hero Group, 30820, Murcia, Spain
| | - Michael Siegrist
- ETH Zurich, Department Health Science and Technology (D-HEST), Consumer Behaviour, Switzerland
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Nansel TR, Schwedhelm C, Lipsky LM, Faith MS, Siega-Riz AM. Socioeconomic Characteristics and the Home Food Environment Are Associated With Feeding Healthful and Discretionary Foods During the First Year of Life in the Pregnancy Eating Attributes Study. J Acad Nutr Diet 2024:S2212-2672(24)00249-1. [PMID: 38777149 DOI: 10.1016/j.jand.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Feeding of nutrient-poor foods begins in infancy and may adversely influence long-term food preferences. OBJECTIVE To examine associations of socioeconomic characteristics, childbearing parent eating behaviors, and home food environment with infant feeding characteristics. DESIGN Secondary analysis of a prospective cohort study from first trimester of pregnancy through 12 months postpartum. PARTICIPANTS/SETTING Participants with uncomplicated singleton pregnancies and no major chronic illness were enrolled from November 2014 through October 2016 from 2 university-based obstetrics clinics in Chapel Hill, NC. Of 458 enrolled, 321 were retained through 12 months postpartum. MAIN OUTCOME MEASURES Participants completed infant food frequency questionnaires indicating age at introduction and frequency of consuming multiple food groups. Exposures included childbearing parent socioeconomic characteristics, hedonic hunger, addictive-like eating, Healthy Eating Index 2015 calculated from three 24-hour diet recalls, and home food environment fruit/vegetable and obesogenic scores. STATISTICAL ANALYSES PERFORMED Multiple imputation using Heckman selection model; linear and logistic regressions examining associations with infant feeding characteristics. RESULTS Lower education and income were associated with later infant age at introduction to, and lower frequency of consuming fruits and vegetables at age 12 months. Socioeconomic characteristics were not associated with age at introduction to discretionary solid foods; however, lower education and income were associated with greater infant frequency of intake of discretionary foods and greater odds of introducing fruit juice and sweetened beverages by age 12 months. Childbearing parent Healthy Eating Index 2015, hedonic hunger, and addictive-like eating were not consistently associated with infant feeding characteristics. A more obesogenic food environment was associated with greater frequency of intake of discretionary foods, lower frequency of intake of fruit, and greater odds of fruit juice introduction by age 12 months. CONCLUSIONS Infant feeding characteristics may be important intervention targets for addressing socioeconomic disparities in child diet quality. Efforts to reduce routine feeding of discretionary foods across socioeconomic groups are needed; modifying the home food environment may promote healthful infant feeding.
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Affiliation(s)
- Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
| | - Carolina Schwedhelm
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Molecular Epidemiology Research Group, Berlin, Germany
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Myles S Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo- SUNY, Buffalo, New York
| | - Anna Maria Siega-Riz
- Epidemiology and Biostatistics, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
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Kristiansen AL, Myhre JB, Paulsen MM, Totland TH, Lande B, Andersen LF. Secular trends in infant feeding practices during the first year of life in Norway: findings from 1998 to 2019 - the Spedkost surveys. Br J Nutr 2024; 131:851-859. [PMID: 37822223 PMCID: PMC10864993 DOI: 10.1017/s0007114523002246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/22/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
The aims of the present study were to assess secular trends in breast-feeding and to explore associations between age at introduction of solid foods and breast-feeding duration. Data from three national dietary surveys in Norway were used, including infants born in 1998 (Spedkost 1, n 1537), 2006 (Spedkost 2, n 1490) and 2018 (Spedkost 3, n 1831). In all surveys, around 80 % of the infants were breastfed at 6 months of age. At 12 months of age, breast-feeding rate was 41 % in Spedkost 1, increasing to 48 % in Spedkost 2 and 51 % in Spedkost 3. Compared with earlier introduction, introduction of solid foods at ≥ 5 months of age was associated with a lower risk of breast-feeding cessation during the first year of life in the two most recent Spedkost surveys. In Spedkost 2, the adjusted hazard ratio for breast-feeding cessation during the first year of life for those introduced to solid foods at ≥ 5 months of age was 0·43 (95 % CI (0·31, 0·60)), P < 0·001, while the corresponding number in Spedkost 3 was 0·44 (95 % CI (0·29, 0·67)), P < 0·001. In conclusion, breast-feeding at infant age 12 months increased over time. Introduction of solid foods at ≥ 5 months of age was positively associated with breast-feeding duration in the two most recent Spedkost surveys. As breast-feeding contributes to numerous health benefits for infant and mother, and possibly improved dietary sustainability in infancy, findings point to the importance of continued protection, support and promotion of breast-feeding.
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Affiliation(s)
- Anne Lene Kristiansen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Bakkenteigen, Norway
| | - Jannicke Borch Myhre
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Mari Mohn Paulsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Torunn Holm Totland
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Britt Lande
- Division for Prevention and Public Health, Norwegian Directorate of Health, Oslo, Norway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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House E, Xu H, Taki S, Denney‐Wilson E, Baur L, Wen LM. Mothers' sociodemographic factors and use of health professionals for child feeding advice. MATERNAL & CHILD NUTRITION 2024; 20:e13586. [PMID: 37932246 PMCID: PMC10750020 DOI: 10.1111/mcn.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/12/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
This study examined sociodemographic factors associated with mothers seeking child feeding advice from health professionals (HPs). Cross-sectional analysis of survey data from linked randomized controlled trials was conducted. Surveys asked which sources of feeding information mothers used when their child was 6 months and 5 years old. Logistic regression was used to examine associations between sociodemographic characteristics and use of information from HPs. Here, 947 and 405 mothers completed 6-month and 5-year surveys, respectively. At 6 months, multiparous mothers were less likely to seek advice from child and family health nurses (CFHNs) (adjusted odds ratio [AOR]: 0.558, 95% confidence interval [95% CI]: 0.416-0.749) and other HPs (AOR: 0.706, 95% CI: 0.542-0.919), unmarried mothers were less likely to seek advice from other HPs (AOR: 0.582, 95% CI: 0.342-0.990). At 5 years, mothers with household income ≥$80,000 p.a. were less likely to seek advice from CFHNs (AOR: 0.514, 95% CI: 0.302-0.875) and working mothers less likely to seek advice from general practitioners (GPs) (AOR: 0.581, 95% CI: 0.374-0.905). Mothers born in Australia were less likely to seek information from CFHNs (AOR: 0.462, 95% CI: 0.257-0.833) and GPs (AOR: 0.431, 95% CI: 0.274-0.677). There was a greater likelihood that multiparous mothers (AOR: 2.114, 95% CI: 1.272-3.516) and mothers of children whose fathers had not attended university (AOR: 2.081, 95% CI: 1.256-3.449) had never sought advice from CFHNs, and that mothers who had not attended university (AOR: 1.769, 95% CI: 1.025-3.051), multiparous (AOR: 1.831, 95% CI: 1.105-3.035) and employed (AOR: 2.058, 95% CI: 1.135-3.733) mothers had never sought advice from other HPs. Understanding sociodemographic factors associated with seeking child feeding advice from HPs may inform priorities for engaging families in health promotion.
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Affiliation(s)
- Eve House
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
| | - Huilan Xu
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
- Health Promotion UnitPopulation Health Research & Evaluation Hub, Sydney Local Health DistrictSydneyNSWAustralia
| | - Sarah Taki
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
- Health Promotion UnitPopulation Health Research & Evaluation Hub, Sydney Local Health DistrictSydneyNSWAustralia
| | - Elizabeth Denney‐Wilson
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
- Susan Wakil School of Nursing and MidwiferyFaculty of Medicine and Health, University of SydneySydneyNSWAustralia
| | - Louise Baur
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Specialty of Child and Adolescent HealthSydney Medical School, Faculty of Medicine and Health, The University of SydneySydneyNSWAustralia
| | - Li M. Wen
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
- Health Promotion UnitPopulation Health Research & Evaluation Hub, Sydney Local Health DistrictSydneyNSWAustralia
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Thompson KL, Conklin JL, Thoyre S. Parental Decision-Making Around Introducing Complementary Foods: An Integrative Review. JOURNAL OF FAMILY NURSING 2023; 29:348-367. [PMID: 36899486 PMCID: PMC10629252 DOI: 10.1177/10748407231156914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
A primary role in infant parenting is feeding, and this role undergoes a significant transition when introducing complementary foods (CF), with important long-term health implications. Understanding the influences on parental decision-making around timing the introduction to CF can help health care providers provide parents with effective support for feeding; however, the factors that influence parental decision-making have not been recently reviewed in the United States. To determine influences and information sources, this integrative review examined the literature from 2012 to 2022. Results indicated that parents are confused and distrustful of inconsistent and changing guidelines around CF introduction. Instead, developmental readiness signs may be a more appropriate way for practitioners and researchers to support parents in appropriate CF introduction. Future work is needed to evaluate interpersonal and societal influences on parental decision-making, as well as to develop culturally sensitive practices to support healthful parental decisions.
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Spurlock K, Deave T, Lucas PJ, Dowling S. Parental engagement with complementary feeding information in the United Kingdom: A qualitative evidence synthesis. MATERNAL & CHILD NUTRITION 2023; 19:e13553. [PMID: 37551916 PMCID: PMC10483955 DOI: 10.1111/mcn.13553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/22/2023] [Accepted: 07/20/2023] [Indexed: 08/09/2023]
Abstract
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.
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Affiliation(s)
- Kelly Spurlock
- School of Health and Social WellbeingUniversity of the West of EnglandBristolUK
| | - Toity Deave
- School of Health and Social WellbeingUniversity of the West of EnglandBristolUK
| | | | - Sally Dowling
- Bristol Medical SchoolUniversity of BristolBristolUK
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Mulville K, Kai J, Kearney JM, Ng-Osorio J, Boushey CJ, Fialkowski MK. 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. Nutrients 2022; 14:nu14163268. [PMID: 36014772 PMCID: PMC9412982 DOI: 10.3390/nu14163268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to investigate caregivers’ experiences of complementary feeding (CF) among the Native Hawaiian and Other Pacific Islander (NHPI), and Filipino populations. Research focused on the timing of CF commencement, and the influence of transgenerational experience on feeding practices. The experiences and practices of those who fed human milk exclusively (HME), were compared to those who included infant formula (F&HM). Caregivers of a subset of 32 infants who were participating in a larger longitudinal study relating to CF and diet diversity, took part in voluntary in-depth interviews relating to CF practices. Interviews were recorded and transcribed. Two researchers analyzed interview transcripts. Interrater reliability and saturation were established. Institutional Review Board exemption was confirmed prior to study commencement. Interviews with 29 caregivers of infants were included in this study. Only infants of the F&HM group had an early introduction to complementary foods (<4 months of age). Caregivers reported receiving conflicting advice from healthcare professionals (HCPs) in relation to timing of the introduction of complementary foods. Nonetheless, the majority of caregivers reported following the advice of HCPs. Extended family (including grandparents) played less of a role in infant feeding, compared to previous generations. While transgenerational practices were valued and included, ultimately, the perceived health and safety of the practice for infants influenced decisions.
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Affiliation(s)
- Kara Mulville
- School of Biological Sciences, Technological University Dublin, Grangegorman, D02 HW71 Dublin, Ireland
- Trinity College Dublin, The University of Dublin, College Green, D02 PN40 Dublin, Ireland
| | - Jessie Kai
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - John M. Kearney
- School of Biological Sciences, Technological University Dublin, Grangegorman, D02 HW71 Dublin, Ireland
| | - Jacqueline Ng-Osorio
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Carol J. Boushey
- University of Hawaii Cancer Center, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Marie K. Fialkowski
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
- Correspondence:
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Flannery C, Shea C, O’Brien Y, O’Halloran J, Matvienko-Sikar K, Kelly C, Toomey E. Investigating group-based classes ('weaning workshops') to support complementary infant feeding in Irish primary care settings: a cross-sectional survey. Public Health Nutr 2022; 25:1-12. [PMID: 35260219 PMCID: PMC9991655 DOI: 10.1017/s1368980022000477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aims to (1) investigate current practice regarding 'weaning workshops' to support complementary infant feeding delivered within Irish primary care, (2) explore the experiences and opinions of community dietitians regarding optimal content and modes of delivery of weaning workshops and (3) identify the key factors to be considered in the development and implementation of weaning workshops delivered within primary care. DESIGN Cross-sectional survey. SETTING Irish primary care. PARTICIPANTS Forty-seven community-based dietitians. RESULTS Sixteen dietitians reported that workshops were run in their area with variable frequency, with ten reporting that workshops were never run in their area. Participants reported that mostly mothers of medium socio-economic status (SES) attended weaning workshops when infants were aged between 4 and 7 months, and that feedback from workshop attendees was predominantly positive. Dietitians identified that key factors to be considered in future development and delivery of weaning workshops are (1) workshop characteristics such as content, timing and venue, (2) organisational characteristics such as availability of resources and multidisciplinary involvement and (3) attendee characteristics such as SES. CONCLUSIONS This study highlights substantial variability regarding provision of weaning workshops in Ireland, and a lack of standardisation regarding the provider, content and frequency of workshops where workshops are being delivered. The study also provides unique insights into the experiences and opinions of primary care community dietitians regarding the development and delivery of weaning workshops in terms of optimal content and delivery options. These perspectives will make a valuable contribution given the dearth of evidence in this area internationally.
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Affiliation(s)
- Caragh Flannery
- School of Public Health, University College Cork, CorkT12 K8AF, Ireland
- INFANT Centre, Cork University Maternity Hospital, University College Cork, Cork, Ireland
| | - Caroline Shea
- School of Public Health, University College Cork, CorkT12 K8AF, Ireland
| | - Yvonne O’Brien
- Community Nutrition and Dietetic Service, Cork Kerry Community Healthcare, HSE, Cork, Ireland
| | - Joanne O’Halloran
- Primary Care Centre, Mountkennedy Town Centre, Newtownmountkennedy, Co Wicklow, Ireland
| | | | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland
| | - Elaine Toomey
- School of Allied Health, University of Limerick, Co. Limerick, Ireland
- Health Research Institute, University of Limerick, Co. Limerick, Ireland
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Nekitsing C, Hetherington MM. Implementing a 'Vegetables First' Approach to Complementary Feeding. Curr Nutr Rep 2022; 11:301-310. [PMID: 35152358 PMCID: PMC9174121 DOI: 10.1007/s13668-022-00399-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/30/2022]
Abstract
Purpose of Review To provide a rationale for promoting a vegetables first approach to complementary feeding (CF), building on prior exposure to vegetable flavours experienced in utero and via breastfeeding (chemosensory continuity). Recent Findings Vegetables confer selective health benefits but population intakes are below recommendations globally; maternal intake of vegetables during both pregnancy and lactation promotes familiarity with some vegetable flavours. Building on this exposure, vegetables as a first food during CF further promote acceptance. However, experiments testing efficacy of a vegetables first approach to CF demonstrate increased liking and intake, some evidence of generalisability but little evidence of sustained effects beyond infancy. Summary The aim to increase the quantity and variety of vegetables eaten by children is both desirable, to improve nutrient quality of the diet, and achievable. However, longer, larger, randomised control trials are needed to evidence any longer term, sustainable benefits to liking and intake of vegetables.
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McLennan JD, Pérez Agramonte M, Mosquea Hernández M. A mixed method inquiry of early complementary feeding of infants in the Dominican Republic. Appetite 2021; 170:105873. [PMID: 34923031 DOI: 10.1016/j.appet.2021.105873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 11/02/2022]
Abstract
Exclusive breastfeeding (EBF) is infrequent and decreasing over time in the Dominican Republic. This study aimed to identify patterns of, and women's rationale for, early complementary feeding. Mothers of children under 12 months of age living in a low-resource peri-urban community had three opportunities to contribute: (i) responding to feeding questions embedded in a standardized questionnaire used at a well-baby clinic (n = 101), (ii) participating in focus groups (n = 31), and (iii) engaging in home-based, semi-structured individual interviews (n = 25). Quantitative questionnaire data were analyzed to identify feeding practices as a function of child age. Textual data from the individual interviews and focus groups were systematically reviewed and coded to identify key constructs through a qualitative descriptive approach. The majority (>86%) of mothers reported breastfeeding at all monthly age bands up to six months. However, EBF was rare, with more than half reporting use of other milks and other foods by the infants' second and fifth month, respectively. Overarching themes to explain early complementary feeding from the qualitative data can be broadly captured by the complementary perceptions that there are problems with relying on breastfeeding alone and that there are benefits to early complementary feeding in the early months of an infant's life. EBF was experienced as (A) insufficient, (B) not always available, (C) sometimes not safe, (D) having potentially negative effects on the mother, and (E) bringing challenges. Complementary feeding was identified as helpful in addressing each of these concerns. Although mothers typically endorsed breastmilk as the preferable and best option for infant feeding, this did not translate into EBF and was not presented as contradictory to the use and perceived benefits of early complementary feeds.
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Affiliation(s)
- John D McLennan
- Departments of Psychiatry & Community Health Sciences, Cumming School of Medicine, Alberta Children's Hospital Research Institute, and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Canada.
| | - Miki Pérez Agramonte
- Hospital Dr. Elías Santana, Los Alcarrizos, Santo Domingo Oeste, Dominican Republic
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