A qualitative systematic review of maternal infant feeding practices in transitioning from milk feeds to family foods

Abstract

Evidence supports the establishment of healthy feeding practices early in life to promote lifelong healthy eating patterns protective against chronic disease such as obesity. Current early childhood obesity prevention interventions are built on extant understandings of how feeding practices relate to infant's cues of hunger and satiety. Further insights regarding factors that influence feeding behaviors in early life may improve program designs and outcomes. Four electronic databases were searched for peer-reviewed qualitative studies published between 2000 to 2014 with transitional infant feeding practice rationale from developed countries. Reporting transparency and potential bias was assessed using the Consolidated Criteria for Reporting Qualitative Research quality checklist. Thematic synthesis of 23 manuscripts identified three themes (and six sub-themes): Theme 1. Infant (physical cues and behavioural cues) focuses on the perceived signs of readiness to start solids and the feeding to influence growth and "health happiness." Theme 2. Mother (coping strategies and knowledge and skills) focuses on the early survival of the infant and the family and the feeding to satisfy hunger and influence infant contentment, and sleep. Theme 3. Community (pressure and inconsistent advice) highlights the importance of generational feeding and how conflicting feeding advice led many mothers to adopt valued familial or culturally established practices. Overall, mothers were pivotal to feeding decisions. Satisfying infant's needs to reach "good mothering" status as measured by societal expectations was highly valued but lacked consideration of nutrition, obesity, and long term health. Maternal interpretation of healthy infant feeding and successful parenting need attention when developing strategies to support new families.

Reducing childhood obesity: opportunities to influence transitional infant feeding

“…203 Mothers in the study concerned about their child becoming overweight were more likely to use restriction, whereas concern about underweight had a wider impact on feeding decisions. Not only was underweight concern associated with pressure-to-eat, it was also linked to the early introduction of solids, a risk factor for childhood obesity.…”

“…While Guidelines knowledge in this study was related to the delay in the introduction of solids, the use of 'food to soothe' infant distress and promote sleep and growth is prominent in the literature, and another key modifiable obesity risk factor to address. 133,134,203,[293][294][295] Fruit and vegetable intake are fundamental indicators of a healthy diet and early exposure during infancy is associated with higher intakes during childhood. 179 Our findings that both feeding confidence and maternal self-efficacy directly affected infant fruit and vegetable intake builds on the limited studies on this relationship.…”

“…286,287 Acceptance of advice from family and friends in this transitional feeding stage may reflect similar lived experiences, including feeding to influence infant growth and contentment. 203,286 The relationships between feeding practices, infant dietary intake and weight in this study have been described elsewhere. 203 To guide infant feeding interventions, this paper aims to investigate the relationship between maternal infant feeding knowledge, self-efficacy and support on maternal feeding practices and parenting styles and infant dietary intake.…”

“…203,286 The relationships between feeding practices, infant dietary intake and weight in this study have been described elsewhere. 203 To guide infant feeding interventions, this paper aims to investigate the relationship between maternal infant feeding knowledge, self-efficacy and support on maternal feeding practices and parenting styles and infant dietary intake. Maternal parenting self-efficacy was measure through the global parental self-efficacy question from the Longitudinal Study of Australian of Children (i.e.…”

“…In the context of infant feeding in this study, motherhood has been defined by the mother's ability to meet professional and lay feeding recommendations while satisfying the needs of the infant. 203 Choosing how their infants were fed generated strong emotional responses in mothers, ranging from anticipation and enjoyment to guilt and failure. Mothers often described infant feeding decisions and practices in terms that implied a moral evaluation of their identity as mothers.…”