Physicians advice, parental practice and adherence to doctor’s advice: an original survey on infant feeding

Abstract

Background: Despite several years of guidance on infant feeding, there has been only a slight change in consumer compliance. Therefore, this study aimed to analyse parents feeding practices, explore physicians’ advice about infant feeding and subsequent parent’s adherence to advice. Methods A multicentric cross-sectional qualitative and descriptive self-report online study was conducted in volunteers to participate in the study. Results Fifty-four physicians (paediatricians and general practitioners) and 600 parents of infants were recruited. Of the infants, 20.2% presented at inclusion with at least one type of functional gastrointestinal disorder. The breastfeeding prevalence was quite low (37.3%). The main initial deviance from guidelines said they observed in infant feeding was the early use of cow’s milk. More than two-thirds of infants older than 8 months were drinking cow’s milk. The introduction of solid foods was globally in line with recommendations. Most physicians gave advice about the different aspects of infant feeding but were seeking more information, as did the parents. A discrepancy between the physicians’ statements and the parents’ perceptions was observed. However the majority (95.4%) of parents reported that they followed totally or partially the advice received, especially by abandoning subsequently the use of cow’s milk in favour of a formula. The main reason for not adhering to the advice was that they did not consider it suitable for their infant and they preferred to rely on their feelings or recommendations from familiars. Conclusions This survey provides good insights into parents’ infant feeding practices together with the advice given by their doctor. The gap between practices and current guidelines is notable only for breast-feeding and use of formula. Despite several guidelines professionals and parents seek nutrition information. It highlights the need to deliver consistent, relevant, and less confusing messages about infant feeding. Electronic supplementary material The online version of this article (10.1186/s12887-019-1697-y) contains supplementary material, which is available to authorized users.

Are the recommendations of paediatricians about complementary feeding aligned with current guidelines in Uruguay?

“…Soft pureed vegetables were regarded as the most appropriate foods to start complementary feeding, as well as the most important food during the first meals. Similar results were reported by a recent study conducted in France (43) . Interestingly, the variety of vegetables mentioned by the paediatricians was limited and mainly stressed pumpkin, potatoes and carrots.…”

“…This points out that traditional approaches to complementary feeding are still predominant in the recommendations of Uruguayan paediatricians, whereas baby-led weaning still has a marginal role. Similar results have been reported in previous studies conducted in different countries (43,(47)(48)(49) . This result is probably related to the fact that baby-led weaning has not been introduced as an alternative recommended practice in the national and international guidelines on complementary feeding (5,37,38) .…”

“…Although national guidelines recommend the early introduction of potentially allergenic foods, a great proportion of paediatricians seemed to have not incorporated the update in their practice. Lack of familiarisation with this specific recommendation has been reported by other authors (27,43,59) .…”

Counseling Parents About Child Feeding: a Qualitative Evaluation of French Healthcare and Childcare Professionals’ Experiences and Their Perception of a Brochure Containing New Recommendations

“…This study did not reveal important differences between the new recommendations and the advising practices of professionals (especially HCPs) but still pointed out particular advice given by professionals that could be updated and improved in light of the new recommendations, in particular with regard to the introduction of allergens and of all types of food between four to six months of age. Our results are in line with those of a study conducted in France in 2016, in which the interviewed general practitioners and pediatricians reported giving advice on child feeding in line with recommendations (55). For instance, in this study, professionals acknowledged that the right age for introducing complementary food was between four and six months of age and gave the appropriate advice to parents in 85.2% of cases.…”

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

“…Another contributing factor of the diverging views might be the varying levels of health professionals' knowledge of current evidence on complementary feeding. A survey by Chouraqui et al revealed a discordance between parents' statements of the infant feeding advice received and the statements of paediatricians who offered this advice (82) . Hence, an assessment of healthcare staff's knowledge of current complementary feeding guidelines and their perceived barriers to an effective nutritional education is required to complement parental perspectives and give directions for improved access to feeding recommendations.…”