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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. Matern Child Nutr 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] [What about the content of this article? (0)] [Affiliation(s)] [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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2
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Weber MB, Palmer W, Griffin M, Welsh JA. Infant and young child feeding practices and the factors that influence them: a qualitative study. J Health Popul Nutr 2023; 42:32. [PMID: 37055864 PMCID: PMC10103516 DOI: 10.1186/s41043-023-00371-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/25/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Early child feeding is important for healthy growth and forming positive eating behaviors. METHODS This qualitative study sought to describe early childhood feeding behaviors, challenges, and opportunities through four focus group discussions with a diverse group of mothers of at least one child under two years or pregnant with their first child. RESULTS Although providing healthy foods was a priority, feeding behaviors reflected the mothers' partial understanding of infant and child nutrition. Mothers sought guidance on early child feeding from several sources, including in-person and virtual relationships but made decisions based largely on their own instincts. Participants consulted clinicians the least often, and mothers often felt frustrated by strict guidelines and negative messaging. Mothers were most receptive to suggestions when they felt supported and valued in the decision-making process. CONCLUSIONS In order to help mothers provide the best nutrition for their young children, clinicians should use positive tones, provide flexibility when possible, and work to create open lines of communication with parents.
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Affiliation(s)
- Mary Beth Weber
- Hubert Department of Global Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, USA.
- Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA.
| | - Wendy Palmer
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | | | - Jean A Welsh
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
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Spyreli E, McKinley MC, Dean M. Parental considerations during complementary feeding in higher income countries: a systematic review of qualitative evidence. Public Health Nutr 2021; 24:2834-47. [PMID: 33877043 DOI: 10.1017/S1368980021001749] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
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.
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Porto JP, Bezerra VM, Pereira Netto M, Rocha DDS. Exclusive breastfeeding and introduction of ultra-processed foods in the first year of life: a cohort study in southwest Bahia, Brazil, 2018. ACTA ACUST UNITED AC 2021; 30:e2020614. [PMID: 33950111 DOI: 10.1590/s1679-49742021000200007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/10/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To analyze association between exclusive breastfeeding (EBF) and the introduction of ultra-processed foods in children under 12 months old. METHODS This was a Cohort study, conducted with children in Vitória da Conquista, Bahia, Brazil. The main exposure was EBF (days: <120; 120-179; ≥180). The outcome variable was the introduction of four or more types of ultra-processed foods in the first year of life. Poisson regression analysis was used. RESULTS 286 children were evaluated, of whom 40.2% received four or more ultra-processed foods and 48.9% EBF for less than 120 days. EBF for less than 120 days (RR=2.94 - 95%CI 1.51;5.71) and for 120-179 days (RR=2.17 - 95%CI 1.09;4.30) was associated with the outcome after adjustment by socioeconomic, maternal, paternal and child variables. CONCLUSION EBF for less than 180 days increased the risk of introducing four or more ultra-processed foods in the first year of life.
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Affiliation(s)
- Jessica Prates Porto
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista, BA, Brasil
| | - Vanessa Moraes Bezerra
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista, BA, Brasil
| | - Michele Pereira Netto
- Universidade Federal de Juiz de Fora, Departamento de Nutrição, Juiz de Fora, MG, Brasil
| | - Daniela da Silva Rocha
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista, BA, Brasil
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Abstract
Purpose: During the transition from ingesting milk to ingesting solid food, infants substantiate their eating habits. The present study focuses on this transition. Specifically, it aimed to explore first-time parents’ lived experiences of their infants’ transition from milk to solid foods. Method: The study is based on the descriptive phenomenological approach Reflective Lifeworld Research (RLR). Ten mothers and ten fathers were interviewed twice; when the infants were aged four to five months and again at seven to eight months of age. Data were analysed according to RLR principles. Results: The findings show that the transition from milk to solid food is a demanding in-between phase. The physically intimate feeding situation is replaced by unfamiliar situations in which parents and infant are physically separated and new types of food are introduced. The process of feeding requires parents’ full attention and sensitivity towards the infant’s reactions. Conclusion: The study highlights how shared parental experiences were reflected in frames for how a meal should normally proceed, including parents’ desire to create healthy eating habits and uphold harmony duringfamily meals We suggest for health professionals to present parents with a wider frame of normality, especially as concerns the concept of what constitutes “normal” eating patterns.
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Affiliation(s)
- Annelise Norlyk
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | | | - Hanne Kronborg
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark
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Spyreli E, McKinley MC, Allen-Walker V, Tully L, Woodside JV, Kelly C, Dean M. "The One Time You Have Control over What They Eat": A Qualitative Exploration of Mothers' Practices to Establish Healthy Eating Behaviours during Weaning. Nutrients 2019; 11:E562. [PMID: 30845694 DOI: 10.3390/nu11030562] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Weaning marks the transition from a milk-only diet to the consumption of solid foods. It is a time period where nutrition holds an undeniable importance and taste experiences have a long-lasting effect on food preferences. The factors and conditions that form parental feeding practices are yet to be fully understood; doing so can help target problematic behaviours and develop interventions aiming to modify them. OBJECTIVE This study used a qualitative methodology to gain a better understanding of parental experiences of weaning a child. Particular emphasis was placed on exploring the factors and conditions that favour the establishment of a healthy relationship with food in infancy and those that impede it. METHODS Thirty-seven mothers of healthy infants 3⁻14 months with no previous history of allergies or food-related disorders were recruited. Eight semi-structured focus group discussions were conducted, transcribed and analysed thematically. RESULTS Discussions revealed a number of opportunities to establish healthy eating habits during weaning, as well as relevant challenges. Important opportunities included: acting as a role model for healthy foods; giving multiple opportunities to try a food; food variety "so you don't have a fussy eater"; and without food variety "things aren't going to work properly". Additionally, some of the challenges identified were: misconceptions about the definition of food variety; and distractions occurring during feeding. CONCLUSIONS Mothers were mindful of the need to provide their children with appropriate nutritional stimuli during weaning. They were aware of their role in influencing their infants' likes and used strategies such as modelling and repeated food exposure. The importance of a diverse diet in infancy was acknowledged, although knowledge gaps exist in relation to its definition. Distractions were tactfully employed by mothers to assist feeding. Findings of this study have applications in developing interventions for nutritional education in the complementary feeding period.
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Liu X, Liao X, Ren Q, Luo M, Yang L, Lin J, Chang J. Concerns regarding complementary feeding practices among urban Chinese mothers: a focus group study in Xi'an. J Health Popul Nutr 2018; 37:20. [PMID: 30041700 PMCID: PMC6056920 DOI: 10.1186/s41043-018-0151-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 07/17/2018] [Indexed: 06/01/2023]
Abstract
BACKGROUND Complementary feeding (CF) is an important determinant of infant growth and development. However, CF practices are influenced by caregivers' perceptions and knowledge. This study aimed to describe perceptions and factors that potentially influence CF practices among Chinese mothers living in Xi'an, a rapidly developing city in China. METHODS This focus group study included three discussion groups. Topics related to practices and concerns regarding CF were discussed among women with at least one child aged 4-36 months. A brief questionnaire was used to collect demographic information for mothers and their children. RESULTS Among study participants, the timing of starting CF for their children varied from age 4 to 8 months. Grain was ranked as the top food for CF, and homemade food was preferred to commercial CF products. Food additives and preservatives were the priority concerns when purchasing commercial baby food, particularly regarding uncertainty about their safety. In terms of nutrition, deficiencies in minerals and vitamins were of major concern. The issue of bio-availability of added nutrients in baby food was also raised during the discussions. Participants showed a strong reliance on information obtained from the Internet via computers or smartphones as their main source of CF knowledge, but felt this information lacked expertise. CONCLUSIONS Participating mothers from Xi'an prefer homemade food for CF to commercial products. More scientific knowledge of CF and related food safety issues should be available, perhaps via Internet-based approaches.
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Affiliation(s)
- Xin Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, 76 West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Xia Liao
- Department of Nutrition, The First Affiliated Hospital, Xi’an Jiaotong University Health Science Center, 227 West Yanta Road, Xi’an, Shaanxi People’s Republic of China
| | - Qiannan Ren
- The Second Affiliated Hospital, Xi’an Jiaotong University Health Science Center, 157 West 5 Road, Xi’an, Shaanxi People’s Republic of China
| | - Meng Luo
- The Second Affiliated Hospital, Xi’an Jiaotong University Health Science Center, 157 West 5 Road, Xi’an, Shaanxi People’s Republic of China
| | - Lei Yang
- The Second Affiliated Hospital, Xi’an Jiaotong University Health Science Center, 157 West 5 Road, Xi’an, Shaanxi People’s Republic of China
| | - Jing Lin
- Department of Child and Adolescent Health, School of Public Health, Xi’an Jiaotong University Health Science Center, 76 West Yanta Road, Xi’an, Shaanxi People’s Republic of China
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Health Science Center, Xi’an Jiaotong University, 76 West Yanta Road, Xi’an, Shaanxi People’s Republic of China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, 76 West Yanta Road, Xi’an, Shaanxi People’s Republic of China
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Barrett KJ, Wasser HM, Thompson AL, Bentley ME. Contributions of nonmaternal caregivers to infant feeding in a low-income African-American sample. Matern Child Nutr 2018; 14:e12610. [PMID: 29693776 DOI: 10.1111/mcn.12610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 02/20/2018] [Accepted: 03/01/2018] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Katherine J Barrett
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Heather M Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amanda L Thompson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret E Bentley
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Moore DA, Goodwin TL, Brocklehurst PR, Armitage CJ, Glenny AM. When Are Caregivers More Likely to Offer Sugary Drinks and Snacks to Infants? A Qualitative Thematic Synthesis. Qual Health Res 2017; 27:74-88. [PMID: 27956658 DOI: 10.1177/1049732316673341] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Many children consume more sugar than is recommended, and caregivers often find it difficult to change this habit once established. This thematic synthesis aims to identify the "critical situations" where caregivers may be more likely to offer infants sugary drinks and snacks. This thematic synthesis is reported in accordance with the statement for enhancing transparency in reporting the synthesis of qualitative research (ENTREQ). Our confidence in the findings of our synthesis was assessed using the CERQual (Confidence in the Evidence From Reviews of Qualitative Research Approach). We included 16 studies from the United States, the United Kingdom, Australia, and Denmark. We identified eight "critical situations" when caregivers may be more likely to offer sugary drinks and snacks to infants. Interventions that seek to reduce sugar intake for caries prevention in infants and young children may be more successful if they provide caregivers with practical parenting strategies to replace the nonnutritive functions of sugary foods and drinks, as opposed to taking an information-giving approach.
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Affiliation(s)
- Deborah Anne Moore
- University of Manchester, Manchester, United Kingdom
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Tom Lloyd Goodwin
- University of Manchester, Manchester, United Kingdom
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
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Harrison M, Brodribb W, Hepworth J. A qualitative systematic review of maternal infant feeding practices in transitioning from milk feeds to family foods. Matern Child Nutr 2016; 13. [PMID: 27696658 DOI: 10.1111/mcn.12360] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 06/23/2016] [Accepted: 07/08/2016] [Indexed: 01/10/2023]
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.
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Affiliation(s)
- Michelle Harrison
- Discipline of General Practice (DGP) and Child Health Research Centre (CHRC), Faculty of Medicine and Biomedical Sciences, The University of Queensland (UQ), Brisbane, Queensland, Australia
| | - Wendy Brodribb
- Discipline of General Practice (DGP), Faculty of Medicine and Biomedical Sciences, The University of Queensland (UQ), Brisbane, Queensland, Australia
| | - Julie Hepworth
- School of Public Health and Social Work Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
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Wandel M, Terragni L, Nguyen C, Lyngstad J, Amundsen M, de Paoli M. Breastfeeding among Somali mothers living in Norway: Attitudes, practices and challenges. Women Birth 2016; 29:487-493. [PMID: 27117640 DOI: 10.1016/j.wombi.2016.04.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/06/2016] [Accepted: 04/07/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Data from previous studies indicate a short duration of breastfeeding, especially exclusive breastfeeding, among infants of immigrant mothers living in Norway and other Western countries. Norway has a long tradition of supporting breastfeeding. AIM To explore infant feeding practices among Somali-born mothers in Norway, and the ways in which they navigate among different information sources. METHODS Qualitative in-depth interviews and focus groups were carried out with mothers of children 6, 12 and 24 months of age. Women were recruited by a multi-recruitment strategy. Twenty-one mothers participated in interviews and twenty-two in five focus groups. The analysis was guided by Grounded Theory. FINDINGS The mothers had positive attitudes to breastfeeding, but were unfamiliar with the concept of exclusive breastfeeding. Early introduction of water and infant formula was a common practice that interfered with exclusive breastfeeding. The mothers experienced challenges of dealing with conflicting recommendations and expectations regarding infant feeding. They navigated among different sources of information, taking into consideration traditional values, experiences and habits from living in Norway, and research-based knowledge. Their prioritization of the different information sources varied with different life situations, children's age, and the extent to which the mothers trusted the information sources. DISCUSSION AND CONCLUSIONS Despite the strong focus on breastfeeding in Norway, Somali-born mothers encounter obstacles in their breastfeeding practices. These may be due to lack of information about exclusive breastfeeding and to the conflicting information they received. Breastfeeding practices may be enhanced by promoting culturally sensitive communication, and relations of trust at health-care centers.
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Affiliation(s)
- Margareta Wandel
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway.
| | - Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University of Applied Sciences, Norway
| | - Camilla Nguyen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Julianne Lyngstad
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University of Applied Sciences, Norway
| | - Marlen Amundsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University of Applied Sciences, Norway
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Thorisdottir B, Gunnarsdottir I, Steingrimsdottir L, Palsson GI, Birgisdottir BE, Thorsdottir I. Vitamin D Intake and Status in 6-Year-Old Icelandic Children Followed up from Infancy. Nutrients 2016; 8:75. [PMID: 26861385 PMCID: PMC4772039 DOI: 10.3390/nu8020075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/12/2016] [Accepted: 01/27/2016] [Indexed: 12/17/2022] Open
Abstract
High serum 25-hydroxyvitamin D (25(OH)D) levels have been observed in infants in Nordic countries, likely due to vitamin D supplement use. Internationally, little is known about tracking vitamin D status from infancy to childhood. Following up 1-year-old infants in our national longitudinal cohort, our aims were to study vitamin D intake and status in healthy 6-year-old Icelandic children (n = 139) and to track vitamin D status from one year of age. At six years, the mean 25(OH)D level was 56.5 nmol/L (SD 17.9) and 64% of children were vitamin D sufficient (25(OH)D ≥ 50 nmol/L). A logistic regression model adjusted for gender and breastfeeding showed that higher total vitamin D intake (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.08–1.49), blood samples collected in summer (OR = 8.88, 95% CI = 1.83–43.23) or autumn (OR = 5.64, 95% CI = 1.16–27.32) compared to winter/spring, and 25(OH)D at age one (OR = 1.02, 95% CI = 1.002–1.04) were independently associated with vitamin D sufficiency at age six. The correlation between 25(OH)D at age one and six was 0.34 (p = 0.003). Our findings suggest that vitamin D status in infancy, current vitamin D intake and season are predictors of vitamin D status in early school age children. Our finding of vitamin D status tracking from infancy to childhood provides motivation for further studies on tracking and its clinical significance.
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Affiliation(s)
- Birna Thorisdottir
- Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali University Hospital, Reykjavik 101, Iceland.
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali University Hospital, Reykjavik 101, Iceland.
| | - Laufey Steingrimsdottir
- Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali University Hospital, Reykjavik 101, Iceland.
| | - Gestur I Palsson
- Children's Hospital, Landspitali University Hospital, Reykjavik 101, Iceland.
| | - Bryndis E Birgisdottir
- Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali University Hospital, Reykjavik 101, Iceland.
| | - Inga Thorsdottir
- Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland and Landspitali University Hospital, Reykjavik 101, Iceland.
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Nielsen A, Michaelsen KF, Holm L. Beyond an Assumed Mother–Child Symbiosis in Nutritional Guidelines: The Everyday Reasoning Behind Complementary Feeding Decisions. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/13575279.2014.905452] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Thorisdottir B, Gunnarsdottir I, Steingrimsdottir L, Palsson GI, Thorsdottir I. Vitamin D intake and status in 12-month-old infants at 63-66° N. Nutrients 2014; 6:1182-93. [PMID: 24662162 DOI: 10.3390/nu6031182] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 03/01/2014] [Accepted: 03/10/2014] [Indexed: 11/17/2022] Open
Abstract
The objective was to assess the vitamin D status in healthy 12-month-old infants in relation to quantity and sources of dietary vitamin D, breastfeeding and seasons. Subjects were 76 12-month-old infants. Serum levels of 25-hydroxyvitamin D (25(OH)D) ≥ 50 nmol/L were considered indicative of vitamin D sufficiency and 25(OH)D < 27.5 nmol/L as being indicative of increased risk for rickets. Additionally, 25(OH)D > 125 nmol/L was considered possibly adversely high. Total vitamin D at 9-12 months (eight data collection days) included intake from diet and supplements. The mean ± SD of vitamin D intake was 8.8 ± 5.2 μg/day and serum 25(OH)D 98.1 ± 32.2 nmol/L (range 39.3-165.5). Ninety-two percent of infants were vitamin D sufficient and none at increased risk for rickets. The 26% infants using fortified products and supplements never/irregularly or in small amounts had lower 25(OH)D (76.8 ± 27.1 nmol/L) than the 22% using fortified products (100.0 ± 31.4 nmol/L), 18% using supplements (104.6 ± 37.0 nmol/L) and 33% using both (110.3 ± 26.6 nmol/L). Five of six infants with 25(OH)D < 50 nmol/L had no intake of supplements or fortified products from 0 to 12 months. Supplement use increased the odds of 25(OH)D > 125 nmol/L. Breastfeeding and season did not affect vitamin D status. The majority of infants were vitamin D sufficient. Our findings highlight the need for vitamin D supplements or fortified products all year round, regardless of breastfeeding.
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