A Qualitative Study to Asses which Sources of Advice Impact on Knowledge of, and Compliance with, Department of Health Infant Feeding Guidelines in 25 Mothers Attending 4 North Yorkshire Children’s Centres.

ABSTRACT

Introduction: The Department of Health (DH) [1] Infant Feeding Guidelines recommend that solid foods (SF) are introduced to infants at around 6 months. Moore et al.[2] suggest knowledge of DH guidelines improves compliance; this study assesses which sources of advice and which settings, improves participant’s knowledge and is influential on the participants’ decision to commence SF. Methods: Focus groups were conducted with a convenience sample of 25 participants at 4 children’s centres during pre-existing mother and baby sessions. The participants were all white British who spoke English as a first language. Semi-structured questions were used as the basis for discussion with groups of 2-3 mothers. Systematic analysis was used to examine the resulting transcript for key themes. An analysis matrix was used to identify links between knowledge, attitudes and influences, and infant feeding behaviour. Ethical approval was obtained from Leeds Metropolitan University Faculty of Health Ethics Committee. Results: Most introduced SF to their infant at 6 months, 1 introduced prior to 4 months and the rest (n=23) introduced between 4-5 months. Participants demonstrated good knowledge of the recommend timing of introducing SF but a poor knowledge of what constitutes valid signs of hunger from their infants and of what foods the DH recommends are avoided. Participants expressed poor confidence in the relevance of the guidelines. Participants introduced finger foods quickly on commencing SFs, with many of those (n=14) introducing some foods containing gluten, ham or egg between 4 and 5 months. A high number of participants (n=19) consulted written information published by a commercial infant food manufacturer, all of these introduced SF at 4 months. Some of the participants (n=6) had attended a health visitor led-education session at their children’s centre, these participants demonstrated improved compliance, knowledge and attitude towards the DH infant feeding guidelines when compared with the rest of the cohort. Discussion: This study suggests that it is the setting in which information is given which impacts on how influential it is. This study highlights the value of incorporating evidence based education sessions into children’s centre services. The results of this study suggest that commercial infant food manufacturers may be influencing the timing of the introduction of SF. Conclusion: Participants did not feel the DH guidelines were relevant to the situation they were in with their own infants, which contributed to poor compliance and attitude towards the DH guidelines. Health visitor-led education sessions incorporated into children’s centre services improved knowledge and practices of the participants. More research is required into the potential effects of the early introduction of finger foods and into the influence of information published by commercial infant food manufacturers.