Exploratory analysis of factors that influence maternal deviation from prenatal infant feeding plans: A research brief.

AIM: The purpose of this study was to examine factors associated with maternal deviation from prenatal infant feeding plans. BACKGROUND: Infant feeding practices influence infant growth and development, thus, having long term implications for child health. Literature suggests that, prenatally, mothers plan to breastfeed, however, breastfeeding rates remain low, additionally, early introduction of complementary foods (CF) is common. Understanding the discrepancy between high maternal intentions for breastfeeding yet low breastfeeding practices and early CF introduction is needed. METHODS: This descriptive study recruited first-time mothers and their infants (N = 33) from the community; pre-pregnancy height and weight, demographics, and infant feeding plans (breast/formula feeding; CF introduction age) were collected in the third trimester. Four months after birth, infant feeding practices were collected. Prenatal plans and practices at 4 months were compared and dichotomized into a yes/no variable. Bivariate analyses were conducted. RESULTS: Almost half (46 %) of mothers deviated from their prenatal infant feeding plans. Analyses reveal that mothers with a higher BMI were more likely to deviate from their prenatal feeding intentions when compared to mothers with a lower BMI (Mdn = 29.82 vs Mdn = 24.2, p = 0.05, r = 0.34). Though not significant, maternal race/ethnicity, marital status, and employment status are important variables to consider in future work. CONCLUSION: The finding that women with a higher BMI are more likely to deviate from their prenatal infant feeding intentions is consistent with prior research. Future research should focus on the reason this difference exists. Additionally, reasons for deviation should be explored in a larger, more diverse sample.

Factors influencing obesity among preschoolers: multilevel approach.

BACKGROUND: Childhood obesity is a complex and multifaceted problem involving interactions among child, family and community environment. AIM: The purpose of this study was to examine the contributing factors to early childhood obesity within a multilevel context, including child and family, childcare setting and community. METHODS: A cross-sectional, quantitative research design was employed. A total of 129 preschoolers and their parents in northwest Florida participated in this study. Child height and weight were measured, and body mass index (BMI) was calculated. Parents and directors of preschools completed survey questionnaires to assess child/family, childcare setting and community factors, respectively. Hierarchical multiple regression was used to evaluate the association of each level of factors with child BMI z-score. RESULTS: Twenty-one per cent of children were overweight or obese (≥85th BMI percentile). In hierarchical multiple regression, household income, parent beliefs, attitudes and practices for child feeding, family obesogenic environment, child routines (screen time on weekends, sleep hours, bedtime) and physical activity environment were significantly related to child BMI z-score. CONCLUSIONS: The findings of this study provide a broader understanding of factors that influence child BMI z-score. Shaping a non-obesogenic environment by establishing healthy routines for children in the home, childcare setting and community is essential in childhood obesity prevention. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY: Paediatric nurses should routinely assess accurate parental perception of child weight, feeding style and child routines in well-child care visits. Healthcare professionals and health policymakers should enact policies that build a healthy environment for preschoolers in their childcare setting and community.