Observations and Conversations: Home Preparation of Infant Formula Among a Sample of Low-Income Mothers in the Southeastern US.

OBJECTIVE: Explore infant formula preparation attitudes and beliefs among low-income, formula-feeding, Southeastern US mothers. DESIGN: Cross-sectional study using in-home observations and in-depth interviews. SETTING: Participant homes. PARTICIPANTS: Thirteen low-income mothers of normal birth weight, healthy, term infants aged ≤3 months, who were predominantly feeding powdered or from-concentrate formula. VARIABLES MEASURED: Reading formula preparation instructions; order of added ingredients; leveling powdered formula scoop(s); adding cereal or other ingredients to bottles. PHENOMENON OF INTEREST: Perceptions of formula preparation or manipulation. ANALYSIS: Descriptive statistics described sample characteristics and home observation variables. Thematic analysis of in-depth interviews revealed the following major themes: formula preparation can be intimidating; expressions of complex heuristic perceptions about formula preparation; cost and convenience motivate maternal behaviors; and infant cues override recommendations. Data from qualitative and quantitative activities were triangulated. RESULTS: Behaviors, including improper reconstitution and modifications/additions to prepared formula (eg, infant cereal) were observed during home observations and/or described during in-depth interviews. Inconsistencies were detected between observed behaviors (eg, adding too much water to the bottle) and those reported during in-depth interviews (eg, stating over-dilution could be detrimental to the infant's health). CONCLUSIONS AND IMPLICATIONS: Targeting knowledge or skills gaps and behavioral motivators in the formula-feeding population could positively affect infant-feeding practices that occur outside of recommendations.

Breastfeeding knowledge, attitudes, prior exposure, and intent among undergraduate students.

BACKGROUND: Understanding breastfeeding knowledge, attitudes, and exposures among nonpregnant youth who are likely to be future parents may provide significant pathways to successfully increasing breastfeeding as the normal, accepted way of feeding infants. However, based on a recent review of the literature, only 3 studies have assessed these factors in nonpregnant, young adults in the United States in the past 10 years. OBJECTIVE: The objective of this study was to gather more recent data regarding breastfeeding knowledge, attitudes, and prior exposure among undergraduate university students. METHODS: This was a cross-sectional survey, conducted in November 2010. A convenience sample, consisting of undergraduates in attendance in 2 sections of an introductory nutrition class at a large research university, was used for this project (N = 248). RESULTS: Breastfeeding knowledge was relatively good. However, overall breastfeeding attitudes were more neutral, which appeared to be explained by the belief that breastfeeding is painful, restrictive, and inconvenient, both in general and specifically for the working mother. Though support for breastfeeding in public was low, men were significantly less likely than women to believe it to be embarrassing or unacceptable. In addition, breastfeeding attitudes were more positive among older students and those who were breastfed as infants. Those who were breastfed as infants were also significantly more likely to intend to breastfeed future children. CONCLUSIONS: Though this sample indicates good breastfeeding knowledge, attitudes were more neutral, and support for breastfeeding in public appears low. This finding is contradictory and warrants further exploration.

Roles, perceptions and control of infant feeding among low-income fathers.

OBJECTIVE: Introduction of solid foods before the recommended age of 4-6 months is a common practice in the USA, and appears to be especially prevalent among infants who are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Currently, little is known about how fathers influence early infant feeding decisions, outside the decision to breast- or formula-feed. The purpose of the current study was to explore how fathers perceive the role they play in feeding and caring for their infants. DESIGN: Participants were twenty-one male caregivers, who were fathers or partners of the mothers of WIC income-eligible infants residing in two rural East Tennessee counties. In-depth, audio-taped telephone interviews were completed. Interviews were transcribed, coded and analysed according to standard grounded theory procedures to identify emergent concepts. These concepts were explored and linked together to become themes. RESULTS: Three themes emerged: (i) fathers' roles; (ii) fathers' perceptions; and (iii) control. Concepts within the theme of fathers' roles included physical and emotional support for both mother and infant, validation of maternal decisions, and financial support. In the present study, fathers' perceptions were primarily shaped by their own experiences, advice from those with experience, and information sought by the fathers. The theme of control appears to be the linkage between the fathers' attempts to modify infant behaviour and infants' response. CONCLUSIONS: A final conceptual model was created to explain the interrelated nature of the themes and may be helpful to those who work with fathers and/or families of new infants.