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Early-life nutrition plays a key role in establishing healthy lifestyles and preventing chronic disease. This study aimed to (1) explore healthcare professionals’ (HCP) opinions on the acceptability of and factors influencing the delivery of interventions to promote healthy infant feeding behaviours within primary care and (2) identify proposed barriers/enablers to delivering such interventions during vaccination visits, to inform the development of a childhood obesity prevention intervention.
A qualitative study design was employed using semi-structured telephone interviews. Data were analysed using qualitative content analysis; findings were also mapped to the Theoretical Framework of Acceptability (TFA).
Primary care in Ireland
Twenty-one primary care-based HCP: five practice nurses, seven general practitioners, three public health nurses, three community dietitians and three community medical officers.
The acceptability of delivering interventions to promote healthy infant feeding within primary care is influenced by the availability of resources, HCP’s roles and priorities, and factors relating to communication and relationships between HCP and parents. Proposed barriers and enablers to delivering interventions within vaccination visits include time constraints v. opportunistic access, existing relationships and trust between parents and practice nurses, and potential communication issues. Barriers/enablers mapped to TFA constructs of Affective Attitude, Perceived Effectiveness and Self-Efficacy.
This study provides a valuable insight into HCP perspectives of delivering prevention-focused infant feeding interventions within primary care settings. While promising, factors such as coordination and clarity of HCP roles and resource allocation need to be addressed to ensure acceptability of interventions to HCP involved in delivery.
Food portion sizes routinely consumed by children have increased over time and consumption of larger portion sizes is associated with higher weight status. Parents often have the critical role of deciding portion sizes of foods to serve their children. It is not well understood, however, how parents decide the amount of food to serve. This research aimed to investigate parental views on portion sizes of foods and beverages served to children.
A purposive sample of preschools and primary schools geographically located in either urban or rural areas of Northern Ireland and the Republic of Ireland, and classified as either high or low deprivation were recruited. Selected schools were invited to facilitate this research. Parents with at least one child aged 2–12 years attending a recruited school were then invited to participate in a focus group. A maximum of three groups were scheduled with interested parents at each school. One researcher moderated the focus groups, assisted by another researcher in all groups where possible. A semi-structured discussion guide was followed, using probes to stimulate discussion. The guide explored practices in portioning foods and beverages for children, factors influencing portioning and views on portion sizes of foods and beverages served to children. Discussions were audio-recorded, transcribed verbatim and data was analysed thematically. Nvivo software was used to manage the coded data.
Focus groups (n = 24) ranging in size from 3–12 parents were conducted across 19 schools. The response rate from parents at recruited schools ranged from 1–16%. A total of 144 parents (86% female, mean age 46y) participated, of which 60% had a child attending a high deprivation school and 64% had a child attending a rural school. Factors influencing parental portioning included seven themes comprised of sub-themes: parent knowledge (portion size knowledge, serving a learned amount), parent motivations (ensure child is fed, encourage healthier food), child-related factors (appetite, body size, food preferences, eating patterns), family influence (spouses and grandparents serving), food retail and other settings (restaurants, takeaways, special occasions), socio-cultural influences (parent childhood experiences, parents’ portion size norms) and portioning resources used (serve ware, utensils, hand sizes).
Parents’ main concern regarding the amount they feed their children was to ensure that they are fed a sufficient amount to feel full. Parents learned this amount through experience and felt it was specific to each child's appetite. These findings will inform future interventions and information campaigns to help parents understand child portion sizes.
Early complementary feeding has been shown to increase the risk of overweight, obesity and chronic diseases later in life. Poor compliance with current guidelines on complementary feeding has been reported by Irish studies. The aim of the present paper is to identify predictors of early complementary feeding in order to help health professionals target population groups in greater need of dietary intervention as well as to provide effective advice.
Cross-sectional analysis of the national, longitudinal Growing Up in Ireland study.
Data were derived from the first wave (2007–2008) of the Growing Up in Ireland infant cohort.
A cohort of mothers (n 11 134) from the Republic of Ireland, interviewed when their infants were 9 months of age.
Of the infants, 1469 (13·5 %) had been regularly taking solids in the period between 12 and 16 weeks; this percentage increased to 47·0 % of the sample in the period between 16 and 20 weeks. Timing of formula feeding commencement, high maternal BMI and choosing a relative as the infant's minder were strongly associated with early introduction of solids both in bivariate and multivariate analysis. Those infants who started formula feeding at >4 months were 88·4% less likely to be introduced to solids early compared with those who started at <2 months (OR = 0·116; 95% CI 0·072, 0·186; P < 0·001).
The results demonstrate that biological, social and behavioural aspects exert an important role in infant feeding practices. These findings are relevant to the design of policies and intervention programmes aimed at educating parents.
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