Abstract
ObjectivesTo explore optimal infant feeding and care practices and their drivers within the British-Bangladeshi population of East London, UK, as an exemplar to inform development of a tailored, coadapted participatory community intervention.DesignQualitative community-based participatory research.SettingCommunity and children’s centres and National Health Service settings within Tower Hamlets, London, UK.Participants141 participants completed the community study including: British-Bangladeshi mothers, fathers, grandmothers and grandfathers of infants and young children aged 6–23 months, key informants and lay community members from the British-Bangladeshi population of Tower Hamlets, and health professionals working in Tower Hamlets.Results141 participants from all settings and generations identified several infant feeding and care practices and wider socioecological factors that could be targeted to optimise nutritional outcomes. Our modifiable infant feeding and care practices were highlighted: untimely introduction of semi and solid foods, overfeeding, prolonged parent-led feeding and feeding to ‘fill the belly’. Wider socioecological determinants were highlighted, categorised here as: (1) society and culture (e.g. equating ‘chubby baby’ to healthy baby), (2) physical and local environment (e.g. fast food outlets, advertising) and (3) information and awareness (e.g. communication with healthcare professionals around cultural norms).ConclusionsParenting interventions should be codeveloped with communities and tailored to recognise and take account of social and cultural norms and influence from different generations that inform infant feeding and care practices and may be of particular importance for infants from ethnically diverse communities. In addition, UK infant feeding environment requires better regulation of marketing of foods for infants and young children if it is to optimise nutrition in the early years.
Highlights
The first 1000 days of life presents a critical window, and an opportunity to prevent the dual burden of undernutrition and overnutrition
Some of the highest burdens of inequity and obesity are measured among ethnic minority populations, a tendency to aggregate data from South Asian (SA) populations limits a full understanding of trends that may result from different sociocultural norms and practices
Two overarching themes were identified during interviews and group discussions: (1) modifiable infant feeding and care practices that participants suggested
Summary
The first 1000 days of life presents a critical window, and an opportunity to prevent the dual burden of undernutrition and overnutrition. Health inequities contribute to the risk of nutritionally related diseases across the life course, such as diabetes, coronary heart disease and allergies.[5,6,7,8,9,10,11] Prevalence of childhood obesity is twice as high among those living in the most deprived, compared with the least deprived areas of the UK12 and a similar trend is observed elsewhere in Europe.[13] acculturating to a host country has been shown to have significant impact on obesogenic behaviours. Immigrants post migration have been found to have poor health and more susceptible to be obese or overweight compared with the host population.[14] Some of the highest burdens of inequity and obesity are measured among ethnic minority populations, a tendency to aggregate data from South Asian (SA) populations limits a full understanding of trends that may result from different sociocultural norms and practices. Previous studies examined nutritional outcomes in the British-B angladeshi population reporting an increased risk of vitamin D deficiency[15] and iron deficiency,[16] which are essential nutrients for brain development in children; the highest proportion of obesity (31%) of any ethnic group among 6-year-old boys[17]; and poorer oral health in preschool children.[18]
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