Parental self-efficacy and infant feeding practices in a group of first-time, low-income, African-American mother-infant dyads

Abstract

Category/Date Research Poster presented at Posters on The Move, at NAPNAP's 40th National Conference on Pediatric Health Care, March 7, 2019, New Orleans, LA. Purpose To test the hypothesis that parental self-efficacy (PSE) is associated with infant feeding practices in a group of low-income, African-American (AA) mother-infant dyads. Background/Significance Infant feeding practices of low-income, AA infants do not align with recommendations. These infants are fed formula more often than breastmilk, if breastfed, only for a short duration, and given complementary foods (CFs) early. Understanding factors that contribute to this trend are needed, early feeding practices have implications for dietary practices and weight status later in life. Parental self-efficacy (PSE) has been found to be associated with infant feeding practices, however, this association has not been examined in a sample at risk for unhealthy feeding practices. Research questions 1) Is PSE associated with milk feeding type? 2) Is PSE associated with the duration of any breastfeeding? 3) Is PSE associated with age at introduction of CFs? 4) Is PSE associated with the introduction of inappropriate foods during infancy? Methods This correlation study was a secondary data analysis of the Infant Care, Feeding, and Risk of Obesity study (Infant Care). The study was deemed exempt by the IRB at the University of Alabama at Birmingham. The Infant Care study enrolled first-time AA mothers and their healthy, full-term infants (N = 217) between birth and 3 months of age. In home study visits were conducted at infant age of 3, 6, 9, and 12 months. At each visit, mothers completed the Parenting Sense of Competence Scale, which provided a measure of PSE; infant dietary history and three dietary recalls were also gathered. Dietary data was organized into four variables: 1) ever breastfed; 2) if breastfed, how long; 3) age of first CFs; and 4) if foods considered inappropriate for an infant were provided. Using generalized estimating equations and generalized linear mixed models, crude and covariate-adjusted relationships between PSE and each feeding practice were examined. Covariates included: infant sex, infant birthweight, maternal age, maternal body mass index, maternal education level, maternal marital status, and maternal depression score. Results The feeding practices of this sample were consistent with previous research, low breastfeeding rates and early introduction of CFs were seen. Additionally, PSE was high (M=38.7, range 8-48). No significant associations were seen between PSE and each infant feeding practice, even after adjusting for covariates. Married mothers and those with a college education level were more likely to breastfeed (p Conclusion Prior research has suggested that PSE is associated with infant feeding practices, however, this association was not supported in the current sample. Cultural and sociodemographic differences of this sample compared to prior samples should be explored further to understand if these differences contributed to the contradictory findings. Future research should consider inclusion of a tool that measures cultural beliefs regarding infant feeding. Additionally, the high sense of PSE reported by this sample was unexpected. Understanding predictors to PSE in low-income, AA mother may be needed in future research. Support for the Infant Care study was provided by NIH R01 HD042219-02 (PI: Bentley) Support for this study was provided by the National Association of Pediatric Nurse Practitioners (NAPNAP) 2017 Foundation Research Grant