Toward Understanding How Social Factors Shaped a Behavioral Intervention on Healthier Infant Formula-Feeding.

Cornelia Guell,Ken K Ong,Fiona Whittle,Rajalakshmi Lakshman

doi:10.1177/1049732318764386

Cornelia Guell, Ken K Ong + Show 2 more

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https://doi.org/10.1177/1049732318764386

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Abstract

As part of a process evaluation, we explored in semi-structured interviews the experiences of 19 mothers who had taken part in a trial to reduce infant formula-milk intake and promote healthy weight gain, and reflections of three facilitators who delivered the intervention and control group protocols. Mothers appreciated the nonjudgmental support provided during the trial, after experiencing stigma and receiving limited advice on how, how much, and how often formula-milk should be given. The information mothers had previously found, printed on formula-milk tins, or provided by family, friends, and health professionals was often perceived as contradictory; the trial guidance also conflicted with social norms relating infant health positively with weight gain. For those recruited into the trial with older infants, who had already exceeded the recommendations, reducing formula-milk amounts was difficult. The findings highlight the difficulties of addressing a highly stigmatized, complex social practice with an individual, behavioral intervention approach.

Highlights

Childhood obesity is a major public health challenge (World Health Organization [WHO], 2016)
Efforts to prevent obesity in later years of childhood and adolescence are considered less effective than early intervention in infant years (Taveras, 2016), so one focus has been on infant formula-feeding as it is associated with rapid excess weight gain and later obesity (Ong & Loos, 2006)
Theme 1 shows that the mothers we interviewed felt that they lacked support for bottle-feeding their infants, in contrast to the support breastfeeding new mothers seemed to get in their view

Summary

Introduction

Childhood obesity is a major public health challenge (World Health Organization [WHO], 2016). Efforts to prevent obesity in later years of childhood and adolescence are considered less effective than early intervention in infant years (Taveras, 2016), so one focus has been on infant formula-feeding as it is associated with rapid excess weight gain and later obesity (Ong & Loos, 2006). As many infants exceed this guidance leading to rapid infant weight gain (Ong, Emmett, Noble, Ness, & Dunger, 2006), the Baby-Milk Trial aimed to evaluate the efficacy, cost-effectiveness, and acceptability of a theory-based, multicomponent behavioral intervention to reduce formula-milk intake based on the new WHO recommendations and prevent excess weight gain during infancy (Lakshman et al, 2015). This article aims to explain some of the underlying mechanisms that might have been at play when implementing and participating in the Baby-Milk Trial and shaped its outcome

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