Parental experiences and perceptions of infant complementary feeding: a qualitative evidence synthesis

Abstract

Background: Current childhood obesity interventions increasingly focus on infant feeding but often do so without considering parental perceptions and experiences. Qualitative research on infant feeding has yet to be systematically evaluated to inform intervention development. A qualitative evidence synthesis (QES) of the extant literature focusing on experiences, barriers and facilitators to healthy infant feeding and feeding guideline adherence is therefore crucial. Methods: A QES of papers examining caregivers’ experiences of complementary feeding and weaning of infants (< 2 years) was conducted. Twenty-three papers, comprising 1047 participants, were included in the QES. A ‘Best Fit’ Framework Synthesis approach, with the COM-B model as the analysis framework, was used. Themes emerging from the data that were not accounted for by the COM-B model were added to the coding framework. Results: Beliefs about health and behavioural outcomes, and daily pressures and time constraints, are important considerations for parental feeding approaches. Infant feeding guidelines and advice are more likely valued and adhered to when they are consistent, from a trusted and experienced source, and are compatible with caregiver experiences. The role of ‘maternal instinct’ guides much infant feeding and often justifies lack of adherence to feeding guidelines. Discussion: The key factors in infant feeding relate to presentation and trust in infant feeding advice. How guidelines correspond to feeding beliefs, experiences and beliefs about capabilities further influence parental engagement in healthy feeding practices. The findings of this review highlight key areas for intervention to help improve infant feeding for childhood overweight and obesity.