Maternal and infant factors influencing infant feeding – a longitudinal study

Abstract

Introduction: There has been a lack of longitudinal studies on maternal and infant factors associated with feeding difficulties. Feeding difficulties are common, cause much anxiety for parents, and are associated with a range of child health and behavioural outcomes. This study aims to gain an understanding of the prevalence and type of feeding difficulties found in a community sample, the prevalence of maternal mental ill-health and identify maternal and infant factors predictive of feeding difficulties. A final aim is to identify factors associated with successful and unsuccessful feeding experiences from a maternal perspective. Method: A short questionnaire with questions about support and help-seeking was compiled, and several standardised measures were included in the pack; a measure of maternal mood (DASS-21), social support (SOS-S), and eating disorder symptomatology (EAT-26). Questionnaires were given to mothers in pregnancy, and again when infants were around 3 and 7 months old. An adapted version of the Child Feeding Assessment Questionnaire, and the food fussiness subscale from the Children’s Eating Behaviour Questionnaire examined feeding behaviour and maternal response. The Infant Temperament Questionnaire examined maternal perception of infant temperament. Content analysis was used to identify themes in mother’s narrative about factors which help feeding and barriers to a successful feeding experience. A within subjects design was employed to examine predictors of infant feeding difficulties. Results: 23% of mothers of 3 to 5 month old infants, and 13% of mothers of 7 to 10 month olds reported their child as having one or more feeding difficulties. Levels of stress remained stable across the length of the study, but prevalence of maternal anxiety and depression reduced. 47% of those mothers who breast fed found breast feeding difficult or very difficult. Maternally identified barriers to successful feeding with feeding were child illness, and painful or difficult breastfeeding. Mothers wanted an improvement in support and knowledge of health professionals, and a reduction in pressure from health professionals in relation to feeding method. Maternal depression and stress were correlated with severity of food refusal in infants, as well as maternal anxiety and food fussiness, prior to post-hoc analyses. Following post-hoc analyses these relationships were no longer significant. Discussion: Relationships between infant behaviour, maternal health and feeding difficulties are explored. The low prevalence of feeding difficulties and reasons for negative findings in relation to predictors of feeding difficulties are discussed. Implications for health services are presented in the light of maternal views about support and barriers to successfully feeding their child.