Introduction of Complementary Foods to Premature Infants During the First Year of Life
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Date
2018-05
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The Ohio State University
Abstract
Purpose and Background/Significance: During the first year of life, questions arise as to when complementary foods should be introduced to premature infants. Debate centers on whether actual age or corrected age should be used. Guidelines specify that complementary foods should be introduced between 4-6 months corrected age. Mothers are usually the decision-maker in relation to the introduction of complementary foods. What is unclear are the factors that influence maternal decision-making. The purpose of this study was to understand maternal reasoning in relation to the introduction of complementary foods to their premature infants. Method: A secondary analysis was conducted of interview data from 21 mothers who participated in a study to understand mothers' intentions to feed their premature infants. In the original study, mothers of very low birthweight (birthweight less than 1500 grams) infants were recruited prior to discharge from the neonatal intensive care unit. Mothers were interviewed when their infants were at 1, 4, 8, and 12 months corrected age. All interviews were transcribed verbatim. Three key concepts from the Theory of Planned Behavior guided the secondary analysis of the interview data: behavioral beliefs, normative beliefs, and control beliefs. Results: Overwhelmingly, mothers introduced complementary foods earlier than recommended. Maternal behavioral beliefs centered on the benefit to their infants. Perceived benefits included enhanced sleeping at night, improved growth, and remaining "full" longer. The influence of normative beliefs was demonstrated by strong reliance on the advice of peers including friends and relatives. Few mothers followed the Pediatrician's recommendations. Mothers' control of introducing complementary foods was influenced by interpretation of their infant's readiness cues, concern over infant hunger, and trust in their own judgement. Conclusion: Mothers believe that they know what is best for their infant and make decisions based on this principle. Research is needed to understand why mothers readily follow the advice of peers and are reluctant to follow established guidelines.
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Keywords
Premature Infants, Complementary Foods, Maternal Decision-Making