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Hidden realities influencing parent’s feeding choices and behaviours

5 mins


Nutrition during the first 1000 days has a critical influence on immediate and long-term health.1

Parenting encompasses the social, cultural and economic structure of a parent’s life and infant nutrition is a large part of parenting.2

There is an opportunity within infant nutrition for healthcare professionals to provide education and support that will empower parents to adopt recommended infant feeding guidelines.3

Laughing parents in a park holding a baby

What the research says

In this article, Dr Ai Zhao addresses the importance of the first 1000 days and the positive influence this knowledge has had, there has been significant progress with improved infant feeding and nutrition through education, however, when measured against the World Health Organisation (WHO) growth standards, the percentage of childhood growth either resulting in faltering growth or obesity is still a significant public health concern across the world.4

Early nutrition and feeding are key parts of parenting,2 understanding the modifiable factors which influence a parent’s feeding choices and behaviours is essential to providing the relevant support and nutrition education.

A recent systematic review of 73 qualitative studies published between 2015 to 2019 identified that:3

  • Parents predominantly agree that breastfeeding is the best way to feed their baby
  • There are distinct attitudes, beliefs, and perceptions of mothers that breastfeed, compared to those that could not or chose not to breastfeed.
  • Infant feeding behaviours are influenced by the socio-cultural environment of the family
  • Parent’s expectations of nutritional education and support, addressing their personal infant feeding choices may not have always been met.


Family and cultural practices are strong influences on infant feeding behaviors5-8 therefore, education and support that addresses family and cultural priorities and empowers parents to adopt recommended infant feeding guidance, while preventing or addressing internalized feelings of shame or guilt, provides an unmet opportunity within nutrition education.3

  1. Unicef. (2015). Breastfeeding and complementary feeding. Available: Accessed: January 2016

  2. Black, M. M.; Aboud, F. E., Responsive feeding is embedded in a theoretical framework of responsive parenting. The Journal of nutrition 2011, 141 (3), 490-4.

  3. Dattilo, A.M.; Carvalho, R.S.; Feferbaum, R.; Forsyth, S.; Zhao, A., Hidden realities of infant feeding: Systematic review of qualitative findings from parents. Behav Sci 2020, 10, 83; doi:10.3390/bs10050083.

  4. NCD Risk Factor Collaboration (NCD-RisC)., Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017, 390 (10113), 2627-2642.

  5. Harrison, M.; Brodribb, W.; Hepworth, J., A qualitative systematic review of maternal infant feeding practices in transitioning from milk feeds to family foods. Matern Child Nutr 2017, 13 (2).

  6. Matvienko-Sikar, K.; Kelly, C.; Sinnott, C.; McSharry, J.; Houghton, C.; Heary, C.; Toomey, E.; Byrne, M.; Kearney, P. M., Parental experiences and perceptions of infant complementary feeding: a qualitative evidence synthesis. Obesity reviews : an official journal of the International Association for the Study of Obesity 2018, 19 (4), 501-517.

  7. Bazzano, A. N.; Kaji, A.; Felker-Kantor, E.; Bazzano, L. A.; Potts, K. S., Qualitative Studies of Infant and Young Child Feeding in Lower-Income Countries: A Systematic Review and Synthesis of Dietary Patterns. Nutrients 2017, 9 (10)

  8. Raman, S.; Nicholls, R.; Ritchie, J.; Razee, H.; Shafiee, S., How natural is the supernatural? Synthesis of the qualitative literature from low and middle income countries on cultural practices and traditional beliefs influencing the perinatal period. Midwifery 2016, 39, 87-97.