Understanding infant and young child feeding and oral health practices and perceptions in Tower Hamlets: moving from knowledge to practice and impact

Keith, R., Draper, A., Adegboye, A.R., Senior, L., Mba, E. and Azagba Nyako, J. 2017. Understanding infant and young child feeding and oral health practices and perceptions in Tower Hamlets: moving from knowledge to practice and impact. University of Westminster.

TitleUnderstanding infant and young child feeding and oral health practices and perceptions in Tower Hamlets: moving from knowledge to practice and impact
AuthorsKeith, R., Draper, A., Adegboye, A.R., Senior, L., Mba, E. and Azagba Nyako, J.
TypeProject report
Abstract

Introduction: This research was commissioned by Tower Hamlets Public Health Team and Tower Hamlets Together. The study was carried out by the Food Nutrition and Public Health Division of the University of Westminster. The aim of the research was to gain a greater understanding of the factors that influence mother’s perceptions and practices in relation to infant and young child feeding and oral health in Tower Hamlets. The research will feed into the THPHT restructuring decisions, being finalised in October 2017. The borough has prioritised increased investment into supporting improvements in early years public health and nutrition outcomes, especially in relation to improving infant feeding practices since 2011.

Methodology: A qualitative methodology was applied to capture an in-depth view of mother’s and service providers practices and perceptions, in relation to early years nutrition and oral health. The target group were mothers with children under five, service providers and carers. The participants were selected using purposeful, convenience and snowball sampling methods. Data was collected using key informant interviews, focus group discussions and direct observation of health promotion classes. In all, 36 key informant interviews, 3 direct observations and 18 focus group discussions were carried out throughout the borough. The focus group discussions included 144 participants including 95 mothers, 21 service providers, seventeen expectant parents, eight husbands and three mothers in laws. On June 9th a workshop was held to present the initial findings and get feedback from the key informants and service providers in the borough. A thematic analysis was used to determine key issues arising from the data, resulting in seven themes.

Findings: The themes identified included communication, access, trust, reaching the most vulnerable, policy adherence, capacity, leadership and governance. There was generally universal knowledge that breastfeeding is best for infants and that too much sugar is unhealthy. However, there was less clarity on what drinks and food contain the least sugar and when you should take your infant to see the dentist. Mothers reported mixed messages, pain and pressure from the media and families as the main reasons for changing from exclusive breastfeeding to mixed feeding, most mothers felt this was normal. Service providers are being trained in effective baby feeding but mothers reported a lack of support and mixed messages regarding feeding in public, mixed feeding and when to wean. Many mothers did not take their infants to the dentist until they started school. Mothers find adhering to healthy eating guidelines too expensive, and snacks like chicken and chips were not thought of as food, just snacks. Not all dentists were seeing infants. Mothers prefer face to face health information rather than leaflets.

Recommendations and conclusions: The borough should continue their support for the baby feeding initiative and increase the training of service providers in healthy eating and oral health. An annual workshop bringing together the different early years’ service providers could help increase integration and more effective support services. Lists with available dentists should be posted on the borough website, along with borough guidelines on healthy eating and oral health. A nutrition adviser should be available to coordinate growing nutrition concerns, like fussy eating and childhood obesity.  

KeywordsInfant and Young Child Feeding, Oral Health, Breastfeeding, childhood obesity
Year2017
PublisherUniversity of Westminster
Publication dates
Published10 Oct 2017
Page range63 pages

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Qualitative research in nutrition and dietetics: data collection issues
Draper, A. and Swift, J.A. 2011. Qualitative research in nutrition and dietetics: data collection issues. Journal of Human Nutrition and Dietetics. 24 (1), pp. 3-12. https://doi.org/10.1111/j.1365-277X.2010.01117.x

Systematic review of clinical trials on dietary interventions to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women
Adegboye, A.R., Tanentsapf, I. and Heitmann, B.L. 2011. Systematic review of clinical trials on dietary interventions to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women. BMC Pregnancy Childbirth. 11 (1). https://doi.org/10.1186/1471-2393-11-81

Recommended aerobic fitness level for metabolic health in children and adolescents: a study of diagnostic accuracy
Adegboye, A.R., Anderssen, S.A., Froberg, K., Sardinha, L.B., Heitmann, B.L., Steene-Johannessen, J., Kolle, E. and Andersen, L.B. 2011. Recommended aerobic fitness level for metabolic health in children and adolescents: a study of diagnostic accuracy. British Journal of Sports Medicine. 45 (9), pp. 722-728. https://doi.org/10.1136/bjsm.2009.068346

Exploring food attitudes and behaviours in the UK: findings from the Food and You Survey 2010
Prior, G., Hall, L., Morris, S. and Draper, A. 2011. Exploring food attitudes and behaviours in the UK: findings from the Food and You Survey 2010. London Food Standards Agency. https://doi.org/UnitReport13

Exploring food attitudes and behaviours in the UK: findings from the Food and You Survey 2010
Prior, G., Hall, L., Morris, S. and Draper, A. 2011. Exploring food attitudes and behaviours in the UK: findings from the Food and You Survey 2010. London Food Standards Agency.

Food and public health: contemporary issues and future directions
Gustafsson, U., Wills, W. and Draper, A. 2011. Food and public health: contemporary issues and future directions. Critical Public Health. 21 (4), pp. 385-393. https://doi.org/10.1080/09581596.2011.625759

Chasing the dragon: developing indicators for the assessment of community participation in health programmes
Draper, A., Hewitt, G. and Rifkin, S.B. 2010. Chasing the dragon: developing indicators for the assessment of community participation in health programmes. Social Science & Medicine. 71 (6), pp. 1102-1109. https://doi.org/10.1016/j.socscimed.2010.05.016

Low calcium intake is related to increased risk of tooth loss in men
Adegboye, A.R., Fiehn, N.E., Twetman, S., Christensen, L.B. and Heitmann, B.L. 2010. Low calcium intake is related to increased risk of tooth loss in men. Journal of Nutrition. 140 (10), pp. 1864-1868. https://doi.org/10.3945/jn.109.117770

Linking definition of childhood and adolescent obesity to current health outcomes
Adegboye, A.R., Andersen, L.B., Froberg, K., Sardinha, L.B. and Heitmann, B.L. 2010. Linking definition of childhood and adolescent obesity to current health outcomes. International Journal of Pediatric Obesity. 5 (2), pp. 130-142. https://doi.org/10.3109/17477160903111730

Relationships between prenatal smoking cessation, gestational weight gain and maternal lifestyle characteristics
Adegboye, A.R., Rössner, S., Neovius, M., Lourenço, P.M. and Linné, Y. 2010. Relationships between prenatal smoking cessation, gestational weight gain and maternal lifestyle characteristics. Women and Birth. 23 (1), pp. 29-35. https://doi.org/10.1016/j.wombi.2009.05.002

Development work for wave 2 of the food and you survey
Smeaton, D., Draper, A., Durante, L. and Vowden, K. 2010. Development work for wave 2 of the food and you survey. London Food Standards Agency. https://doi.org/UnitReport16

Food and climate change: a review of the effects of climate change on food within the remit of the Food Standards Agency
Lake, I.R., Abdelhamid, A., Hooper, L., Bentham, G., Boxall, A.B.A., Draper, A., Fairweather-Tait, S., Hulme, M., Hunter, P.R., Nichols, G. and Waldron, K.W. 2010. Food and climate change: a review of the effects of climate change on food within the remit of the Food Standards Agency. Food Standards Agency.

Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial
Wall, M., Hayes, R., Moore, D.G., Pettigrew, M., Clow, A., Schmidt, E., Draper, A., Lock, K., Lynch, R. and Renton, A. 2009. Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial. BMC Public Health. 9 (207), p. 1. https://doi.org/10.1186/1471-2458-9-207

The social aspects of food and nutrition
Gustafsson, U. and Draper, A. 2009. The social aspects of food and nutrition. Journal of Human Nutrition and Dietetics. 22 (2), pp. 87-88. https://doi.org/10.1111/j.1365-277X.2009.00951.x

Can maternal leptin level at early gestation be used as a predictor of postpartum weight retention?
Adegboye, A.R. 2008. Can maternal leptin level at early gestation be used as a predictor of postpartum weight retention? The Indian Council of Medical Research (ICMR).

Accuracy and correlates of maternal recall of birthweight and gestational age
Adegboye, A.R. and Heitmann, B.L. 2008. Accuracy and correlates of maternal recall of birthweight and gestational age. BJOG: An International Journal of Obstetrics and Gynaecology. 115 (7), pp. 886-893. https://doi.org/10.1111/j.1471-0528.2008.01717.x

Assessment of weight changes during and after pregnancy: practical approaches
Adegboye, A.R., Linné, Y., Lourenço, P.M. and Kac, G. 2008. Assessment of weight changes during and after pregnancy: practical approaches. Maternal & Child Nutrition. 4 (1), pp. 1-13. https://doi.org/10.1111/j.1740-8709.2007.00093.x

Staple foods
Draper, A. and Tuffrey, V. 2008. Staple foods. in: Millstone, E. and Lang, T. (ed.) The atlas of food: who eats what, where and why. 2nd edition London, UK Earthscan. pp. 80-81

Nutritional deficiencies
Draper, A. and Tuffrey, V. 2008. Nutritional deficiencies. in: Millstone, E. and Lang, T. (ed.) The atlas of food: who eats what, where and why. 2nd edition London, UK Earthscan. pp. 26-27

Changing diets
Draper, A. and Tuffrey, V. 2008. Changing diets. in: Millstone, E. and Lang, T. (ed.) The atlas of food: who eats what, where and why. 2nd edition London, UK Earthscan. pp. 82-83

Community participation in nutrition programmes for child survival and anemia
Rifkin, S.B., Hewitt, G. and Draper, A. 2007. Community participation in nutrition programmes for child survival and anemia. Centre for Public Health Nutrition, University of Westminster for A2Z, Washington DC.

Improving food provision in a Guyanese home for the elderly: a participatory approach
Hewitt, G., Draper, A., Ismail, S. and Patterson, S. 2007. Improving food provision in a Guyanese home for the elderly: a participatory approach. Public Health Nutrition. 10 (6), pp. 552-558. https://doi.org/10.1017/S1368980007246804

Losing weight after pregnancy: diet plus exercise better than diet alone
Adegboye, A.R. 2007. Losing weight after pregnancy: diet plus exercise better than diet alone. The Cochrane Library.

Does weight gain during pregnancy predict future weight?
Adegboye, A.R. 2007. Does weight gain during pregnancy predict future weight? Frost & Sullivan.

The use and interpretation of anthropometric indicators of nutritonal status during preganancy
Adegboye, A.R., Kac, G. and Lacerda, E. 2007. The use and interpretation of anthropometric indicators of nutritonal status during preganancy. in: Kac, G., Sichieri, R. and Gigante, D.P. (ed.) Epidemiologia nutricional (Portuguese Edition of 'Nutritional Epidemiology') Ministry of Health, Brazil SciELO Editora FIOCRUZ.

Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI?
Adegboye, A.R., Rössner, S., Neovius, M., Lourenço, P.M. and Linné, Y. 2007. Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI? Obesity. 15 (5), pp. 1278-1286. https://doi.org/10.1038/oby.2007.149

The nutritional vulnerability of older Guyanese in residential homes
Hewitt, G., Ismail, S., Patterson, P. and Draper, A. 2006. The nutritional vulnerability of older Guyanese in residential homes. West Indian Medical Journal. 55 (5), pp. 334-339.

Gestational weight gain differentials in the presence of intimate partner violence
Adegboye, A.R., Moraes, C.L. and Reichenheim, M.E. 2006. Gestational weight gain differentials in the presence of intimate partner violence. International Journal of Gynecology & Obstetrics. 95 (3), p. 254–260. https://doi.org/10.1016/j.ijgo.2006.08.015

Risk and trust: determinants of public perceptions
Draper, A., Green, J., Dowler, E., Fele, G., Hagenhoff, V., Rusanen, M. and Rusanen, T. 2006. Risk and trust: determinants of public perceptions. in: Dora, C. (ed.) Health, hazards and public debates: lessons for risk communication from the BSE/CJD saga Copenhagen, Denmark WHO Regional Office for Europe. pp. 62-83

A compilation of energy costs of physical activities
Vaz, M., Karaolis, N., Draper, A. and Shetty, P. 2005. A compilation of energy costs of physical activities. Public Health Nutrition. 8 (7A), pp. 1153-1183. https://doi.org/10.1079/PHN2005802

Public understanding of food risks in four European countries: a qualitative study
Green, J., Draper, A., Dowler, E., Fele, G., Hagenhoff, V., Rusanen, M. and Rusanen, T. 2005. Public understanding of food risks in four European countries: a qualitative study. European Journal of Public Health. 15 (5), pp. 523-527. https://doi.org/10.1093/eurpub/cki016

Letter to editor on Neonatal Survival Series
Keith, R. 2005. Letter to editor on Neonatal Survival Series. The Lancet. 365 (9474), p. 1845. https://doi.org/10.1016/S0140-6736(05)66608-1

Engaging the hard-to-reach: an evaluation of participatory methods used in research with secondary school students
Mitchell, J., Draper, A., Green, J., Thorogood, N. and Gustafsson, U. 2005. Engaging the hard-to-reach: an evaluation of participatory methods used in research with secondary school students. British Sociological Association Annual Conference 2005. York, UK 21-23 Mar 2005

All the nuts in one basket: participatory research and unexpected ethics
Mitchell, J., Draper, A., Green, J., Thorogood, N. and Gustafsson, U. 2005. All the nuts in one basket: participatory research and unexpected ethics. British Sociological Association Annual Conference 2005. York, UK 21-23 Mar 2005

Public involvement in food policy: guidelines for commissioning consultative activities with the hard-to-reach
Mitchell, J., Draper, A., Green, J., Gustafsson, U. and Thorogood, N. 2005. Public involvement in food policy: guidelines for commissioning consultative activities with the hard-to-reach. London, UK University of Westminster.

Women health care provider projects: joint findings from Ghana and Uganda
Hewitt, G., Draper, A., Hall, A., Amoaful, E., Newton, S., Jitta, J. and Kyaddondo, D. 2005. Women health care provider projects: joint findings from Ghana and Uganda. London, UK University of Westminster.

Tony Blair won't eat our dinner, why do we?
Gustafsson, U., Mitchell, J., Draper, A., Green, J. and Thorogood, N. 2005. Tony Blair won't eat our dinner, why do we? British Sociological Association Annual Conference 2005. York, UK 21-23 Mar 2005

Sample surveys of public perceptions and opinions
Gasperoni, G., Draper, A., Hagenhoff, V., Rusanen, M. and Rusanen, T. 2005. Sample surveys of public perceptions and opinions. in: Dora, C. (ed.) Health hazards and public debate: lessons for risk communication from the BSE/CJD saga Copenhagen, Denmark WHO Regional Office for Europe.

An evaluation of participatory methods for research with hard-to-reach groups
Draper, A., Mitchell, J., Newton, P., Gustafsson, U., Green, J. and Thorogood, N. 2005. An evaluation of participatory methods for research with hard-to-reach groups. Fare Choice. 33 (2), p. 4.

Methods to access consumer views on food policy issues: an evaluation of their viability and efficacy for inclusive participation in food policy making
Draper, A., Mitchell, J., Newton, P. and Green, J. 2005. Methods to access consumer views on food policy issues: an evaluation of their viability and efficacy for inclusive participation in food policy making. London, UK University of Westminster.

Food choice, influencing factors
Draper, A. 2005. Food choice, influencing factors. in: Caballero, B., Allen, L. and Prentice, A. (ed.) Encyclopedia of human nutrition. 2nd edition Amsterdam ; London Elsevier.

The principles and application of qualitative research
Draper, A. 2004. The principles and application of qualitative research. Proceedings of the Nutrition Society. 63 (4), pp. 641-646. https://doi.org/10.1079/PNS2004397

Researching food habits: methods and problems
Draper, A. 2004. Researching food habits: methods and problems. Journal of Human Nutrition and Dietetics. 17 (5), pp. 485-486. https://doi.org/10.1111/j.1365-277X.2004.00556.x

Engaging the hard-to-reach: an evaluation of participatory methods for research with secondary school students
Draper, A., Mitchell, J., Newton, P., Gustafsson, U., Green, J. and Thorogood, N. 2004. Engaging the hard-to-reach: an evaluation of participatory methods for research with secondary school students. Consumer and Nutrition: Challenges and Chances for Research and Society: 9th Karlsruhe Nutritional Congress. Karlsruhe, Germany 10-12 Oct 2004 pp. 163-167

Short cuts to safety: risk and 'rules of thumb' in accounts of food choice
Green, J., Draper, A. and Dowler, E. 2003. Short cuts to safety: risk and 'rules of thumb' in accounts of food choice. Health, Risk & Society. 5 (1), pp. 33-52. https://doi.org/10.1080/1369857031000065998

Food safety and consumers: constructions of choice and risk
Draper, A. and Green, J. 2003. Food safety and consumers: constructions of choice and risk. in: Dowler, E. (ed.) The welfare of food: rights and responsibilities in a changing world Oxford, UK Blackwell. pp. 54-69

Food safety and consumers: constructions of choice and risk
Draper, A. and Green, J. 2002. Food safety and consumers: constructions of choice and risk. Social Policy and Administration. 36 (6), pp. 610-625. https://doi.org/10.1111/1467-9515.00307

Community development to improve diet and nutrition
Hewitt, G., Draper, A. and Dowler, E. 2002. Community development to improve diet and nutrition. London, UK University of Westminster.

Under-nutrition
Gandy, J. and Draper, A. 2002. Under-nutrition. in: Millstone, E. and Lang, T. (ed.) The atlas of food: who eats what, where and why London, UK Earthscan. pp. 22-23

Changing diets
Gandy, J. and Draper, A. 2002. Changing diets. in: Millstone, E. and Lang, T. (ed.) The atlas of food: who eats what, where and why London, UK Earthscan. pp. 80-91

Lay perceptions of risk in relation to food safety and BSE in the UK: preliminary findings
Draper, A., Dowler, E. and Green, J. 2001. Lay perceptions of risk in relation to food safety and BSE in the UK: preliminary findings. Annals of Nutrition and Metabolism. 45 (supplement 1), p. 544.

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