A qualitative analysis of factors influencing infant and young children feeding perceptions and practices, of working mothers, in London Borough of Ealing

Introduction: Optimum infant feeding practices, during the first 1000 days of life, are essential for children's health and development. The World Health Organization (WHO) recommends putting the infant to the breast within the first hour of life, and exclusively breastfeeding for six months. If every infant was exclusively breastfed 823,000 infant deaths could be avoided annually. Despite this fact only 41% of infants worldwide are exclusively breastfed. The Global Nutrition Target 5 seeks to increase this figure to 50% by 2025. In the UK, although there is widespread knowledge on the benefits of breastfeeding, with 81% mothers initiating breastfeeding, only 24% are exclusively breastfeeding at 6 weeks. By six months only 1% of mothers are still exclusively breastfeeding. This is the lowest rate in Europe. This research aimed to explore the infant feeding practices and perceptions of a small group of working mothers, with children under the age of five, in the London Borough of Ealing.

Methodology: This study applied a qualitative methodology to gain a deeper understanding of factors influencing infant and young child feeding practices in a small group of working women. Two gatekeepers were used to recruit 14 participants through a mixture of convenience and snowball sampling. All mothers included were working and living in the Ealing Borough of London with children under five. Methods utilised for data collection included online interviews and open-ended surveys. Data were analysed using an inductive thematic approach, identifying four themes and eleven sub themes from the participants.

Results: The study identified that mothers sought information on infant feeding from online sources, printed books, family and friends, and educational classes. However, most mothers expressed the need to have more information on different feeding methods and childbirth in general. Mothers highlighted that the main factors influencing their decision on how to feed their baby included the need to develop a strong connection with their baby, nutritional benefits for the infant and general knowledge about the benefits of breastfeeding. Most participants reported that they started breastfeeding at birth. Six mothers exclusively breastfed their baby until six months, followed by the introduction of complementary foods. Three of these mothers continued to breastfeed until nine months. Five mothers started formula feeding within two months due to personal challenges such as lack of support, perceived lack of milk supply and anatomical challenges such as tongue-tied infants. Mothers did not find work as a major barrier to breastfeeding.

Conclusions: Increased information and support on all aspects of infant feeding could help the UK achieve their 2025 target. The timing of complementary feeding and clear advice on where to seek nutrition support could be included in an English Infant Feeding Strategy, like the strategy implemented in Scotland. More discussion on the small size of an infant’s stomach could reduce early breastfeeding cessation due to perceptions around lack of milk.