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A Leader Jefferson School of Population Health, Thomas Jefferson University, Philadelphia, PA


The purpose of this research study was to document the feeding guidelines from medical associations, understand what pediatricians are recommending to new mothers, and to capture the response from mothers regarding their understanding and personal practices in feeding. Previous studies have found that mothers were not following feeding recommendations by the American Academy of Pediatrics (AAP). Furthermore, the role of infant rice cereal as an early first food is currently under debate. Qualitative research was conducted through interviews with five mothers of children under 2 years, five healthcare providers in pediatric settings, and three policy experts. The Theory of Reasoned Action was used to understand how attitudes, beliefs, and social norms shaped the behavior outcomes of mothers. Transcribed interviews were coded to uncover the various themes, similarities, and differences between the three groups. The results of the study found that mothers were unaware of AAP guidelines on infant feeding, confused by the amount of conflicting information, and heavily relied on their own attitudes and subjective norms. Also, the majority of the mothers introduced rice cereal as a first food. Healthcare providers had a limited understanding of feeding standards beyond breastfeeding, expressed a greater need for nutrition education, and often recommended rice cereal to their patients. Finally, policy makers emphasized that nutrition was only a moderate policy priority, called for more evidence based research, and had neutral or negative attitudes toward rice cereal. Results of this study concluded that recommendations from policy experts were contradictory and as a result, providers were unable to give effective feeding recommendations and mothers developed their own feeding plans based off personal attitudes and subjective norms.

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