Abstract
The promotion of healthy infant feeding is increasingly recognized as an important
obesity-prevention strategy. This is relevant for American Indian populations that
exhibit high levels of obesity and low compliance with infant feeding guidelines.
The literature examining the knowledge, attitudes, and beliefs surrounding infant
feeding within the American Indian population is sparse and focuses primarily on breastfeeding,
with limited information on the introduction of solid foods and related practices
that can be important in an obesity-prevention context. This research presents descriptive
findings from a baseline knowledge, attitudes, and beliefs questionnaire on infant
feeding and related behaviors administered to mothers (n=438) from five Northwest
American Indian tribes that participated in the Prevention of Toddler Overweight and
Teeth Health Study (PTOTS). Enrollment occurred during pregnancy or up to 6 months
postpartum. The knowledge, attitudes, and beliefs questionnaire focused on themes
of breastfeeding/formula feeding and introducing solid foods, with supplemental questions
on physical activity. Knowledge questions were multiple choice or true/false. Attitudes
and beliefs were assessed on Likert scales. Descriptive statistics included frequencies
and percents and means and standard deviations. Most women knew basic breastfeeding
recommendations and facts, but fewer recognized the broader health benefits of breastfeeding
(eg, reducing diabetes risk) or knew when to introduce solid foods. Women believed
breastfeeding to be healthy and perceived their social networks to agree. Attitudes
and beliefs about formula feeding and social support were more ambivalent. This work
suggests opportunities to increase the perceived value of breastfeeding to include
broader health benefits, increase knowledge about solid foods, and strengthen social
support.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Academy of Nutrition and DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Preventing childhood obesity: What works?.Int J Obes. 2009; 33: S74-S81
- Policies to support obesity prevention for children: A focus on of early childhood policies.Pediatr Clin North Am. 2011; 58: 1521-1541
- Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature.Obes Rev. 2007; 8: 327-338
- Interventions to prevent obesity in 0-5 year olds: An updated systematic review of the literature.Obesity. 2010; 18: S27-S35
- Breastfeeding during the first year promotes satiety responsiveness in children aged 18-24 months.Pediatr Obes. 2012; 7: 382-390
- Do infants fed directly from the breast have improved appetite regulation and slower growth during early childhood compared with infants fed from a bottle? [published online August 2011.].Int J Behav Nutr Phys Act. 2011; 8: 89
- Mechanisms underlying the association between breastfeeding and obesity.Int J Pediatr Obes. 2009; 4: 196-204
- Timing of solid food introduction and risk of obesity in preschool-aged children.Pediatrics. 2011; 127: e544-e551
- Early childhood healthy and obese weight status: Potentially protective benefits of breastfeeding and delaying solid foods.Matern Child Health J. 2014; 18: 1224-1232
- Pediatric Nutrition Surveillance 2010 Report.US Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA2012
World Health Organization. Media Centre, World Health Organization Statement, January 15, 2011, Exclusive breastfeeding for six months best for babies everywhere. http://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/. Accessed February 1, 2014.
- Position of the American Dietetic Association: Promoting and supporting breastfeeding.J Am Diet Assoc. 2009; 109: 1926-1942
- Breastfeeding and the use of human milk.Pediatrics. 2012; 129: e827-e841
Centers for Disease Control and Prevention. Centers for Disease Control and Prevention National Immunization Survey Data, Exclusive Breastfeeding Rates at Six Months by Socio-Demographics Factors, Among Children Born in 2007. http://www.cdc.gov/breastfeeding/data/NIS_data/2007/socio-demographic.htm. Accessed February 27, 2014.
Centers for Disease Control and Prevention. Centers for Disease Control and Prevention National Immunization Survey Data, Breastfeeding Rates by Socio-Demographic Factors, Among US Children Born in 2007. http://www.cdc.gov/breastfeeding/data/NIS_data/2007/socio-demographic_any.htm. Accessed February 27, 2014.
- Food consumption patterns of infants and toddlers: Where are we now?.J Am Diet Assoc. 2010; 110: S38-S51
- The Feeding Infants and Toddlers Study 2008: Opportunities to assess parental, cultural, and environmental influences on dietary behaviors and obesity prevention among young children.J Am Diet Assoc. 2010; 110: S11-S15
- American Indian breastfeeding attitudes and practices in Minnesota.Matern Child Health J. 2008; 12: 46-54
- Using cultural knowledge in health promotion: Breastfeeding among the Navajo.Health Educ Behav. 1997; 24: 625-639
- Breast-feeding practices of Native American mothers participating in WIC.J Am Diet Assoc. 2001; 101: 245-247
- Traditional breastfeeding practices of the Ojibwe of Northern Minnesota.Health Care Women Int. 2003; 24: 49-61
- An ecological perspective of breastfeeding in an indigenous community.J Nurs Scholarsh. 2002; 34: 235-241
- Prenatal infant feeding intent and perceived social support for breastfeeding in Manitoba first nations communities: A role for health care providers.Arctic Med Res. 1997; 56: 104-120
- A community-based intervention to prevent obesity beginning at birth among American Indian Children: Study design and rationale for the PTOTS study.J Prim Prev. 2012; 33: 161-174
- Vitamin D supplements enhance weight gain and nutritional status in pregnant Asians.Br J Obstet Gynaecol. 1981; 88: 987-991
- Child of Mine: Feeding with Love and Good Sense, Revised and Updated Edition.Bull Publishing Company, Boulder, CO2000
US Department of Agriculture Food and Nutrition Service, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) website. http://www.fns.usda.gov/wic/women-infants-and-children-wic. Accessed February 27, 2014.
- Active Start: A Statement of Physical Activity Guidelines for Children from Birth to Age 5.2nd ed. American Alliance for Health, Physical Education, Recreation and Dance, Reston, VA2009
- Youth-onset type 2 diabetes among American Indians and Alaska natives.J Public Health Manag Pract. 2010; 16: 388-393
- Diabetic nephropathy in American Indians, with a special emphasis on the Pima Indians.Curr Diab Rep. 2008; 8: 486-493
- Diagnosed diabetes among American Indians and Alaska Natives aged <35 years—United States, 1994-2004.MMWR Morb Mortal Wkly Rep. 2006; 55: 1201-1203
Biography
C. L. Eckhardt is an assistant professor, Portland State University, School of Community Health, Portland, OR.
Biography
T. Lutz is a doctoral candidate and junior investigator/project director, Northwest Portland Area Indian Health Board, Portland, OR.
Biography
N. Karanja is a senior investigator, Kaiser Permanente Center for Health Research, Portland, OR.
Biography
J. B. Jobe is retired; at the time of the study, he was health scientist administrator, Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Biography
G. Maupomé is a professor, Indiana University School of Dentistry, Indianapolis.
Biography
C. Ritenbaugh is a professor, Department of Family and Community Medicine, The University of Arizona, Tucson.
Article info
Publication history
Published online: June 18, 2014
Accepted:
April 15,
2014
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT Funding and support for this project came from the National Institutes of Health grant “Primordial Prevention of Overweight in AI Children” (U01 HL081624), through the National Heart, Lung, and Blood Institute.
Identification
Copyright
© 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
