Study Finds Mothers' Misunderstanding of Infant Nutrition

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A study in the Journal of Pediatric Health Care examines mothers' feeding choices and nutritional knowledge and finds that "the lack of knowledge demonstrated by this sample of mothers is of great concern. It is evident that parents need more information about basic nutritional information." Researchers surveyed 490 mothers or mothers-to-be on nutritional information. Between 34% and 61% of the mothers responded correctly to each separate question.

Respondents were asked to indicate whether they agreed or disagreed with the following seven statements:

• Cow's milk can be introduced into a baby's diet when the baby begins to take solids;
• Fruit juice provides nutritional benefits unavailable in infant formula or breast milk;
• Fruit juice is a necessary part of a baby's diet;
• If a breastfeeding mother has a low milk supply, she should switch to formula feeding;
• The best time to wean babies from the breast is when they start to develop teeth;
• Low-iron formula causes less fussiness and constipation in babies; and
• Milk allergy is the most common cause of frequent spitting up in infancy.

According to the article, "disagree" is the correct answer for all the questions.

Results indicate that:

• 37% of respondents thought that if a breastfeeding mother has a low milk supply, she should switch to formula feeding (when exclusive breastfeeding is not possible, partial breastfeeding, supplemented with iron-fortified infant formula, is still preferable to premature weaning);
• 30% of respondents thought that the best time to wean babies from the breast is when they start to develop teeth (parents need to know that there is no need to wean babies when teeth erupt);
• 26% of respondents thought that low-iron formula causes less fussiness and constipation in babies, and 39% did not know or did not answer the question, indicating that many mothers do not know the correct answer to this question (iron-fortified infant formula is the only appropriate substitute for breast milk during the first year of life);
• 29% of respondents believed the most common cause of frequent spitting up is a milk allergy, and 37% did not know or did not answer the question (unless certain other symptoms are present, health care providers can reassure parents that spitting up is normal and that most babies outgrow it by about age one);
• 19% of respondents thought that cow's milk can be introduced when solid food is introduced, and 21% did not know or did not answer the question (cow's milk should not be introduced during the first year of life, because introducing it earlier puts the infant at risk for iron-deficiency anemia); and
• 17% of respondents thought fruit juice provides nutritional benefits unavailable in infant formula or breast milk, and 35% thought that fruit juice is an important part of a baby's diet (infants do not need fruit juice, and infants younger than six months of age should not be fed juice, as it can take the place of other foods or drinks that provide important nutrients).

The article concludes that "pediatric providers must continually work to increase parental understanding of basic infant nutrition," and that "to help parents understand and learn, the information will need to be presented again and again in different ways."

Hobbie, Cynthia, Susan Baker, and Cynthia Bayerl. "Parental Understanding of Basic Infant Nutrition: Misinformed Feeding Choices." Journal of Pediatric Health Care. 2000; 14(1): 26-31.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.