Understanding the role of mothers and other caregivers in the context of infant feeding using the family ecological model

Abstract

Background: Despite the high prevalence of early childhood obesity and persistent racial and ethnic disparities, there remains a critical gap in understanding how the broader social-ecological context-including the roles of mothers and other trusted caregivers-shapes infant feeding practices in low-income Latinx families. Non-maternal caregivers can influence infant feeding, growth, and development, potentially impacting chronic health conditions like early onset obesity.

Methods: We conducted a food diary debriefing interview with 42 mothers, followed by mother-caregiver dyadic interviews. We utilized the Family Ecological Model, which focuses on the intersection of macrosystem (e.g., social and cultural factors) with mesosystem (systems of care, information sources, as our guiding theoretical framework for data analysis and interpretation of mother-caregiver relationship dynamics and decision making around infant feeding.

Results: All mothers and most (85.7 %) non-maternal caregivers self-identified as Latinx, with a mean age of 30.8 ± 6.4 and 37 ± 12.7 years, respectively. Most non-maternal caregivers were the infant's father or grandmother. Social and cultural context (macrosystem), and the systems of care that mothers and non-maternal caregivers accessed for infant feeding information (mesosystem) influenced their relationship in the context of infant feeding. Grandmothers had an important role in sharing knowledge with mothers, as they were seen as experienced caregivers. Fathers' roles varied from supporting mothers' decisions to engaging in shared decision making.

Discussion: These findings can inform future interventions aimed to improve infant feeding practices and diet, promote healthy growth and decrease early childhood obesity in low-income Latinx families, and also highlight the need to include other non-maternal caregivers in educational programs and interventions.