Perspectives on Infant Feeding Beliefs, Attitudes, and Practices of Hispanic Mothers Enrolled in WIC: Implications for Breastfeeding Peer Counseling

Abstract

Hispanic children have the highest rate of overweight and obesity for children and youth ages 2-19 in the U.S. amongst all major racial and ethnic groups. Recent research has highlighted the important role that infancy and early childhood may have in the development of obesity, particularly for Hispanic children. Mixed feeding (breastfeeding and formula) and early introduction of solid food has been shown to increase weight gain in infancy and early childhood BMI.

The practice of mixed feeding or “las dos” is common in Hispanic mothers, both new immigrant and U.S. born. Although a few recent studies have explored “las dos” and early introduction of solid food among low-income Hispanic mothers and their infants, the literature is sparse. There are significant insights into these practices that can be gained both from the perspectives of Hispanic mothers enrolled in WIC, and the experiences of WIC breastfeeding peer counselors that regularly work with Hispanic mothers and their infants in the community.

This dissertation aimed to expand the level of knowledge and understanding of the beliefs, motivations, and behaviors of Hispanic mothers enrolled in WIC regarding mixed feeding (“las dos”) and the early introduction of solid foods, along with perceived effective communication strategies to address both of these practices. Using a mixed-methods approach, the research examined the experiences of bilingual (Spanish-speaking) WIC breastfeeding peer counselors in North Carolina and feeding practices and beliefs of WIC enrollees in Texas that were majority Hispanic.

In this study, the results demonstrated that there are demographic differences in the reasons mothers introduce formula to breastfed infants, and that demographic and socioeconomic factors, acculturation, cultural context and social environment play a role in “las dos.” It also produced valuable findings around overfeeding and communication strategies to address “las dos.” The results for early introduction of solid foods indicated that Hispanic mothers in WIC are less likely to introduce solid food early and add cereal to a baby’s bottle. The Plan for Change uses the results to create a multi-pronged strategy to improve communication about “las dos,” to reduce the risk of early childhood obesity in low-income Hispanic children.