Janie Burney

Observations and Conversations: Home Preparation of Infant Formula Among a Sample of Low-Income Mothers in the Southeastern US

Objective: Explore infant formula preparation attitudes and beliefs among low‐income, formula‐feeding, Southeastern US mothers. Design: Cross‐sectional study using in‐home observations and in‐depth interviews. Setting: Participant homes. Participants: Thirteen low‐income mothers of normal birth weight, healthy, term infants aged ≤3 months, who were predominantly feeding powdered or from‐concentrate formula. Variables Measured: Reading formula preparation instructions; order of added ingredients; leveling powdered formula scoop(s); adding cereal or other ingredients to bottles. Phenomenon of Interest: Perceptions of formula preparation or manipulation. Analysis: Descriptive statistics described sample characteristics and home observation variables. Thematic analysis of in‐depth interviews revealed the following major themes: formula preparation can be intimidating; expressions of complex heuristic perceptions about formula preparation; cost and convenience motivate maternal behaviors; and infant cues override recommendations. Data from qualitative and quantitative activities were triangulated. Results: Behaviors, including improper reconstitution and modifications/additions to prepared formula (eg, infant cereal) were observed during home observations and/or described during in‐depth interviews. Inconsistencies were detected between observed behaviors (eg, adding too much water to the bottle) and those reported during in‐depth interviews (eg, stating over‐dilution could be detrimental to the infants health). Conclusions and Implications: Targeting knowledge or skills gaps and behavioral motivators in the formula‐feeding population could positively affect infant‐feeding practices that occur outside of recommendations.