Rachel S Gross1, Nicole M Brown2, Alan L Mendelsohn3, Michelle W Katzow4, Mayela M Arana5, Mary Jo Messito5. 1. Division of General Pediatrics, Department of Pediatrics (RS Gross, MM Arana, MJ Messito), New York University Grossman School of Medicine, New York, NY. Electronic address: Rachel.Gross@nyulangone.org. 2. Strong Children Wellness Medical Group (NM Brown), Jamaica, NY. 3. Division of Developmental-Behavioral Pediatrics, Department of Pediatrics (AL Mendelsohn), New York University Grossman School of Medicine, New York, NY. 4. Division of General Pediatrics, Department of Pediatrics (MW Katzow), Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY. 5. Division of General Pediatrics, Department of Pediatrics (RS Gross, MM Arana, MJ Messito), New York University Grossman School of Medicine, New York, NY.
Abstract
OBJECTIVES: Maternal stress has been associated with early child obesity through pathways related to decreased exclusive breastfeeding and increased nonresponsive maternal-infant feeding styles. We sought to gain an in-depth understanding of how maternal stress, sadness, and isolation are perceived to affect feeding, in order to inform modifiable targets of intervention. METHODS: We conducted semi-structured qualitative interviews with Hispanic mothers living in poverty with young infants between 3 and 7 months old (n = 32) from the intervention group of a randomized controlled trial of an early child obesity prevention intervention (Starting Early Program). Bilingual English-Spanish interviewers conducted the interviews, which were audio recorded, transcribed, and translated. Building on an existing theoretical framework developed by the National Scientific Council on the Developing Child, we used an iterative process of textual analysis to code the transcripts, until thematic saturation was reached. RESULTS: Three key themes were described: 1) maternal stress responses were varied and included positive (brief and mild), tolerable (sustained but limited long-term impacts), or toxic stress (sustained and severe); 2) buffers included support from family, infants, health care providers, social service programs, and community organizations; 3) perceived effects on infant feeding included decreased breastfeeding due to concerns about stress passing directly through breast milk and indirectly through physical closeness, and increased nonresponsive feeding styles. CONCLUSIONS: Maternal stress, particularly toxic stress, was perceived to negatively affect infant feeding. Mothers reported disrupting healthy feeding to avoid infant exposure to stress. Interventions to enhance buffering may help to mitigate toxic stress and promote healthy feeding interactions.
OBJECTIVES: Maternal stress has been associated with early child obesity through pathways related to decreased exclusive breastfeeding and increased nonresponsive maternal-infant feeding styles. We sought to gain an in-depth understanding of how maternal stress, sadness, and isolation are perceived to affect feeding, in order to inform modifiable targets of intervention. METHODS: We conducted semi-structured qualitative interviews with Hispanic mothers living in poverty with young infants between 3 and 7 months old (n = 32) from the intervention group of a randomized controlled trial of an early child obesity prevention intervention (Starting Early Program). Bilingual English-Spanish interviewers conducted the interviews, which were audio recorded, transcribed, and translated. Building on an existing theoretical framework developed by the National Scientific Council on the Developing Child, we used an iterative process of textual analysis to code the transcripts, until thematic saturation was reached. RESULTS: Three key themes were described: 1) maternal stress responses were varied and included positive (brief and mild), tolerable (sustained but limited long-term impacts), or toxic stress (sustained and severe); 2) buffers included support from family, infants, health care providers, social service programs, and community organizations; 3) perceived effects on infant feeding included decreased breastfeeding due to concerns about stress passing directly through breast milk and indirectly through physical closeness, and increased nonresponsive feeding styles. CONCLUSIONS: Maternal stress, particularly toxic stress, was perceived to negatively affect infant feeding. Mothers reported disrupting healthy feeding to avoid infant exposure to stress. Interventions to enhance buffering may help to mitigate toxic stress and promote healthy feeding interactions.
Authors: Rachel S Gross; Alan L Mendelsohn; Arthur H Fierman; Andrew D Racine; Mary Jo Messito Journal: Pediatrics Date: 2012-07-23 Impact factor: 7.124
Authors: Kimberley A Baxter; Smita Nambiar; Tsz Hei Jeffrey So; Danielle Gallegos; Rebecca Byrne Journal: Int J Environ Res Public Health Date: 2022-05-05 Impact factor: 4.614