# Communication on complementary feeding: attitudes of parents versus pediatricians in France

Sofia de Rosso, Sophie Nicklaus, Camille Schwartz, Pauline Ducrot

► To cite this version:

Sofia de Rosso, Sophie Nicklaus, Camille Schwartz, Pauline Ducrot. Communication on complementary feeding: attitudes of parents versus pediatricians in France. 16. World Congress on Public Health, Oct 2020, Rome, Italy. , European Journal of Public Health, 30 (Supplement 5), pp.ckaa166.368, 2020, 10.1093/eurpub/ckaa166.368 . hal-04164431

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Submitted on 9 Aug 2023

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# Communication on complementary feeding: attitudes of parents versus pediatricians in France.

* Sofia De Rosso<fnref n="1" />, Sophie Nicklaus<fnref n="1" />, Pauline Ducrot<fnref n="2" />, Camille Schwartz<fnref n="2" />

¹Centre for Taste and Feeding Behavior, AgroSup, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France

²Nutrition and physical activity unit, Santé publique France, French national public health agency. Saint-Maurice, France

Acknowledgements: Dr. Fabienne Kochert (AFPA), Dr. Marie-Laure Frelut (pediatrician), BVA group; Claire Chabanet and Emile Szleper (INRAE)

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## Background

Appropriate complementary feeding (CF) practices can be seen as a promising strategy to prevent childhood obesity<fnref n="1" />. Children's eating behavior is influenced by multiple factors (intrinsic and environmental), among which parents play a key role in modelling eating habits of their children<fnref n="2" />. For this reason, in a public health perspective, parents must be informed and guided properly through the CF process<fnref n="3" />. Pediatricians (PED) interact with parents before and at the onset of the CF transition, they can thus exert an influence related parental decisions<fnref n="4" />. In this perspective, they need updated information about best recommended CF practices. In France, new recommendations on infant feeding have been released in 2019. In this context, the **objective** of this study was to inform the new national communication strategy by evaluating the information needs of parents and PED on child feeding practices.

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## Material and methods

PED members of AFPA (French Association of Ambulatory Pediatrics) were asked on their attitudes and practices in counselling parents on CF. In addition, a representative national sample of parents, was interviewed to investigate their sources and expectations regarding information on CF, as summarized in Table 1.

<table><caption>Table 1. Method and populations of the two surveys with pediatricians or parents</caption><thead><tr><th></th><th>Pediatricians</th><th>Parents</th></tr></thead><tbody><tr><td>Type of survey</td><td>Online</td><td>Online, quotas</td></tr><tr><td>Collection dates</td><td>October 2019</td><td>10th to 29th January 2020</td></tr><tr><td>Population</td><td>AFPA members (N=1402)</td><td>parents, with at least one child under 4 years old</td></tr><tr><td>Nr of respondents</td><td>N=318</td><td>N=1001</td></tr><tr><td>Included in the analysis</td><td>N=301**</td><td>N=826***</td></tr></tbody></table>

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## Results

<table><caption>Table 2. Description of the two samples.</caption><thead><tr><th></th><th>Pediatricians</th><th>Parents</th></tr></thead><tbody><tr><td>Years of experience</td><td>0-10y= 26%<br>11-20y= 19%<br>21-30y= 25%<br>30+ y= 30%</td><td>SES+= 49%<br>SES-= 47%<br>Inactive= 4%</td></tr><tr><td>Sex</td><td>Women= 80%<br>Men= 20%</td><td>Perceived financial situation<br>Good= 45%<br>Difficult= 55%</td></tr><tr><td>Working area</td><td>Rural= 10%<br>Urban= 90%</td><td>Nr of children<br>1 child= 39%<br>2 children= 39%<br>3 and more= 22%</td></tr><tr><td>Has children</td><td>Yes= 86%<br>No= 14%</td><td>Age of the youngest child<br>&lt;6 months= 13%<br>6-11 months= 14%<br>1y= 26%<br>2y= 27%<br>3y= 20%</td></tr></tbody></table>

### Attitudes of parents and PED

* The importance of CF for the healthy growth of the child was well recognized by parents and PED (99%);

* 31% of parents consider that the available advice on CF could be contradictory, it was not always consistent and it could even make parents feel guilty in 30% of cases;

* Parents began to look for information about CF when the child was about 5 months old;

* 93% of PED always gave advice on CF during routine visits with parents when the child was on average 2/3 months old;

* According to parents, CF was discussed with PED only in 50% of the cases when the child was less than 6 months old;

* 99% of PED considered as their responsibility counselling parents on CF and parents acknowledged them as the most influential source;

* Only 28% of PED thought that it was important to give more information on menus and recipes, while 64% of parents searched for this information;

* Parents' social network was a source used by 63% of parents and had a quite high influence (Fig. 1). Yet only 13% of PED believed parents rely on that source;

* 73% of parents make use of Internet, 44% continue to use paper tools to gather information (Fig. 1 for use and influence of each source).

<figure><img src="image_6.png" /><figcaption>Figure 1. Influence of parents' sources of information in the way of feeding their child according to the use of those sources.</figcaption></figure>

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## Conclusions

* Information relay: Via PED / Health care professionals.

* When to disseminate information: More systematically when the child is less than 6 months, but at every step of CF until 36 months.

* Support and content: Paper and digital tools (brochure and institutional website or application for smartphone).

This study will contribute to the evidence for public health stakeholders and communicators when updating and providing new resources in line with parents' and PED's needs on CF information.

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## References

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<footnote>**N=17 respondents were excluded because General Practitioners (we considered only PED)</footnote>

<footnote>***N=175 parents were excluded from the analysis because their last child had or had had a health problem that could strongly affect his diet</footnote>

<footnote n="1">¹Blake-Lamb TL et al, American Journal of Preventive Medicine, 2016.</footnote>

<footnote n="2">²Scaglioni S et al, Nutrients, 2018.</footnote>

<footnote n="3">³Golan M et al, The American Journal of Clinical Nutrition, 1998.</footnote>

<footnote n="4">⁴Gage H et al, European journal of clinical nutrition, 2012.</footnote>