title: Do mothers understand healthy eating principles for low-birth-weight infants?
abstract: OBJECTIVE
  To describe feeding patterns and mothers' perceptions of desirable feeding practices in low-birth-weight (LBW) infants after hospital discharge in England and to test for the association of inappropriate practices/perceptions with identifiable demographics.
  
  
  METHODS
  Postal questionnaires from 198 mothers of LBW infants in London, Liverpool and Winchester were analysed regarding infant demographics, mothers' demographics, infant milks used, solid feeding practices and mothers' perceptions of infant feeding practices.
  
  
  RESULTS
  At birth, the median weight, independent of gestational age, was 1.80 kg (range 0.6-2.50 kg) and 37.1% of infants received breast milk exclusively; 83.7% were breast-fed at some stage, a practice favoured more by first-time mothers (90.2%) than multiparous mothers (73.4%) (P = 0.004) as well as by mothers of higher social groups (P = 0.019). The median age of solid food introduction was 17 postnatal weeks (range 8-36 weeks); the timing correlated strongly with infant birth weight (P < 0.001). A high-fibre diet and a low-fat diet were incorrectly considered important for their infants by 67.1% and 51.6% of mothers, respectively. Regarding a high-fibre diet as important was associated with being a multiparous mother (P = 0.006), while regarding a low-fat diet as important was associated with low social group (P = 0.018). A quarter of mothers did not consider 'plenty of calories' to be important for their infants, reflecting similar attitudes in 1990 for mothers of term infants; this incorrect attitude exhibited an association with being a first-time mother (P = 0.047).
  
  
  CONCLUSIONS
  Infant feeding practices were very variable, showing poor concordance with national and international recommendations for term infants. In selecting foods for their infants, many mothers appeared to be applying principles more appropriate to planning a healthy diet for adults. There is an urgent need to develop and implement evidence-based guidelines for feeding LBW infants after hospital discharge, with special attention given to multiparous mothers as well as mothers from lower social groups.
authors.affiliation: Department of Mathematics and Statistics, University of Surrey, Guildford, Surrey, GU2 7XH, UK. j.morgan@surrey.ac.uk
authors.forename: Jane B
authors.initials: JB
authors.lastname: Morgan
authors.forename: Peter
authors.initials: P
authors.lastname: Williams
authors.forename: Keith D
authors.initials: KD
authors.lastname: Foote
authors.forename: Lynne D
authors.initials: LD
authors.lastname: Marriott
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D053198:Child Nutrition Sciences / Q000193:education*; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008895:Milk, Human / Q000276:immunology / Q000502:physiology; D009035:Mothers / Q000193:education* / Q000523:psychology*; D010298:Parity; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors