All ETDs from UAB

Advisory Committee Chair

Gwendolyn D Childs

Advisory Committee Members

Lori A Loan

Marti Rice

Andres Azuero

Paula C Chandler-Laney

Eric A Hodges

Document Type

Dissertation

Date of Award

2018

Degree Name by School

Doctor of Philosophy (PhD) School of Nursing

Abstract

Mechanisms contributing to childhood obesity begin during early life, including infant feeding practices and an excessive rate of infant growth. Parental decisions regarding their infant contribute to these mechanisms. Parental self-efficacy (PSE) is the belief parents have in their ability to accomplish the tasks of parenting and is associated with infant outcomes. A high sense of PSE, breastfeeding self-efficacy, or self-efficacy for feeding has been found to be associated with healthy infant feeding practices. However, this research is limited in scope and has not been conducted in populations at greatest risk for childhood obesity such as low-income or African-American infants. Therefore, more research is needed to examine associations among PSE, infant feeding practices, and infant growth, particularly in high risk populations. The purpose of this dissertation was to examine associations among PSE, infant feeding practices, and infant weight gain. This purpose was accomplished through three manuscripts. The first was an integrative review that examined associations among these concepts in diverse samples across the globe. Two additional studies were secondary analyses of the Infant Care, Feeding, and Risk of Obesity (Infant Care) dataset. These data were collected in low-income, African-American mother-infant dyads. The second manuscript focused on the association between PSE and infant feeding practices, and the third on the association between PSE and infant weight-for-length z-score (WLZ) trajectories. The resulting body of work contributes to literature examining early life factors placing an infant at risk for later childhood obesity. Findings from the integrative review suggest that mothers with a high sense of breastfeeding self-efficacy are more likely to initiate breastfeeding and breastfeed longer. Using the Infant Care data, the association between PSE and infant feeding practices was not supported. Cultural and sociodemographic characteristics of this sample may contribute to findings. The data did support an association between PSE and infant WLZ trajectories. Infants of mothers with a higher sense of PSE at infant age of three months, followed an excessive WLZ trajectory. This trajectory has previously been demonstrated to be predictive of later obesity risk. More research is warranted, but these findings yield important insight into infant growth trajectories.

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