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Health visitors fear loss of rapport by asking parents about infant nutrition

Transition nutrition data from child health records could be beneficial in health promotion

Health visitors worry about losing rapport by asking parents standardised questions about infants' nutrition, but data collection is needed

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Health visitors may be reluctant to question parents of young children about nutrition due to concerns that they could lose rapport, even though such surveys are useful, a Scottish study shows.

The transition to solid feeding sets the foundations for future healthy eating, but there is no routine data collection on infant dietary diversity.

This study developed a transition nutrition survey with questions on types of food, aversive feeding behaviours, flavour categories and sugar intake. Questions were compatible with health visitors’ electronic records completed on tablets.

The survey was administered by health visitors from two teams who approached 319 parents of infants aged one year. It was completed by 59% (187) of the parents, although 91% of the responses were on paper rather than on the health visitors’ tablets. The main barrier to using the electronic version was internet connectivity.

Acceptability issues

Although the responses demonstrated that feeding practices were broadly in line with nutritional guidelines, subsequent interviews pointed to acceptability issues.

The health visitors found the survey comparable with their standard nutrition conversations, but some parents were defensive about the eating behaviours section, and there was confusion about what was normal.

Limited time and concerns about losing rapport with parents through the standardised approach of the survey were cited as a reason for their reluctance to use it.

The authors said routine data collection on transition nutrition obtained from child health records seemed feasible and a potential asset to health visitors in their health promotion work.


Tully L, Wright C, McCormick D et al (2019) Assessing the potential for integrating routine data collection on complementary feeding to child health visits: A mixed-methods study. International Journal of Environmental Research and Public Health. 16, 10. doi: 10.3390/ijerph16101722

Vari Drennan is professor of healthcare and policy research at Kingston University and St George’s, University of London

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