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Estimating the Impact on Parents' Infant Feeding Choices of Increasing Age Guidance and Adding Sugar Warning Labels
Rana E Conway1, Ivonne Derks1, Florence Sheen1,2
1Research Department of Behavioural Science and Health, University College London, London, United Kingdom.
Background:
Minimum age guidance on commercial infant food (CIF) does not always align with government advice. Despite marketing suggesting that CIF is healthy, many are high in sugar.
Objectives:
To estimate the impact on parents' feeding choices of increasing age guidance on CIF and adding sugar warning labels (SWLs), including differential impact according to socioeconomic position.
Methods:
A convergent parallel mixed-methods study was conducted with parents or main caregivers of children aged 6-23-mo in the United Kingdom. In an online quantitative survey, participants (n = 1237) reported feeding behaviors and were asked about CIF choices when randomly assigned to view products with different ages or sugar labeling. In qualitative focus group interviews, parents (n = 22) discussed feeding choices and labeling. Quantitative results were analyzed using χ2 tests and binary logistic regression, while framework analysis was applied to qualitative data. Quantitative and qualitative findings were then integrated for overall interpretation.
Results:
Similar numbers of participants selected products labeled "6-mo+" (84.5%) or "4-mo+" (88.0%, P = 0.07), but fewer chose snacks labeled "12-mo+" (86.3%) compared with "6-mo+" (96.6%, P < 0.001). In focus groups, parents described multiple factors guiding their feeding choices; they felt labels were misleading and wanted age guidance on labels to align with government recommendations. Both survey and focus group participants trusted that CIF was low in sugar. CIF desserts displaying SWLs were chosen by 27.1% fewer participants than CIF without SWLs (P < 0.001). Differences according to label condition were similar, irrespective of income, occupation, or education. Focus group interviewees strongly supported the introduction of SWLs on CIF.
Conclusions:
Results suggest that the mandatory use of minimum age guidance and SWLs on CIF could provide parents with agency and shift feeding behaviors toward closer alignment with recommendations. Importantly, the impact of these label changes appears socioeconomically equitable, and they are supported by parents.
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