Gendered heuristics and social pressure in infant feeding: a qualitative study of formula choice and legitimation

This study examined how expectant mothers, mothers, and fathers in Southeastern Brazil interpret and justify infant formula use. Four focus groups (n = 28) underwent a hybrid inductive-deductive thematic analysis. Four domains emerged: social pressure; technology and risk control; safety in preparation procedures; and legitimation of parental choices. Expectant mothers framed formula as a justifiable last resort; mothers invoked necessity to reconcile formula use with maternal expectations; fathers more often weighed pragmatic needs, professional recommendations, and observed infant outcomes. Social and family expectations could heighten guilt and uncertainty; counseling could legitimize formula use but also reinforce tensions when breastfeeding was treated as the norm. Parents balanced credibility with practicality, prioritizing infant well-being while reflectively considering goals and alternatives. Salient cues could lead to different judgments than structured evaluations. Counseling should therefore explore how parents define responsible feeding, which sources they trust, and which constraints shape feasible choices.