Caregiver Feeding Practices in Guinea: Implications for Infant Dietary Diversity.

The aim of this study was to assess the extent to which specific feeding styles may be associated with the diets of infants aged 6-9 months in Guinea. This study was designed to have multiple, iterative phases with methodological triangulation. During Phase 1 of data collection, direct observations (n = 10) were used to develop a tailored tool for Phase 2, during which 72 meal observations were conducted among infants aged 6-9 months to define caregiver feeding styles. Specific behaviours underlying established feeding styles were recorded at the level of the intended bite. Following each observation, infant diet diversity scores (DDS), or the number of food groups consumed in the previous 24 h, were collected. During Phase 3, we interviewed 34 caregivers to understand the drivers of their feeding styles. Caregiver feeding styles were determined using cluster analysis of observed behaviours and a linear regression was used to explore the relationship between feeding style and infant DDS. Textual data from interviews were thematically analysed to explain the drivers of feeding style. Caregivers were characterized as those using forceful (n = 12), responsive (n = 52) or uninvolved (n = 8) feeding styles. Our study found that responsive feeding was not associated with a higher DDS when controlling for child age in months. The most salient factors shaping feeding style in this setting included perception around infant and young child developmental stage, food refusals and trust in infant cues. Overall, food insecurity may need to be addressed in addition to feeding styles to improve DDS.