Peer-reviewed article
Impact of baby behaviour on caregiver's infant feeding decisions during the first 6 months of life: A systematic review
Mireya Vilar‐Compte, Rafael Pérez‐Escamilla, Dania Orta‐Aleman, Valeria Cruz‐Villalba, Sofía Segura‐Pérez et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined how baby behaviours such as crying, sleep waking, and posseting influence caregiver feeding decisions during the first 6 months of life. The review included 22 quantitative studies showing that these behaviours affect decisions about breastfeeding, reports of milk insufficiency, and formula introduction. The authors found that without proper counselling, caregivers may misinterpret normal infant behaviours as problems and alter feeding practices in ways that could harm breastfeeding. The review concludes that parents need anticipatory guidance from well-trained health providers to understand normal infant behaviour.
Key points
- All 22 studies reviewed found that baby behaviours affect parental feeding decisions
- Crying and fussiness were the most commonly studied infant behaviours
- Baby behaviours were associated with reports of milk insufficiency, reduced breastfeeding confidence, shorter breastfeeding duration, and earlier introduction of formula
- More than half of included studies were from high-income countries
- Many factors influence whether caregivers perceive baby behaviours as problematic
Limitations
This systematic review synthesizes existing literature rather than collecting new primary data, so it depends on the quality and design of included studies. The review includes mostly descriptive and cross-sectional studies with no experimental designs, limiting causal inference about how infant behaviour directly causes changes in feeding decisions.
Abstract
Caregivers are often concerned about baby behaviours. Without adequate counselling, parental response can lead to altering infant feeding and jeopardizing breastfeeding. We conducted a systematic review to assess the evidence about the influence of baby behaviours perceived as problematic (crying, sleep waking and posseting) on infant feeding decisions during the first 6 months of life (self-reported milk insufficiency, breastfeeding duration and introduction of formula). The review focused on quantitative studies published in English, Portuguese or Spanish without date restriction. The search was designed with the support of a medical librarian and conducted in seven databases. Data were managed in Covidence and risk of bias was assessed through the Johanna Briggs Institute critical appraisal checklists. Synthesis of the literature was guided by a conceptual model of the impact of baby behaviours on caregivers feeding practices. We retrieved and reviewed 4312 titles/abstracts and selected 22 for review; 10 were purely descriptive and 12 were cross-sectional, prospective and quasi-experimental studies. Although studies from diverse regions were included in the review, more than half were from high-income countries. All studies reported that baby behaviours affect feeding decisions, the most common baby behaviours studied were crying and fussiness, and the studies suggested relationships with lactation problems and reports of milk insufficiency, maternal breastfeeding confidence, breastfeeding duration and discontinuation, and introduction of formula. There are many factors that lead to perceiving baby behaviours as problematic and there is a need to provide anticipatory guidance to parents and caregivers, starting in pregnancy and counselling through well-trained health providers.