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The University of Southampton

Research project: Parental perceptions, experiences, and help-seeking behaviour for common infant symptoms: qualitative interview study

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In the first year of life, infants commonly experience symptoms such as crying or vomiting. Such symptoms may have an underlying medical cause but are usually self-limiting and can be viewed as part of 'normal' infant behaviour.  Infant crying, vomiting or other symptoms such as food aversion may be given a diagnostic label of cow’s milk protein allergy (CMPA) or gastro-oesophageal reflux, which can cause unintended harms and is associated with significant resource use for the NHS. There has been a huge increase in prescribing for specialised formula milk and anti-reflux medicine without any evidence of rising prevalence, suggestive of over-diagnosis and overprescribing.

There are many causes of common infant symptoms, including constipation or overfeeding, and simple advice can often lead to resolution of symptoms. Other causes can be cow’s milk protein allergy (CMPA) or gastro-oesophageal reflux and prescribing for both of these has risen dramatically in the past few years. This may be related to marketing by pharmaceutical companies and formula manufacturers, which have shifted lay and professional attention to cow’s milk protein allergy (CMPA) or gastro-oesophageal reflux as common causes of these symptoms. Medicines may be given to help manage gastro-oesophageal reflux, but these medicines can cause side-effects. Similarly, excluding dairy from the diet of the breastfeeding mum and infant is difficult and may have negative effects, including stopping breastfeeding early. Specialised formula milk is costly and often not well tolerated.  Little is known about how parents and carers make sense of common infant symptoms, where they seek help, or how it affects their feeding decisions.  

We aim to interview parents and carers of infants (under 12 months in age) to explore their understanding of symptoms and their feeding decisions and help-seeking behaviour. A better understanding of parents and carers’ experiences and actions will inform future research on how healthcare professionals can best help parents and carers look after infants while avoiding unnecessary or excessive use of medications. One of our team members is the parent of a child with suspected food allergy and we have had input on this research plan from a further four mothers of children with allergy symptoms in their first year. 

Lead Investigator(s): Dr Ingrid Muller
Study team: Samantha Hornsey

Co-applicantsDr Miriam Santer, Dr Daniela Ghio, Dr Elizabeth Lovegrove, Kate Sykes
Collaborators: Dr Robert Boyle

Funder: NIHR School for Primary Care Research

Duration: 1 November 2021- 30 October 2022


This study is being conducted by the Primary Care Research Centre.

Related research groups

Primary Care, Population Sciences and Medical Education
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