How Do Health Visitors and Parents Interact in the UK Child Health Clinics around Infant Weight in the Context of Overweight and Obesity: An Interpretative Research Study

Abstract

Background. In 2020, figures estimated that 39 million preschool children worldwide, experienced overweight or obesity. Global prevalence has almost tripled in the last 40–50 years. The number of preschool children impacted makes it severe enough to be one of the most serious public health challenges for the 21st century, which could be addressed during infancy, for improved short- and long-term health outcomes. Objective. Research in a local Trust providing health visiting services in the northeast of England aimed to describe and interpret the interaction between UK parents and health visitors around infant weight (0–2) in delivering the UK Healthy Child Programme. Methods. The research paradigm was social construction, and interpretative phenomenology enabled the interpretation of experiences of self and everyday situational encounters or participants lived experiences. The research applied theoretical perspectives of hermeneutic phenomenology and symbolic interactionism. Purposive sampling recruited 14 parents and 20 health visitors, and 4 focus groups and 8 semistructured interviews were completed. Data analysis was thematic. Findings. Interaction between health visitors and parents around infant weight was complex. Assumptions were made, and the interaction was open to misinterpretation. This impacted the integrity of the conversation. Managing infant weight was superseded by other public health needs of parents. There was no obvious approach to assessment of infant weight that might be exceeding normal growth centiles, whole family approaches, or risk assessment. Infant weight remained an emotive subject for parents and health visitors, and this governed how it was addressed. Conclusion. While existing research has emphasised that infant weight is a sensitive issue to raise with parents, this research is unique, providing detailed implications for UK health visitors and recommendations for future management of infant weight within the UK Healthy Child Programme. Findings are transferrable to other public health professionals communicating with infants and parents in the management of infant weight.