Much is known about national trends in child undernutrition, but there is little information on how socio-economic inequalities are evolving over time. We aimed to assess socio-economic inequalities in stunting prevalence over time.

We selected nationally representative surveys carried out since the mid-1990s for which information was available on asset indices and on child anthropometry. We identified twenty-five countries that had at least two surveys over an interval of 10 years or more, totalling eighty-seven surveys. Stunting prevalence was calculated according to wealth quintiles. Absolute and relative inequalities were calculated and time trends were obtained by regression.

Nationally representative household surveys from twenty-five low- and middle-income countries.

Children <5 years of age.

National prevalence declined significantly in twenty-two of the twenty-five countries. In eighteen out of twenty-five countries, relative reductions were higher among the rich than among the poor. Overall, there was no indication that inequalities improved. Striking examples are Nepal, with a 17·0 percentage points decline in stunting per decade, but where inequalities increased sharply; and Brazil, where stunting fell by 6·7 percentage points and inequalities were all but eliminated.

Global progress in reducing stunting has not been accompanied by improved equity, but countries varied markedly in how successful they were in reducing prevalence among the poorest children. It is important to document how some countries were able to reduce inequalities, so that these lessons can be used to foster global progress, particularly in light of the increased importance of within-country inequalities in the post-2015 agenda.

To describe changes in total and central adiposity and body fat distribution in children over a 5-year period by investigating variations in BMI, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold thicknesses (SFT).

A school-based sample of children from 2nd to 5th grades of elementary schools participated in two cross-sectional studies in 2002 (n 2936) and 2007 (n 1232).

Public and private schools of Florianopolis, Brazil.

Schoolchildren aged 7–10 years had their weight, height, WC and SFT measured according to standard procedures. Body fat distribution was assessed by triceps, subscapular, suprailiac and medial calf skinfold measurements. Changes in BMI, WC, WHtR and SFT were analysed, adjusting for type of school and monthly family income.

Adjusted mean differences between 2002 and 2007 for BMI and WC were always positive and of similar magnitude between boys and girls. However, a statistically significant increase was observed only for BMI (raw and Z-score values) in boys. WHtR remained stable in both sexes. Adjusted median values for SFT also increased in boys and girls, except for triceps skinfold. BMI, WC and SFT tended to increase across age classes in both sexes. The relative change observed for the median central skinfolds (subscapular and suprailiac) was greater than that of peripheral skinfolds (triceps and medial calf).

The subcutaneous adipose tissue (SFT) appeared to increase at a faster rate than total adiposity (BMI). The increase in central SFT indicates that the relative change is due primarily to a rise in central adiposity.

Weight self-perceptions, or how a person perceives his/her weight status, may affect weight outcomes. We use nationally representative data from 1988–1994 and 1999–2008 to examine racial/ethnic disparities in weight self-perceptions and understand how disparities have changed over time.

Using data from two time periods, 1988–1994 and 1999–2008, we calculated descriptive statistics, multivariate logistic regression models and predicted probabilities to examine trends in weight self-perceptions among Whites, Blacks, US-born Mexican Americans and Mexican immigrants to the USA.

National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and continuous NHANES (1999–2008).

Adult NHANES participants aged 18 years and older (n 37 050).

The likelihood of self-classifying as overweight declined between 1988–1994 and 1999–2008 among all US adults, despite significant increases in mean BMI and overweight prevalence. Trends in weight self-perceptions varied by gender and between racial/ethnic groups. Whites in both time periods were more likely than racial/ethnic minorities to perceive themselves as overweight. After adjustment for other factors, disparities in weight self-perceptions between Whites and Blacks of both genders grew between survey periods (P<0·05), but differences between overweight White women and Mexican immigrants decreased (P<0·05).

Weight self-perceptions have changed during the obesity epidemic in the USA, but changes have not been consistent across racial/ethnic groups. Secular declines in the likelihood of self-classifying as overweight, particularly among Blacks, are troubling because weight self-perceptions may affect weight-loss efforts and obesity outcomes.

The present research was an experimental test that aimed to quantify the impact of two dominant front-of-pack (FOP) nutritional label formats on consumer evaluations of food products that carried them. The two FOP label types tested were the traffic light label and the Percentage Daily Intake.

A 4×5 partially replicated Latin square design was used that allowed the impact of the FOP labels to be isolated from the effects of the product and the consumers who were performing the evaluations.

The experiment was conducted on campus at the University of Otago, New Zealand.

The participants were 250 university students selected at random who met qualifying criteria of independent living and regular purchase of the products used in the research. They were not aware of the purpose of the research.

The presence of FOP labels led to significant and positive changes in consumer purchase intentions towards the products that carried them. These changes were not affected by the nature of FOP labels used, their size or the product nutritional status (good/bad) that they were reporting.

The result is consistent with the participants paying attention to the FOP label and then using it as an adimensional cue indicating product desirability. As such, it represents a complete functional failure of both of these FOP label types in this specific instance. This result supports calls for further research on the performance of these FOP labels before any move to compulsory deployment is made.

(i) To examine associations between young adults’ meal routines and practices (e.g. food preparation, meal skipping, eating on the run) and key dietary indicators (fruit/vegetable, fast-food and sugar-sweetened beverage intakes) and (ii) to develop indices of protective and risky meal practices most strongly associated with diet.

Cross-sectional survey.

Minneapolis/St. Paul metropolitan area, Minnesota (USA).

A diverse sample of community college and public university students (n 1013).

Meal routines and practices most strongly associated with healthy dietary patterns were related to home food preparation (i.e. preparing meals at home, preparing meals with vegetables) and meal regularity (i.e. routine consumption of evening meals and breakfast). In contrast, factors most strongly associated with poor dietary patterns included eating on the run, using media while eating and purchasing foods/beverages on campus. A Protective Factors Index, summing selected protective meal routines and practices, was positively associated with fruit/vegetable consumption and negatively associated with fast-food and sugar-sweetened beverage consumption (P<0·001). A Risky Factors Index yielded significant, positive associations with fast-food and sugar-sweetened beverage consumption (P<0·001). The probability test for the association between the Risky Factors Index and fruit/vegetable intake was P=0·05.

Meal routines and practices were significantly associated with young adults’ dietary patterns, suggesting that ways in which individuals structure mealtimes and contextual characteristics of eating likely influence food choice. Thus, in addition to considering specific food choices, it also may be important to consider the context of mealtimes in developing dietary messaging and guidelines.

To assess the association between breakfast energy and total daily energy intake among individuals with type 2 diabetes.

Cross-sectional study. Daily energy intake was computed from a 24 h dietary recall. Multiple regression models were used to estimate the association between daily energy intake (dependent variable) and quartiles of energy intake at breakfast (independent variable), expressed in either absolute or relative (percentage of total daily energy intake) terms. Orthogonal polynomial contrasts were used to test for linear and quadratic trends. Models were controlled for sex, age, race/ethnicity, BMI, physical activity and smoking. In addition, we used separate multiple regression models to test the effect of quartiles of absolute and relative breakfast energy on energy intake at lunch, dinner and snacks.

The 1999–2004 National Health and Nutrition Examination Survey (NHANES).

Participants aged ≥30 years with self-reported history of diabetes (n 1146).

Daily energy intake increased as absolute breakfast energy intake increased (linear trend, P<0·0001; quadratic trend, P=0·02), but decreased as relative breakfast energy intake increased (linear trend, P<0·0001). In addition, while higher quartiles of absolute breakfast intake had no associations with energy intake at subsequent meals, higher quartiles of relative breakfast intake were associated with lower energy intake during all subsequent meals and snacks (P<0·05).

Consuming a breakfast that provided less energy or comprised a greater proportion of daily energy intake was associated with lower total daily energy intake in adults with type 2 diabetes.

To examine demographic and behavioural correlates of unhealthy snack-food consumption among Australian secondary-school students and the association between their perceptions of availability, convenience and intake with consumption.

Cross-sectional survey of students’ eating, physical activity and sedentary behaviours using validated instruments administered via an online questionnaire.

Australian secondary schools across all states/territories.

Secondary-school students aged 12–17 years participating in the 2009–10 National Secondary Students’ Diet and Activity (NaSSDA) survey (n 12 188).

Approximately one in five students (21 %) reported consuming unhealthy snack foods ≥14 times/week (‘frequent snackers’). After adjusting for all covariates, older students and those with a BMI of ≥25 kg/m2 were less likely to be frequent snackers, while students who reported high fast-food and high sugar-sweetened beverage consumption and those who watched television for >2 h/d were more likely to snack frequently. Furthermore, after adjusting for all covariates and demographic factors, students who agreed that snack foods are usually available at home, convenient to buy and that they eat too many snack foods were more likely to be snacking frequently. Conversely, students who agreed that fruit is a convenient snack were less likely to be frequent snackers.

Frequent unhealthy snack-food consumption appears to cluster with other poor health behaviours. Perceptions of availability and convenience are factors most readily amenable to change, and findings suggest interventions should focus on decreasing the availability of unhealthy snack foods in the home and promoting healthier options such as fruit as convenient snacks.

Food neophobia has been associated with decreased consumption of vegetables mainly among children. We hypothesized that food neophobia in adults is also associated with lower overall dietary quality and higher BMI.

Data for the present cross-sectional analyses were derived from parents in a follow-up family study.

The STEPS study, a longitudinal study of health and development of a cohort of children born in south-west Finland.

The parents, 1178 women (age 19–45 years, mean 32·2 years) and 1013 men (age 18–57 years, mean 34·1 years), completed a questionnaire at home when their child was 13 months old. The questionnaire included the Food Neophobia Scale (FNS; range 10–70), the Index of Diet Quality (IDQ; range 0–16) and a measure of fruit and vegetable consumption. At that time the participants’ height and weight were also measured by a research nurse to calculate BMI.

Compared with the food neophilics (FNS score 10–24), the food neophobics (FNS score 40–70) consumed fewer vegetables (women: 15 v. 10 portions/week; men: 13 v. 7 portions/week), scored lower on the IDQ (women: 9·7 v. 8·5; men: 8·8 v. 7·8) and had higher BMI (women: 24·2 v. 26·0 kg/m2; men: 26·5 v. 27·5 kg/m2) as tested by one-way ANOVA, with all P values <0·001 in women and <0·05 in men. The food neophobics followed a diet lower in nutritional quality than did the food neophilics, especially regarding vegetables.

Food neophobia may complicate adaptation to dietary recommendations and predispose to overweight.

To determine the association of gestational weight gain (GWG) or pre-pregnancy BMI with postpartum weight retention (PPWR).

Meta-analysis.

PubMed, Cochrane Controlled Trials Register, EMBASE, Science Citation Index Expanded, Current Contents Connects and Biosis Previews were used to search articles.

Publications that described the influence of pre-pregnancy BMI or GWG on PPWR.

Seventeen studies that satisfied the eligibility criteria were included in the analyses. Women with inadequate and excessive GWG had significantly lower mean PPWR of −2·14 kg (95 % CI –2·43, –1·85 kg) and higher PPWR of 3·21 kg (95 % CI 2·79, 3·62 kg), respectively, than women with adequate GWG. When postpartum time spans were stratified into 1–3 months, 3–6 months, 6–12 months, 12–36 months and ≥15 years, the association between inadequate GWG and PPWR faded over time and became insignificant (−1·42 kg; 95 % CI −3·08, 0·24 kg) after ≥15 years. However, PPWR in women with excess GWG exhibited a U-shaped trend; that is, a decline during the early postpartum time span (year 1) and then an increase in the following period. Meta-analysis of qualitative studies showed a significant relationship between excessive GWG and higher PPWR risk (OR=2·08; 95 % CI 1·60, 2·70). Moreover, meta-analysis of pre-pregnancy BMI on PPWR indicated that mean PPWR decreased with increasing BMI group.

These findings suggest that GWG, rather than pre-pregnancy BMI, determines the shorter- or longer-term PPWR.

To investigate the magnitude and country-specific differences in underestimation of children’s weight status by children and their parents in Europe and to further explore its associations with family characteristics and sociodemographic factors.

Children’s weight and height were objectively measured. Parental anthropometric and sociodemographic data were self-reported. Children and their parents were asked to comment on children’s weight status based on five-point Likert-type scales, ranging from ‘I am much too thin’ to ‘I am much too fat’ (children) and ‘My child’s weight is way too little’ to ‘My child’s weight is way too much’ (parents). These data were combined with children’s actual weight status, in order to assess underestimation of children’s weight status by children themselves and by their parents, respectively. Chi-square tests and multilevel logistic regression analyses were conducted to examine the aims of the current study.

Eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.

A school-based survey among 6113 children aged 10–12 years and their parents.

In the total sample, 42·9 % of overweight/obese children and 27·6 % of parents of overweight/obese children underestimated their and their children’s weight status, respectively. A higher likelihood for this underestimation of weight status by children and their parents was observed in Eastern and Southern compared with Central/Northern countries. Overweight or obese parents (OR=1·81; 95 % CI 1·39, 2·35 and OR=1·78, 95 % CI 1·22, 2·60), parents of boys (OR=1·32; 95 % CI 1·05, 1·67) and children from overweight/obese (OR=1·60; 95 % CI 1·29, 1·98 and OR=1·76; 95 % CI 1·29, 2·41) or unemployed parents (OR=1·53; 95 % CI 1·22, 1·92) were more likely to underestimate children’s weight status.

Children of overweight or obese parents, those from Eastern and Southern Europe, boys, younger children and children with unemployed parents were more likely to underestimate their actual weight status. Overweight or obese parents and parents of boys were more likely to underestimate the actual weight status of their children. In obesity prevention such underestimation may be a barrier for behavioural change.

Acculturation to the UK diet may contribute to the increased burden of non-communicable diseases in Black British communities. The present study aimed to assess nutritional composition and the contribution that traditional foods make to dietary intake in a group of UK-residing Caribbean and West African adults and to explore differences according to ethnicity and duration of residence.

Observational study. Dietary intake was assessed using multiple, standardised triple-pass 24 h recalls and analysed using a nutritional composition database. Associations between sociodemographic variables and duration of residence with dietary intake were assessed using ANCOVA.

London, UK, October 2011–December 2012.

UK adults of Caribbean (n 50) or West African (n 83) ancestry, aged 18–75 years.

The Caribbean participants were older and more likely to be born in the UK. After adjusting for age, sex and ethnicity, those who had been resident in the UK for the longest duration had significantly higher intakes of energy (P<0·001), fat (P=0·002) and Na (P=0·03). The West African participants sourced significantly more energy (P=0·04), fat (P=0·02), saturated fat (P=0·02) and Na (P=0·001) from traditional cultural foods compared with the Caribbean diet, which was more reliant on ‘Westernised’ foods such as sugar-sweetened beverages.

These results are novel in demonstrating dietary acculturation in UK adults of Caribbean and West African ancestry. We have provided detailed data regarding the role of traditional foods, presenting dietary information that may guide in individualising care for patients from these communities and improve the cultural sensitivity of public health strategies.

To evaluate the prevalence of vitamin B12 deficiency and factors associated with vitamin B12 status in Amazonian children.

Genetic risk score (GRS), socio-economic and nutritional status, and morbidity data were the independent variables used in multiple linear regression models to evaluate factors associated with vitamin B12 status in a population-based cross-sectional study. GRS was created by summing a number of known risk alleles for low serum vitamin B12.

Acrelândia, western Brazilian Amazon.

Children (n 988) aged <10 years.

Overall prevalence of vitamin B12 deficiency (<150 pmol/l) was 4·2 (95 % CI 3·0, 5·6) % and was highest in children aged <24 months: 13·6 (95 % CI % 8·8, 19·7) %. For children <24 months, wealth index (β=0·017, P=0·030) and animal protein intake (β=0·219, P=0·003) were positively associated with vitamin B12 status. GRS (β=−0·114, P<0·001) and serum homocysteine (β=–0·049, P<0·001) were negatively associated. Among children aged ≥24 months, vitamin B12 status was positively associated with wealth index (β=0·012, P<0·001), height-for-age Z-score (β=0·024, P=0·033) and serum vitamin A (β=0·089, P<0·001). Age≥60 months (β=–0·118, P<0·001), GRS (β=–0·048, P<0·001), maternal schooling <5 years (β=–0·083, P<0·001), low intake of animal-derived foods (β=–0·050, P=0·030), serum homocysteine (β=–0·053, P<0·001), serum folate ≥23·6 nmol/l (β=–0·055, P=0·012) and geohelminth infection (β=–0·141, P=0·017) were negatively associated with vitamin B12 status.

GRS, poverty, low intake of animal-derived foods, geohelminth infection, vitamin A and folate status were important factors associated with vitamin B12 status of children in our study.

To examine the vitamin D status, SNP of the vitamin D receptor gene (VDR) and the effects of vitamin D supplementation on parathyroid hormone and insulin secretion in adult males with obesity or normal weight in a subtropical Chinese city.

An intervention trial.

Shenzhen City, Guangdong Province, China.

From a cross-sectional survey conducted from June to July, eighty-two normal-weight and ninety-nine obese males (18–69 years) were screened to analyse their vitamin D status and for five SNP of VDR. From these individuals, in the same season of a different year, obese and normal-weight male volunteers (twenty-one per group) were included for an intervention trial with oral vitamin D supplementation at 1250 µg/week for 8 weeks.

For the survey, there was no significant difference (P>0·05) in baseline circulating 25-hydroxyvitamin D concentrations or in the percentages of participants in different categories of vitamin D status between the two groups. The VDR SNP, rs3782905, was significantly associated with obesity (P=0·043), but none of the examined SNP were correlated with serum 25-hydroxyvitamin D when adjusted for age, BMI and study group. After vitamin D supplementation, serum 25-hydroxyvitamin D concentration, hypersecretions of parathyroid hormone and insulin, and insulin resistance in the obese were changed beneficially (P<0·05); however, the increase in serum 25-hydroxyvitamin D was less than that of the normal-weight men.

For obese and normal-weight men of subtropical China, the summer baseline vitamin D status was similar. However, oral vitamin D supplementation revealed a decreased bioavailability of vitamin D in obese men and ameliorated their hypersecretion of parathyroid hormone and insulin resistance.

To provide a richer understanding of food access and purchasing practices among US urban food desert residents and their association with diet and BMI.

Data on food purchasing practices, dietary intake, height and weight from the primary food shopper in randomly selected households (n 1372) were collected. Audits of all neighbourhood food stores (n 24) and the most-frequented stores outside the neighbourhood (n 16) were conducted. Aspects of food access and purchasing practices and relationships among them were examined and tests of their associations with dietary quality and BMI were conducted.

Two low-income, predominantly African-American neighbourhoods with limited access to healthy food in Pittsburgh, PA, USA.

Household food shoppers.

Only one neighbourhood outlet sold fresh produce; nearly all respondents did major food shopping outside the neighbourhood. Although the nearest full-service supermarket was an average of 2·6 km from their home, respondents shopped an average of 6·0 km from home. The average trip was by car, took approximately 2 h for the round trip, and occurred two to four times per month. Respondents spent approximately $US 37 per person per week on food. Those who made longer trips had access to cars, shopped less often and spent less money per person. Those who travelled further when they shopped had higher BMI, but most residents already shopped where healthy foods were available, and physical distance from full-service supermarkets was unrelated to weight or dietary quality.

Improved access to healthy foods is the target of current policies meant to improve health. However, distance to the closest supermarket might not be as important as previously thought, and thus policy and interventions that focus merely on improving access may not be effective.

To assess the effect of the Dutch school-based education programme ‘Taste Lessons’ on children’s behavioural determinants towards tasting unfamiliar foods and eating healthy and a variety of foods.

In a quasi-experimental study design, data on behavioural determinants were collected at baseline, four weeks and six months after the intervention in both the intervention and control group. Children completed consecutively three questionnaires in which knowledge, awareness, skills, attitude, emotion, subjective norm and intention towards the two target behaviours were assessed. Teachers implemented on average a third of the programme activities. Multilevel regression analyses were conducted to compare individual changes in the determinants in the intervention group with those in the control group, corrected for children’s gender and age. Effect sizes were expressed as Cohen’s d.

Dutch elementary schools.

Forty-nine classes (1183 children, 9–12 years old) in grades 5–8 of twenty-one elementary schools.

The intervention group showed a higher increase in knowledge (d=0·26, P<0·01), which persisted after six months (d=0·23, P<0·05). After four weeks, the intervention group showed a higher increase in number of foods known (d=0·22, P<0·05) and tasted (d=0·21, P<0·05), subjective norm of the teacher (d=0·17, P<0·05) and intention (d=0·16, P<0·05) towards the target behaviours.

Partial implementation of Taste Lessons during one school year showed small short-term effects on increasing behavioural determinants in relation to tasting unfamiliar foods and eating healthy and a variety of foods. Full and repeated implementation of Taste Lessons in subsequent years might result in larger effects.

Performing and publishing mediator analyses, whether significant or null, provides insight into where research efforts should focus and will assist in developing effective and powerful behaviour change interventions. The present study examined whether self-efficacy, social support and church support mediated changes in leisure-time physical activity (PA) and fruit and vegetable (F&V) consumption in a faith-based intervention.

A 15-month PA and F&V intervention, guided by the structural ecological model, targeted the social, cultural and policy influences within the church. Outcomes and mediators were measured at baseline and follow-up. Data were collected from 2007 to 2011. MacKinnon’s product of coefficients tested for mediation.

Sixty-eight African Methodist Episcopal churches in South Carolina, USA.

Five hundred and eighty-two (PA) and 588 (F&V) church members.

Despite the significant increases in PA and F&V consumption, none of the hypothesized mediators were significant mediators of change in PA or F&V consumption. When examining each path of the mediation model, the intervention did not change any of the hypothesized mediators. However, changes in some mediators were associated with changes in outcomes.

Although there was no significant mediation, the association between changes in mediators and changes in PA and/or F&V consumption suggest that these variables likely play some role in changing these behaviours. Future studies should consider mediation analyses a priori, putting careful thought into the types of measures used and the timing of those measures, while also being cognizant of participant and staff burden. Finding a balance will be fundamental in successfully understanding how interventions exert their effects.

To assess agreement among three nutrient profiling systems used to evaluate the healthfulness of vending machine products in recreation and sport settings in three Canadian provinces. We also assessed whether the nutritional profile of vending machine items in recreation and sport facilities that were adhering to nutrition guidelines (implementers) was superior to that of facilities that were not (non-implementers).

Trained research assistants audited the contents of vending machines. Three provincial nutrient profiling systems were used to classify items into each province’s most, moderately and least healthy categories. Agreement among systems was assessed using weighted κ statistics. ANOVA assessed whether the average nutritional profile of vending machine items differed according to province and guideline implementation status.

Eighteen recreation and sport facilities in three Canadian provinces. One-half of facilities were implementing nutrition guidelines.

Snacks (n 531) and beverages (n 618) within thirty-six vending machines were audited.

Overall, the systems agreed that the majority of items belonged within their respective least healthy categories (66–69 %) and that few belonged within their most healthy categories (14–22 %). Agreement among profiling systems was moderate to good, with κw values ranging from 0·49 to 0·69. Implementers offered fewer of the least healthy items (P<0·05) and these items had a better nutritional profile compared with items in non-implementing facilities.

The policy outcomes of the three systems are likely to be similar, suggesting there may be scope to harmonize nutrient profiling systems at a national level to avoid unnecessary duplication and support food reformulation by industry.

To examine the characteristics of supporters and opponents of a sugar-sweetened beverage (SSB) tax and to identify pro-tax messages that resonate with the public.

A survey was administered by telephone in February 2013 to assess public opinion about a penny-per-ounce tax on SSB. Support was also examined for SSB consumption reduction and pro-tax messages. Individual characteristics including sociodemographics, political affiliation, SSB consumption behaviours and beliefs were explored as predictors of support using logistic regression.

A representative sample of voters was recruited from a Mid-Atlantic US state.

The sample included 1000 registered voters.

Findings indicate considerable support (50 %) for an SSB tax. Support was stronger among Democrats, those who believe SSB are a major cause of childhood obesity and those who believe childhood obesity warrants a societal intervention. Belief that a tax would be effective in lowering obesity rates was associated with support for the tax and pro-tax messages. Respondents reporting that a health-care provider had recommended they lose weight were less convinced by pro-tax messages. Women, Independents and those concerned about childhood obesity were more convinced by the SSB reduction messages. Overall, the most popular messages focused on the importance of reducing consumption among children without mentioning the tax.

Understanding who supports and opposes SSB tax measures can assist advocates in developing strategies to maximize support for this type of intervention. Messages that focus on the effect of consumption on children may be useful in framing the discussion around SSB tax proposals.

To examine women’s experience of professional support for breast-feeding and health-care professionals’ experience of providing support.

We conducted semi-structured qualitative interviews among women with experience of breast-feeding and health-care professionals with infant feeding roles. Interviews with women were designed to explore their experience of support for breast-feeding antenatally, in hospital and postnatally. Interviews with health-care professionals were designed to explore their views on their role and experience in providing breast-feeding support. Interview transcripts were analysed using content analysis and aspects of Grounded Theory. Overarching themes and categories within the two sets were identified.

Urban and suburban areas of North Dublin, Ireland.

Twenty-two women all of whom had experience of breast-feeding and fifty-eight health-care professionals.

Two overarching themes emerged and in each of these a number of categories were developed: theme 1, facilitators to breast-feeding support, within which being facilitated to breast-feed, having the right person at the right time, being discerning and breast-feeding support groups were discussed; and theme 2, barriers to breast-feeding support, within which time, conflicting information, medicalisation of breast-feeding and the role of health-care professionals in providing support for breast-feeding were discussed.

Breast-feeding is being placed within a medical model of care in Ireland which is dependent on health-care professionals. There is a need for training around breast-feeding for all health-care professionals; however, they are limited in their support due to external barriers such as lack of time. Alternative support such as peer support workers should be provided.