Oswald Külpe

The main participant in the HKP was the infant’s mother. She identified as being from the New Zealand European ethnic group. The main language spoken within the home was English. Prior to being on maternity leave this mother worked as a physiotherapist. Her first child was a typically developing four-month-old female. The mother and her infant attended all six of the HKP intervention sessions. Sessions generally lasted for around 60 minutes. The intervention sessions were all carried out within the family’s home based in suburban Auckland. These home visits did not experience any disturbances or significant interruptions.

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As seen in Table 8 this mother demonstrated a slight decrease in her total score response on the IFSQ from 320 (80%) to 313 (78.25%). She had significant changes in responses to 10 questions (Question 14, 19, 35, 37, 52, 61, 75, 77, 79 & 81) on the IFSQ. Her responses changed from slightly agreeing with the statements in the pre-test ‘I make sure my child does not eat junk food like potato chips’, ‘A toddler should never eat fast food’ and ‘I allow my child to drink sugared drinks/fizzy drinks to keep him/her happy’ to disagreeing with the same statements in the post-test. She also had significant changes in their response to the statement ‘The best way to make an infant stop crying is to feed him/her’ which was agreed with in the pre-test and disagreed with in the post-test.

4.5.3. Maternal Knowledge Scale

As seen in Figure 3 above this mother demonstrated no change in their total score on the MKS from pre-test to post-test. They scored 53 (81%) the assessment both times. Their responses to 5 out of the 13 questions did change. However, this participant tended gave more neutral (3) responses in the post-test than the pre-test.

4.5.4. Responsiveness to Infant Feeding Cues Scale Mother

The mother and infant were evenly paced in terms of feeding rate in both the pre- and post-programme videos. The mother was fairly attentive to her infant’s receptiveness to feeding cues in the pre-programme videos and somewhat attentive in the post-programme video. She demonstrated a positive affect in the pre-programme video and a balanced affect in the post-programme video. She appeared fairly relaxed during both mealtime videos. She was predominately positively expressive in her facial expressions, body language and communication with her infant during the videos.

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The infant was observed to demonstrate a balanced affect in both the pre and post programme videos. The infant was fairly engaged in the pre-programme feeding video. The infant was somewhat engaged in the post-programme feeding video, she was unsettled due to her coughing throughout the feed. The infant was fairly relaxed in the pre-programme video and somewhat relaxed in the post-programme video.

The infant was moderately receptive to feeding in the pre-programme and post- programme feeding videos. She was breast fed by her mother in both videos. It is important to note that the infant had a cold and was coughing throughout the post-programme video.

4.5.5. Semi-structured interview Personal Factors

In the interview this mother spoke about a change she decided to make based on some of the information shared in the first two sessions of the HKP. She reported that

“I was going to start solids with my baby at four months but then when the researcher came over and explained all the pros and cons [of starting complementary foods before six months] I decided to stick it out until, I was trying to stick it out to six months but at five months I started”

This participant initially spoke about wanting to start giving her infant complementary foods before starting the HKP when her infant was four months old. After participating in the HKP sessions which discussed the current WHO organisation recommendations and the rationale behind these recommendations this mother changed her mind regarding when she would start introducing complementary foods to her infant. This participant also reported that people in her social networks and personal beliefs contributed to her wanting to wait before introducing complementary foods to her infant.

This mother reported during the first HKP programme session feeling as though she had no idea where to start with solids, she was not sure what to give, or how much to give her infant. During the semi-structured interview after the completion of the interview she reported

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“I have a lot more confidence in starting solids I guess when it came to it”. She acknowledged that the HKP was only one of her sources of information regarding the introduction of complementary foods “I would say really prepared because of that and then Plunket as well and I had a niece that was just starting solids as well, so I was pretty prepared”. This mother reported feeling as though the HKP was a nice simple introduction to reading her baby’s cues and how to prepare complementary foods to give to them. It was one of multiple sources that she used to gain information regarding the introduction of complementary foods to infants. It contributed to her feeling more prepared and confident to introduce complementary foods to her infant.

Social Factors

This mother utilised a range of sources of information to form her infant feeding decisions including the HKP, family members and people in her social networks

“I have a coffee and we have discussed solids and feeding at that. Family as well I chatted with my parents about what they did and kind of compared what they have done with what the researcher was saying with the programme and then made my own decisions about what I was going to do for my child”

Environmental Factors

This mother reported she found the practical activities included within the HKP most enjoyable and beneficial. She stated that:

“I actually really enjoyed the first or second appointment. Where (the researcher) got out a whole lot of baby rice and we mixed it up, for the consistency. Which was good to start with. It was different to what I imagined. And also same with the banana”

She later reflected she was able to generalise some of the learning from these practical activities into her daily life when starting her infant on complementary foods. She reported “I just went and got some spoons and started with mashed banana because (the researcher)

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showed me”. This mother was able to use the skills she learnt in one of the practical activities in the HKP in real life after the completion of the HKP.

This mother also mentioned that having the intervention sessions being run in her own home made the HKP easy to access. She reflected that “it was very easy. The researcher came to me so it was really easy”. One suggestion made by this mother was that she felt the HKP could be successful completed within a small group setting. She proposed “it (the HKP) could be quite good to do it in small groups, I would say as opposed to individually”.

This mother also reflected that she felt the HKP was lengthy and wondered if it could be condensed. She reflected

“I found six weeks quite a long time for it as well and there was a lot of information which was good but it might have been able to be shorter in some ways. I don’t know if that would be like one session or maybe not six appointments but do it in four appointments”

4.5.6. Summary

This mother had the same total score in the pre and post-test improvements in the MKS. Her total score response in the IFSQ following the competition of the HKP decreased by 1.75%. However, despite these quantitative results the mother reflected that she found the HKP beneficial and was able to identify some behaviour she decided to make based on the information provided in the HKP. She was reportedly well supported by her family and friendship networks throughout her involvement in the HKP. She most enjoyed the practical activities included in the HKP and was able to generalise these tasks into her daily life after the completion of the intervention. She reported the biggest change for her after doing the HKP was delaying her decision regarding when to start giving he infant complementary foods. She reported feeling more confident to introduce complementary foods to her infant after participating in the HKP.

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4.6. Across Case Summary