Reasons for Prolonged Bottle-Feeding and Iron Deficiency Among Mexican-American Toddlers: An Ethnographic Study

Jane M. Brotanek, Damon Schroer, Lee Valentyn, Sandy Tomany-Korman, Glenn Flores

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective: Several studies have shown that prolonged bottle-feeding is associated with iron deficiency. Mexican-American toddlers are the racial/ethnic group at greatest risk for prolonged bottle-feeding and iron deficiency, yet no studies have examined reasons for prolonged bottle-feeding in Mexican-American toddlers. The objective of this study was to assess infant feeding beliefs, knowledge, and behaviors among Mexican-American parents. Methods: Ethnographic interviews were conducted of parents of Mexican-American toddlers 15 to 48 months old at 3 community sites. A 31-question moderator's guide addressed 4 domains: knowledge and cultural beliefs; sources of nutritional information; anticipatory guidance; and suggestions for ways to change infant feeding practices. Interviews were audiotaped, transcribed, and analyzed using grounded theory. Results: Thirty-nine parents were interviewed; the mean parental age was 29 years, and mean child age, 2.2 years. Parents cited convenience as a reason for prolonged bottle-feeding, and believed that they should give toddlers as much milk as they want. Many parents lacked essential knowledge regarding infant feeding practices and iron deficiency, including when to stop bottle-feeding, health problems caused by prolonged bottle-feeding, the quantity of milk to give a child >1 year old, and iron deficiency as a complication of prolonged bottle-feeding. Parents reported not receiving enough education from physicians, and they supported educational interventions on healthy infant feeding practices, including refrigerator magnet charts, videos, brochures, and teaching by physicians. Conclusions: Parents of Mexican-American toddlers often are unaware of the adverse consequences of prolonged bottle-feeding and developmental problems associated with iron deficiency. Parents supported educational interventions, including videos, brochures, and refrigerator magnet charts on healthy infant feeding practices.

Original languageEnglish (US)
Pages (from-to)17-25
Number of pages9
JournalAcademic Pediatrics
Issue number1
StatePublished - Jan 2009


  • Hispanic Americans
  • disparities
  • early childhood
  • iron deficiency
  • nutrition
  • racial/ethnic minorities

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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