What are parents’ perceptions and experiences of help-seeking for common infant symptoms? A qualitative interview study.

Problem

Parents commonly report infant symptoms such as excessive crying and vomiting. Although usually a normal infant behaviour, symptoms can cause parental distress and are often mislabelled as milk allergy or reflux. Mislabelling can lead to feeding changes (e.g., early breastfeeding cessation, dietary exclusion) and inappropriate specialist formula prescription and reflux medications. These are linked to a range of harms including risk of tooth decay, obesity, medication side effects and significant NHS cost. Previous infant crying research highlighted the emotional impact on parents, coping strategies, and the influence of parental uncertainty on diagnosis seeking. Further research is needed to explore parents’ help-seeking for common infant symptoms, including their experiences with health professionals.

This study aimed to explore parents’ perceptions and experiences of help-seeking for common infant symptoms.

Approach

Remote semi-structured qualitative interviews with parents of babies (age <12 months) who had experienced common infant symptoms (such as excessive crying, vomiting, rash and/or stool changes) in their first 4 months of life. Recruitment occurred via social media, GP practice database search and mail out (to parents of babies <12 months old), and opportunistic recruitment in GP practices and health visiting teams. Interviews were transcribed verbatim and analysed using reflexive thematic analysis.

Findings

25 interviews were conducted. Participants were female, aged 24-39 years and from diverse backgrounds. Their infants ranged from 6 weeks to 11 months old. Five main themes were developed. Parents often feel desperate and seek help due to ‘The need for answers’ about suspected underlying causes of symptoms, and uncertainty about what baby behaviours are ‘normal’. ‘The importance of health professionals’, for example different health professional roles and access to support, was highlighted. Often it was important to consult a primary care professional to make sense of symptoms or for management support. Often parents perceived access negatively, or felt their concerns were dismissed. ‘Experiencing health professional advice’ suggested that parents perceive and experience advice differently. Pharmacological and non-pharmacological strategies, testing/diagnosis, and normalisation were discussed, with mixed opinions about advice and health professional communication, depending on different situations. Perceptions of advice/support appeared to impact further help-seeking (e.g., seeking other opinions) and their perceptions and management of symptoms. ‘The role of social support’ and ‘searching online’ appeared a foundation to help-seeking, for validation of experiences and practical support from parents in similar situations.

Consequences

Many parents need support to manage infant symptoms and reduce uncertainties about ‘normality’ and possible underlying causes. Appropriate advice and support about management and when further intervention is required may help reduce over-medicalisation. Findings will inform future development of an online intervention to support families (and professionals) managing symptoms.