IFIAT, IIFAS and demographic data

Bias on the part of healthcare professionals (HCPs), both implicit as well as explicit, can influence mothers’ infant
feeding choices, potentially impacting the health and well-being of both mothers and babies. Understanding and
addressing such bias in advice given by HCPs is crucial to ensure mothers receive evidence-based guidance and
support for their infant feeding decisions. The present study investigated infant feeding bias among HCPs working
across the UK and Ireland (n=66) using an online cross-sectional survey design, consisting of three parts. The first part
collected demographic information, the second measured implicit bias using the Infant Feeding Implicit Association
Test (IFIAT) and the third used the Iowa Infant Feeding Attitude Scale (IIFAS) to measure explicit attitudes regarding
infant feeding. Implicit attitudes, as measured by the IFIAT D-scores, ranged from -0.88 to 0.46, indicating a general
implicit bias in favour of breastfeeding or against bottle feeding. Explicit attitudes, measured by the IIFAS, were generally
positive, with scores ranging from 52 to 85. No significant correlation was found between implicit and explicit attitudes,
suggesting they may operate independently (r = −0.054, p > 0.05). HCPs of older age (r = 0.252, p < 0.05) and
those currently breastfeeding or pregnant (r = −0.293, p < 0.05) exhibited pro-breastfeeding attitudes. This marks
the first use of the IFIAT to assess implicit bias specifically among HCPs. Addressing both implicit and explicit biases in
healthcare care training is crucial to optimising breastfeeding support. Future research should investigate the underlying
mechanisms and the impact of these biases on actual breastfeeding practices.