Cultural beliefs and thermal care of infants Protecting South Asian and white British infants in Bradford from heat and cold

Abstract Maintaining an adequate body temperature is essential for human survival, yet infants are born with significant thermal challenges. Thermoregulation of infants is achieved through both physiological processes and through the thermal care behaviour of their caregivers. Little attention has been paid to infant thermal care beliefs and how thermal care is provided in practice. Thermal care beliefs vary across the world. Humoral beliefs that prescribe thermal balance to maintain health are extremely common globally, but less so in the UK.

Methods This study primarily employed a mixed methods approach, using semi-structured and structured questions in interviews to explore ethnic differences in infant thermal care beliefs and practices of white British and South Asian mothers in the Bradford District, West Yorkshire, England.

Results White British mothers were found to use significantly more bedding in winter for their infants than South Asian mothers (Man Whitney U p=<0.001). White British and South Asian infants were found to sleep in different environmental conditions. Mothers used several physical and behavioural cues to identify thermal stress in their infants and reported 24 different infant health problems caused by heat stress and 21 by cold stress. White British mothers were significantly more likely to be concerned about their infant getting too hot than too cold and South Asian mothers about both (Pearson Chi squared p=<0.001).

Conclusions This thesis has demonstrated that thermoregulation of infants is achieved through internal physiological processes but also cannot be removed from the thermal care behaviour and beliefs of their caregivers. By exploring health beliefs and practices in other cultures, bias in the choice and focus of clinical research in the UK can be understood and addressed.

Implications This thesis provides evidence to inform future directions for research, and policy on infant thermal care and manufacture of infant bedding in the UK