Parents’ experiences of health literacy and parenting infants at home: a qualitative systematic review

OBJECTIVE: This review aimed to identify and synthesize available qualitative evidence on parents' experiences of health literacy in parenting infants at home. INTRODUCTION: Parental health literacy is important for parents' and infants' quality of life, yet many parents struggle to access, understand, appraise, and apply childcare information at home. ELIGIBILITY CRITERIA: This review included qualitative studies conducted in Organisation for Economic Co-operation and Development member countries exploring parents' health literacy experiences in parenting infants at home. METHODS: MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), ProQuest Health and Medical Collection (in English and Japanese), Open Access Theses and Dissertations (in English), Ichushi-Web, CiNii, and the Institutional Repositories Database (in Japanese) were searched in March 2024. Studies published in English or Japanese between 1998 and 2024 were included. Two independent reviewers conducted study selection, data extraction, and quality appraisal. Data were synthesized using the JBI meta-aggregation approach. Synthesized findings were assessed using the ConQual approach. RESULTS: Six qualitative studies involving 119 participants yielded 72 findings, which were aggregated into 19 categories and further into 5 synthesized findings: i) Parents of infants connect with others in-person or online to share knowledge and parenting experiences and to provide and receive reassurance. Some parents distrust anonymous online spaces and manage their exposure to avoid discomfort, while also considering others' backgrounds and personal characteristics when building supportive, reliable online networks. Socially isolated parents tend to depend only on online search information; ii) Parents of infants seek approachable, friendly, and collaborative relationships with community health professionals for timely guidance and clarification on infant care. Clear explanations and feeling understood support shared decision-making, whereas negative professional responses can reduce parents' participation and confidence; iii) Initially, parents of infants have limited knowledge, skills, and confidence, and they may accept information without critical evaluation. Gradually, they develop infant-care skills and become better at assessing their baby's condition through navigating conflicting sources, identifying what is most relevant to their needs, and applying it in problem-solving. Ultimately, their confidence grows as they come to trust their knowledge, skills, and parental intuition; iv) Parents of infants often seek reassurance that their baby's health and development are "normal," even without a clear understanding of what the term means. Reassurance may grow as parents understand their baby's natural state, behaviors, and developmental processes, helping them recognize and accept their child's unique patterns; v) Parents of infants appraise and apply health-related information and advice when making parenting decisions, aiming to harmonize infant caregiving with their own values. Informed by these appraisals and observations of their own and their infants' responses when applying this information in everyday care, they iteratively adjust caregiving practices over time to sustain and enhance parents' and infants' health and comfort in daily life. CONCLUSIONS: Parents develop infant-care-specific health literacy over time through peer support, collaborative relationships with health professionals, and everyday caregiving experiences, which may support both parents' and infants' health and quality of life. REVIEW REGISTRATION: PROSPERO CRD42022345187.