Table 3.

Main content of the mainstream and culturally adapted Healthy Beginnings program

Timing and key content areas / Behaviour targets	Main content
	Mainstream Healthy Beginnings program [36]	Culturally adapted Healthy Beginnings – Arabic speaking migrant mothers	Culturally adapted Healthy Beginnings – Chinese speaking migrant mothers
Antenatal (third trimester) Sustaining breastfeeding / best-practice formula feeding	▪ Breastfeeding guidelines ▪ Health benefits of breastfeeding and strategies to overcome barriers associated with breastfeeding	▪ Breastfeeding guidelines. Reinforce with support of community ▪ Benefits of breastfeeding and colostrum; Breastmilk production in first weeks. ▪ Family and social support ▪ Information about accessing free health services and interpreters	▪ Breastfeeding guidelines. ▪ Benefits of breastfeeding and colostrum; Breastmilk production in first weeks; address concerns of not enough breastmilk for baby. ▪ Family and social support ▪ Information about accessing free health services and interpreters
0–2 months Sustaining breastfeeding / best-practice formula Timing of solid food introduction Promote active play ‘Tummy time’ Response to child cues: hunger, satiety	▪ Rapid response to women with problems initiating breastfeeding after childbirth, especially women who delivered by caesarean section ▪ Advice on establishment of breastfeeding pattern ▪ Management of feeding problems ▪ Infant feeding cues ▪ Baby feed, play, sleep cycle ▪ ‘tummy time’ for babies	▪ Rapid response to women with problems initiating breastfeeding ▪ Advice on establishment of breastfeeding pattern ▪ Management of problems ▪ Reinforce no other fluids or foods needed until around 6 months (e.g. formula and water) ▪ Infant feeding cues ▪ ‘tummy time’ for babies; with increased information about what, why and how ▪ Baby feed, play, sleep cycle; infant crying is normal. ▪ Family and social support; sharing care with fathers and family, and emotional support ▪ Information about accessing free health services and interpreters	▪ Rapid response to women with problems initiating breastfeeding ▪ Advice on establishment of breastfeeding pattern ▪ Management of problems – addressing any concerns of milk quality and/or quantity. ▪ Reinforce no other fluids or foods needed until around 6 months (e.g. formula and water) ▪ Infant feeding cues ▪ ‘tummy time’ for babies; with increased information about what, why and how. ▪ Baby feed, play, sleep cycle; infant crying is normal. ▪ Family and social support; sharing care with fathers and family and emotional support ▪ Information about accessing free health services and interpreters
2–4 months Sustaining breastfeeding / best-practice formula Timing of solid food introduction Promote active play ‘Tummy time’ Response to child cues: hunger, satiety	▪ Advice on establishment of breastfeeding patterns ▪ Management of problems ▪ ‘tummy time’ for babies ▪ Introduction of solids at around 6 months ▪ Encourage mothers going back to work to continue breastfeeding	▪ Advice on establishment of breastfeeding patterns ▪ Management of problems; describe signs that baby is getting enough breastmilk ▪ ‘tummy time’ for babies ▪ Introduction of solids at around 6 months ▪ Baby feed, play, sleep cycle; Sleep and settling techniques ▪ Family and social support ▪ Parenting; looking after mother and father’s emotional health ▪ Information about accessing free health services and interpreters; introduction to family child health nurse	▪ Advice on establishment of breastfeeding patterns ▪ Management of problems; describe signs that baby is getting enough breastmilk ▪ ‘tummy time’ for babies ▪ Introduction of solids at around 6 months, emphasise includes water/fluids too ▪ Encourage mothers going back to work to continue breastfeeding and offer strategies. ▪ Baby feed, play, sleep cycle; Sleep and settling techniques ▪ Family and social support ▪ Parenting; looking after mother and father’s emotional health ▪ Information about accessing free health services and interpreters; introduction to family child health nurse
4–6 months Solid food introduction Healthy food choices Promote active play ‘Tummy time’ and no screen use	▪ Reinforce breastfeeding pattern, Management of problems ▪ ‘tummy time’ for babies ▪ Introduction of solids from 6 months ▪ Encourage mothers going back to work to continue breastfeeding	▪ Reinforce breastfeeding pattern ▪ Management of problems ▪ ‘tummy time’ for babies ▪ Introduction of solids from 6 months; visually illustrating age-appropriate food textures ▪ Learning to eat and making a mess ▪ Following hunger and fullness cues ▪ Encourage mothers going back to work to continue breastfeeding and offer strategies ▪ Family and social support ▪ Parent-child interactions; importance of play for mental & emotional development ▪ Information about accessing free health services and interpreters	▪ Reinforce breastfeeding pattern, Management of problems ▪ ‘tummy time’ for babies ▪ Introduction of solids from 6 months; visually illustrating age-appropriate food textures ▪ Learning to eat and making a mess ▪ Following hunger and fullness cues ▪ Encourage mothers going back to work to continue breastfeeding and offer strategies ▪ Family and social support ▪ Parent-child interactions; importance of play for mental & emotional development ▪ Information about accessing free health services and interpreters