Exploration of parents' and healthcare providers' perceptions on human milk oligosaccharides (HMOs) and willingness to use HMO-enriched formula: a baseline mixed-methods study from the State of Qatar.

Introduction: Human milk oligosaccharides (HMOs) are key bioactive components of breast milk with potential benefits for infant health, immunity, and development. Perceptions of HMOs and willingness to use HMO-enriched formula remain limited in many settings. This study aimed to explore the perceptions of HMOs and willingness to use HMO-enriched formula among parents and healthcare providers (HCPs) in Qatar. Methods: A convergent mixed-methods design was used. Quantitative data were collected through online, anonymous surveys from parents of children aged 0-2 years and HCPs involved in infant care, to explore perceptions of HMOs and willingness to use or recommend HMO-enriched formula. Qualitative data were obtained through focus group discussions with parents and HCPs to explore further infant feeding experiences, perceptions of HMOs, and views on HMO-enriched formula. Quantitative and qualitative findings were analyzed separately and then integrated. Results: Among parents, the perception score of HMOs was low, but interest in learning more was high, and willingness to use HMO-enriched formula was generally cautious and conditional. Parents identified HCPs as the most trusted source of information regarding HMOs and HMO-enriched formula, and expressed concerns about safety, evidence, and affordability. Among HCPs, the perception score of HMOs was higher, but formal training was limited and advice about HMO-enriched formula was variable. Qualitative findings showed that both parents and HCPs viewed breastfeeding as the preferred feeding option, while willingness to use HMO-enriched formula depended on clear evidence, safety reassurance, and professional guidance. Integrated findings indicated that future uptake may depend on HCP-led parent education, evidence-based counseling, and improved clinical communication. Discussion: This is the first exploratory study on HMOs perceptions and willingness to use HMO-enriched formula in Qatar. The findings suggest that perceptions of HMOs and HMO-enriched formula remain variable, and that both parents and HCPs may benefit from clearer, context-appropriate information. The findings indicate that HMO-enriched infant formula use may be associated with multiple practical and informational factors, including professional advice and concerns about safety and evidence. Further research is needed before broader practice implications can be drawn to inform future educational efforts and the integration of HMO-enriched formula into infant nutrition in Qatar.