Infant Feeding Practices and Subsequent Dietary Patterns of School-Aged Children in a US Birth Cohort

AbstractRecognised as the optimum infant feeding method, breastfeeding affords substantial health benefits to mother and infant. Exclusive breastfeeding is recommended to 6 months, with continuation thereafter. In Ireland, data indicates that 60% breastfeed to any extent at hospital discharge and 40% do so at 3 months. However, nationally collected data is limited in detail, particularly with regard to breastfeeding continuation. The ongoing Cork-based COMBINE birth cohort study recruited 456 participants between 2015 and 2017. Through interviewer-led questionnaires, research midwives collected feeding data at hospital discharge, 1, 2, 4, 6 and 9 months of age. Infant feeding was classed as breast (breastmilk as main milk source), combination (both breastmilk and infant formula daily) or infant formula only feeding. Adherence to the World Health Organisation (WHO) recommendation to exclusively breastfeed (breastmilk only, no infant formula, supplementary fluids or solid foods) was examined longitudinally. To explore secular changes, breastfeeding rates in COMBINE were compared to the BASELINE birth cohort study, which recruited participants (n = 2116) between 2008 and 2011 in the same setting. In COMBINE, 75% of mothers provided any breastmilk (breast or combination) at hospital discharge, of whom 44% breastfed only. Two-fifths (40%), one-third (33%) and one-quarter (24%) breastfed at 1, 4 and 6 months, respectively. Combination feeding of breastmilk and infant formula was prevalent at discharge (31%) and 1 month (20%). Advice from healthcare professionals (31%) and concern baby was hungry (30%) were commonly reported reasons for this practice and throughout the study, mothers who combination fed were more likely to stop breastfeeding altogether than those who breastfed (all P < 0.001). Infant formula only feeding increased from 25% at discharge to 40% at 1 month, 49% at 2 months and 74% at 9 months. Half (45%) of mothers who breastfed did so for less than 4 months and insufficient milk/growth faltering was the most commonly cited reason for cessation (27%). The rate of WHO-defined exclusive breastfeeding was 40% from birth to discharge, 22% to 1 month, 15% to 4 months and 2% to 6 months. The breastfeeding (breastmilk as main milk source) rate at discharge did not differ between our two birth cohorts (44 vs. 40%, P = 0.23), but was significantly higher in COMBINE compared to BASELINE at 2 (36 vs. 27%) and 6 (24 vs. 12%) months (both P < 0.05). While these data provide evidence of some progress towards longer breastfeeding durations, there remains much scope to improve infant feeding practices in Ireland.

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Do Early Infant Feeding Practices and Modifiable Household Behaviors Contribute to Age-Specific Inter-Individual Variations in Infant Linear Growth? Evidence from a Birth Cohort in Dhaka, Bangladesh

Current Developments in Nutrition ◽

10.1093/cdn/nzab077 ◽

2021 ◽

Author(s):

Sarah L Silverberg ◽

Huma Qamar ◽

Farhana K Keya ◽

Shaila S Shanta ◽

M Munirul Islam ◽

...

Keyword(s):

Statistical Model ◽

Birth Cohort ◽

Infant Feeding ◽

Linear Growth ◽

Feeding Practices ◽

Infant Feeding Practices ◽

Household Factors ◽

Early Infant ◽

Growth Faltering ◽

Statistical Approaches

Abstract Background Causes of infant linear growth faltering in low-income settings remain poorly understood. Identifying age-specific risk factors in observational studies may be influenced by statistical model selection. Objectives To estimate associations of selected household factors and infant feeding behaviors within discrete age intervals with interval-specific changes in length-for-age z-scores (LAZ) or attained LAZ, using five statistical approaches. Methods Data from a birth cohort in Dhaka, Bangladesh (n = 1157) was analyzed. Multivariable-adjusted associations of infant feeding patterns or household factors with conditional LAZ (cLAZ) were estimated for five intervals in infancy. Two alternative approaches were used to estimate differences in interval changes in LAZ, and differences in end-interval attained LAZ and relative risks of stunting (LAZ←2) were estimated. Results LAZ was symmetrically distributed with mean (standard deviation) -0.95 (1.02) at birth and -1.00 (1.04) at 12 months. Compared to exclusively breastfed infants, partial breastfeeding (difference in cLAZ: -0.11, 95% CI: -0.20, -0.02) or no breastfeeding (-0.30, 95% CI: -0.54, -0.07) were associated with slower growth from 0 to 3 months. However, associations were not sustained beyond 6 months. Modifiable household factors (smoking, water treatment, soap at handwashing station) were not associated with infant growth, attained size or stunting. Alternative statistical approaches yielded mostly similar results as conditional growth models. Conclusions The entire infant LAZ distribution was shifted down, indicating that length deficits were mostly caused by ubiquitous or community-level factors. Early-infant feeding practices explained minimal variation in early growth, and associations were not sustained to 12 months of age. Statistical model choice did not substantially alter the conclusions. Modifications of household hygiene, smoking or early infant feeding practices would be unlikely to improve infant linear growth in Bangladesh or other settings where growth faltering is widespread.

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Reported infant feeding practices and contextual influences on breastfeeding: qualitative interviews with women registered to MomConnect in three South African provinces

International Breastfeeding Journal ◽

10.1186/s13006-020-00315-7 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Zara Trafford ◽

Sara Jewett ◽

Alison Swartz ◽

Amnesty E. LeFevre ◽

Peter J. Winch ◽

...

Keyword(s):

Health System ◽

South African ◽

Infant Feeding ◽

Qualitative Interviews ◽

Feeding Practices ◽

Policy Support ◽

Infant Feeding Practices ◽

Local Policy ◽

Framework Analysis ◽

Younger Women

Abstract Background Global guidelines recommend exclusive breastfeeding (EBF) for the first 6 months of life. South African EBF rates have steadily increased but still only average 32% for infants below 6 months of age. Malnutrition and developmental delays continue to contribute substantially to the morbidity and mortality of South African children. MomConnect, a national mHealth messaging system used to send infant and maternal health messages during and after pregnancy, has a specific focus on improving rates of breastfeeding and has achieved high rates of population coverage. Methods For this qualitative study, we interviewed women who were registered to MomConnect to investigate their breastfeeding and other infant feeding practices, decision-making pre- and post-delivery, and the role of the health system, family members and the wider community in supporting or detracting from breastfeeding intentions. Data were collected from February–March 2018 in South Africa’s KwaZulu-Natal, Free State and Gauteng provinces. Framework analysis was conducted to identify common themes. Results Most women interviewed had breastfed, including HIV-positive women. Even when women had delivered by caesarean section, they had usually been able to initiate breastfeeding a few hours after birth. Understandings of EBF varied in thoroughness and there was some confusion about the best way to cease breastfeeding. Most women felt well-equipped to make infant feeding decisions and to stick to their intentions, but returning to work or school sometimes prevented 6 months of EBF. Advice from the health system (both via clinics and MomConnect) was considered helpful and supportive in encouraging EBF to 6 months, although family influences could thwart these intentions, especially for younger women. Mothers reported a range of breastfeeding information sources that influenced their choices, including social media. Conclusions Efforts to improve EBF rates must include consideration of the social and economic environment surrounding women. Interventions that focus only on improving women’s knowledge are valuable but insufficient on their own. Attention should also be paid to infant behaviors, and how these affect women’s breastfeeding choices. Finally, although there is strong local policy support for EBF, more rigorous implementation of these and other broader changes to create a more enabling structural environment ought to be prioritized.

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Infant feeding practices in the Saharawi refugee camps Algeria, a cross-sectional study among children from birth to six months of age

International Breastfeeding Journal ◽

10.1186/s13006-016-0098-1 ◽

2016 ◽

Vol 12 (1) ◽

Cited By ~ 6

Author(s):

Inger Aakre ◽

Anne Marie Lilleengen ◽

Marie Lerseth Aarsand ◽

Tor A. Strand ◽

Ingrid Barikmo ◽

...

Keyword(s):

Infant Feeding ◽

Feeding Practices ◽

Cross Sectional Study ◽

Refugee Camps ◽

Infant Feeding Practices ◽

Sectional Study ◽

Cross Sectional

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An Assessment of the Breastfeeding Practices and Infant Feeding Pattern among Mothers in Mauritius

Journal of Nutrition and Metabolism ◽

10.1155/2013/243852 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 29

Author(s):

Ashmika Motee ◽

Deerajen Ramasawmy ◽

Prity Pugo-Gunsam ◽

Rajesh Jeewon

Keyword(s):

Infant Feeding ◽

Infant Nutrition ◽

Feeding Practices ◽

Feeding Pattern ◽

Infant Feeding Practices ◽

Chi Square ◽

Breastfeeding Practices ◽

Childhood Morbidity ◽

The Mean ◽

Type Of Delivery

Proper breastfeeding practices are effective ways for reducing childhood morbidity and mortality. While many mothers understand the importance of breastfeeding, others are less knowledgeable on the benefits of breastfeeding and weaning. The aim in here is to assess breastfeeding pattern, infant formula feeding pattern, and weaning introduction in Mauritius and to investigate the factors that influence infant nutrition. 500 mothers were interviewed using a questionnaire which was designed to elicit information on infant feeding practices. Statistical analyses were done using SPSS (version 13.0), whereby chi-square tests were used to evaluate relationships between different selected variables. The prevalence of breastfeeding practice in Mauritius has risen from 72% in 1991 to 93.4% as found in this study, while only 17.9% breastfed their children exclusively for the first 6 months, and the mean duration of EBF (exclusive breastfeeding) is 2.10 months. Complementary feeding was more commonly initiated around 4–6 months (75.2%). Despite the fact that 60.6% of mothers initiate breastfeeding and 26.1% of mothers are found to breastfeed up to 2 years, the practice of EBF for the first 6 months is low (17.9%). Factors found to influence infant feeding practices are type of delivery, parity, alcohol consumption, occupation, education, and breast problems.

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