Feeding patterns in the first two years of life in Basra, Iraq

The feeding patterns of 694 children ranging from 12 to 24 months of age were studied. Approximately 91% were exclusively breast-fed at 1 week of age with a further 4% receiving supplementary foods at this stage. At 1 year of age, 52% were receiving breast milk as the only source of milk and 13% were receiving infant formula in addition to breast milk. Inadequate breast milk was the most common reason reported by mothers for discontinuing breast-feeding. Of children receiving formula, 42.9% were receiving diluted formula.70.9% of mothers introduced solid foods at 4 to 6 months of age while 5.8% did not introduce solid foods until after the age of 8 months

Download Full-text

Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study

British Journal Of Nutrition ◽

10.1017/s0007114515005462 ◽

2016 ◽

Vol 115 (6) ◽

pp. 1024-1032 ◽

Cited By ~ 10

Author(s):

Edith H. van den Hooven ◽

Mounira Gharsalli ◽

Denise H. M. Heppe ◽

Hein Raat ◽

Albert Hofman ◽

...

Keyword(s):

Bone Mass ◽

Breast Feeding ◽

Bone Mineral ◽

Mineral Content ◽

Vitamin D Supplementation ◽

Mineral Density ◽

Feeding Patterns ◽

Solid Foods ◽

Total Body ◽

Breast Fed

AbstractBreast-feeding has been associated with later bone health, but results from previous studies are inconsistent. We examined the associations of breast-feeding patterns and timing of introduction of solids with bone mass at the age of 6 years in a prospective cohort study among 4919 children. We collected information about duration and exclusiveness of breast-feeding and timing of introduction of any solids with postnatal questionnaires. A total body dual-energy X-ray absorptiometry scan was performed at 6 years of age, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC) and bone area (BA) were analysed. Compared with children who were ever breast-fed, those never breast-fed had lower BMD (−4·62 mg/cm2; 95 % CI −8·28, −0·97), BMC (−8·08 g; 95 % CI −12·45, −3·71) and BA (−7·03 cm2; 95 % CI −12·55, −1·52) at 6 years of age. Among all breast-fed children, those who were breast-fed non-exclusively in the first 4 months had higher BMD (2·91 mg/cm2; 95 % CI 0·41, 5·41) and aBMC (3·97 g; 95 % CI 1·30, 6·64) and lower BA (−4·45 cm2; 95 % CI −8·28, −0·61) compared with children breast-fed exclusively for at least 4 months. Compared with introduction of solids between 4 and 5 months, introduction <4 months was associated with higher BMD and aBMC, whereas introduction between 5 and 6 months was associated with lower aBMC and higher BA. Additional adjustment for infant vitamin D supplementation did not change the results. In conclusion, results from the present study suggest that ever breast-feeding compared with never breast-feeding is associated with higher bone mass in 6-year-old children, but exclusive breast-feeding for 4 months or longer was not positively associated with bone outcomes.

Download Full-text

The Use of Whole Cow's Milk in Infancy

PEDIATRICS ◽

10.1542/peds.89.6.1105 ◽

1992 ◽

Vol 89 (6) ◽

pp. 1105-1109 ◽

Cited By ~ 2

Author(s):

Keyword(s):

Breast Milk ◽

American Academy ◽

Infant Formula ◽

Iron Status ◽

The United States ◽

Cow’S Milk ◽

Cow's Milk ◽

Solid Foods ◽

American Academy Of Pediatrics ◽

Iron Deficient

The pediatrician is faced with a difficult challenge in providing recommendations for optimal nutrition in older infants. Because the milk (or formula) portion of the diet represents 35% to 100% of total daily calories and because WCM and breast milk or infant formula differ markedly in composition, the selection of a milk or formula has a great impact on nutrient intake. Infants fed WCM have low intakes of iron, linoleic acid, and vitamin E, and excessive intakes of sodium, potassium, and protein, illustrating the poor nutritional compatibility of solid foods and WCM. These nutrient intakes are not optimal and may result in altered nutritional status, with the most dramatic effect on iron status. Infants fed iron-fortified formula or breast milk for the first 12 months of life generally maintain normal iron status. No studies have concluded that the introduction of WCM into the diet at 6 months of age produces adequate iron status in later infancy; however, recent studies have demonstrated that iron status is significantly impaired when WCM is introduced into the diet of 6-month-old infants. Data from studies abroad of highly iron-deficient infant populations suggest that infants fed partially modified milk formulas with supplemental iron in a highly bioavailable form (ferrous sulfate) may maintain adequate iron status. However, these studies do not address the overall nutritional adequacy of the infant's diet. Such formulas have not been studied in the United States. Optimal nutrition of the infant involves selecting the appropriate milk source and eventually introducing infant solid foods. To achieve this goal, the American Academy of Pediatrics recommends that infants be fed breast milk for the first 6 to 12 months. The only acceptable alternative to breast milk is iron-fortified infant formula. Appropriate solid foods should be added between the ages of 4 and 6 months. Consumption of breast milk or iron-fortified formula, along with age-appropriate solid foods and juices, during the first 12 months of life allows for more balanced nutrition. The American Academy of Pediatrics recommends that whole cow's milk and low-iron formulas not be used during the first year of life.

Download Full-text

Letters to the Editor

PEDIATRICS ◽

10.1542/peds.95.4.617 ◽

1995 ◽

Vol 95 (4) ◽

pp. 617-617

Author(s):

Marsha Walker

Keyword(s):

Quality Improvement ◽

Breast Milk ◽

Breast Feeding ◽

Practice Parameter ◽

Letters To The Editor ◽

Term Newborn ◽

Breast Fed

I read with interest the report by the Provisional Committee for Quality Improvement and Subcommittee on Hyperbilirubinemia (Pediatrics 1994;94:558-565) entitled, "Practice Parameter: Management of Hyperbilirubinemia in the Healthy Term Newborn." I wish to make a couple of comments on jaundice and the breast-fed newborn. It was gratifying to see recommendations discouraging the interruption of breast-feeding and eliminating the use of supplemental water or dextrose and water in this situation. Many jaundiced breast-fed newborns simply need more breast milk, ie, more feedings and a check to see that the newborn is swallowing milk at breast.

Download Full-text

Otitis Media in Infants

PEDIATRICS ◽

10.1542/peds.50.1.167b ◽

1972 ◽

Vol 50 (1) ◽

pp. 167-168

Author(s):

Ralph L. Rothstein

Keyword(s):

Breast Milk ◽

Otitis Media ◽

Breast Feeding ◽

Middle Ear ◽

Recumbent Position ◽

Breast Fed

Dr. Bland found an increase in otitis media in bottle-fed versus breast-fed infants. He speculates that this may be due to transfer of IgA in breast milk. Another possibility is that the increased incidence of otitis is due to positional differences between bottle- and breast-feeding. Bottle babies are often fed in the recumbent position which promotes entry of milk into the eustachian tubes and the middle ear, whereas the anatomy of the maternal breast requires that the infant's head be vertical during feeding. This concept of positional otitis has been recently reviewed.

Download Full-text

Lactic Acid and Breast-Feeding

PEDIATRICS ◽

10.1542/peds.91.5.1016 ◽

1993 ◽

Vol 91 (5) ◽

pp. 1016-1016

Author(s):

MARSHA WALKER

Keyword(s):

Lactic Acid ◽

Breast Milk ◽

Breast Feeding ◽

Breast Fed

To the Editor.— I read the article, "Infant Acceptance of Postexercise Breast Milk" (Pediatrics 1992;89:1245-1247). Although it may be noteworthy that postexercise breast milk contains higher levels of lactic acid which change its taste, does this observation necessitate the recommendation to give a breast-fed baby supplemental feedings after the mother exercises? If the mother feeds the baby before exercising and the baby requires another feeding after the exercise, it is highly unlikely that he will suffer from caloric deprivation or malnutrition if he does not take a full feeding at that time.

Download Full-text

Is there any difference between the iodine statuses of breast-fed and formula-fed infants and their mothers in an area with iodine sufficiency?

British Journal Of Nutrition ◽

10.1017/s0007114518000351 ◽

2018 ◽

Vol 119 (9) ◽

pp. 1012-1018 ◽

Cited By ~ 2

Author(s):

Pantea Nazeri ◽

Hosein Dalili ◽

Yadollah Mehrabi ◽

Mehdi Hedayati ◽

Parvin Mirmiran ◽

...

Keyword(s):

Breast Milk ◽

Breast Feeding ◽

Urinary Iodine ◽

Iodine Concentration ◽

Formula Feeding ◽

Exclusive Breast Feeding ◽

Feeding Group ◽

Feeding Type ◽

Breast Fed ◽

Iodine Sufficiency

AbstractDespite substantial progress in the global elimination of iodine deficiency, lactating mothers and their infants remain susceptible to insufficient iodine intake. This cross-sectional study was conducted to compare iodine statuses of breast-fed and formula-fed infants and their mothers at four randomly selected health care centres in Tehran. Healthy infants <3 months old and their mothers were randomly selected for inclusion in this study. Iodine was measured in urine and breast milk samples from each infant and mother as well as commercially available infant formula. The study included 124 postpartum mothers (29·2 (sd 4·9) years old) and their infants (2·0 (sd 0·23) months old). The iodine concentrations were 50–184 µg/l for infant formula, compared with a median breast milk iodine concentration (BMIC) of 100 µg/l in the exclusive breast-feeding group and 122 µg/l in the partial formula feeding group. The median values for urinary iodine concentration in the exclusive breast-feeding group were 183 µg/l (interquartile range (IQR) 76–285) for infants and 78 µg/l (IQR 42–145) for mothers, compared with 140 µg/l (IQR 68–290) for infants and 87 µg/l (IQR 44–159) for mothers in the formula feeding group. These differences were not statistically significant. After adjustment for BMIC, ANCOVA revealed that feeding type (exclusive breast-feeding v. partial formula feeding) did not significantly affect the infants’ or mother’s urinary iodine levels. Thus, in an area with iodine sufficiency, there was no difference in the iodine statuses of infants and mothers according to their feeding type.

Download Full-text

Executive Summary

PEDIATRICS ◽

10.1542/peds.74.4.579 ◽

1984 ◽

Vol 74 (4) ◽

pp. 579-583

Keyword(s):

Developing Countries ◽

Breast Milk ◽

Infant Feeding ◽

Breast Feeding ◽

Maternal Employment ◽

The United States ◽

Attitudinal Factors ◽

Rate Of Increase ◽

Breast Feed ◽

Breast Fed

Domestic Although the rate of breast-feeding is increasing in the United States, it appears that the rate of increase has been much slower among less well educated and economically disadvantaged women. Relatively little is known about the behavioral and attitudinal factors that affect the decisions to breast-feed or to stop if already breast-feeding. Breast-feeding does appear to decrease an infant's risk of gastrointestinal infection and otitis media. The effect of method of infant feeding on risk of other infections and allergic illness is less certain. International The rate of breast-feeding in developing countries appears to have declined, especially among urban women. Although some sociodemographic correlates of infant-feeding choice have been examined, little is known about the behavioral and attitudinal factors that influence choice and duration of infant-feeding practices. Milk insufficiency, maternal employment, and pregnancy frequently are given as reasons for terminating breast-feeding. Rates of gastrointestinal illness are lower among breast-fed infants and when such illness is an important cause of death, infant mortality from this cause appears to be reduced. A randomized clinical trial carried out among high-risk infants found a significantly lower rate of infections among those given breast milk than those fed with infant formula. The evidence of the effect of breast-feeding on respiratory tract and other infections from other studies was less clear. Direct comparison of the growth of predominately breast-fed v artificially fed infants in the same populations from developing countries generally show faster growth for the breast-fed infants for the first 6 months of life. After 6 months, severe growth faltering occurs regardless of the method of feeding. In communities where the nutritional adequacy of supplementary foods is poor, breast milk is an extremely important, high-quality food during the second half of infancy and beyond.

Download Full-text

Supporting Breast-Feeding

PEDIATRICS ◽

10.1542/peds.63.1.60 ◽

1979 ◽

Vol 63 (1) ◽

pp. 60-63

Author(s):

Sidney R. Kemberling

Keyword(s):

Breast Milk ◽

Breast Feeding ◽

Elderly Woman ◽

Strong Support ◽

Simple Solution ◽

Solid Foods ◽

Lactating Mothers ◽

Breast Feed ◽

Spanish Family ◽

Good Nutrition

For those interested in another approach to breast-feeding, Jelliffe and Jelliffe have recently published an elegant paper titled " Breast Is Best."4 Developing skills that enhance breast-feeding can be learned by reading the books listed at the end of this article. If pediatricians want to be strong advocates of breast-feeding, they must be convinced of the advantages of breast milk. Many physicians say that they support breast-feeding but will, for instance, send formula bottles to the bedside of a breast-feeding mother. The antagonistic physician or member of the office team may make remarks such as "Are you going to breast-feed until your child goes to school?" " Are you still breast-feeding?" or " The baby needs solid foods for good nutrition." These innuendos can defeat and demoralize the breast-feeding mother. Unless the physician provides strong support against these remarks, the mother will lose her confidence. Many husbands who are advocates of breast-feeding will defend her against these discouraging remarks. Group sessions of lactating mothers also bolster morale. Many mothers find duenna substitutes whom they can communicate with by telephone. (A duenna is an elderly woman who has charge of young unmarried women in a Spanish family.) However, when breast-feeding mothers confront a serious problem for which they have no simple solution, the pediatrician has to provide the ultimate backup support.

Download Full-text

When Should One Discourage Breast-feeding

PEDIATRICS ◽

10.1542/peds.67.2.300 ◽

1981 ◽

Vol 67 (2) ◽

pp. 300-302

Author(s):

Lawrence R. Berger

Keyword(s):

Breast Milk ◽

Breast Feeding ◽

Psychosocial Aspects ◽

Rich Source ◽

Rare Disorder ◽

Absolute Contraindication ◽

Low Levels ◽

Breast Fed

Breast-feeding has advantages in terms of psychosocial aspects, maternal considerations, and infant factors.1-3 Within these same broad areas, I want to address circumstances in which reservations about breast-feeding should be considered. In terms of infant conditions, galactosemia is clearly an absolute contraindication to breast-feeding. Breast milk is a rich source of lactose, and the very survival of infants with galactosemia is dependent on their receiving a non-lactose-containing formula. Of course, galactosemia is a rare disorder, occurring in approximately 1:60,000 births. Phenylketonuria is often mentioned as another contraindication to breast-feeding. Breast milk, however, has relatively low levels of phenylalanine; in fact, infants who are exclusively breast-fed may receive a phenylalanine intake near the amount recommended for treating phenylketonuria.4

Download Full-text

Growth Pattern of Early and Late Breast Fed Preterm (30-35 Weeks' Gestation) Neonates: A Hospital Based Study

Bangladesh Journal of Child Health ◽

10.3329/bjch.v31i1.6071 ◽

1970 ◽

pp. 26-31

Author(s):

Tahsinul Amin ◽

MAK Azad Chowdhury ◽

M Monir Hossain ◽

M Mahbubul Hoque

Keyword(s):

Breast Milk ◽

Breast Feeding ◽

Enteral Feeding ◽

Growth Pattern ◽

Controlled Trial ◽

Cost Effective ◽

Preterm Neonates ◽

Early Feeding ◽

Breast Fed ◽

Better Than

Background: There is still controversy among the pediatricians regarding when and how to start enteral feeding in preterm neonates. However, early feeding with breast milk was presumed to be well-tolerated, cost-effective and promote growth better than late feeding. Objectives: To compare growth pattern, benefits and risks between early and late breast feeding in preterm (30-35 weeks' gestation) neonates. Methods: This was a randomized controlled trial. Total 100 preterm neonates were stratified into early feeding (n=50) and late feeding (n=50) groups. Early feeding was started on day 3 and late feeding on day 5 of life with expressed breast milk as 20 ml/ kg/day by gavage feeding with daily increment 20 ml/kg till full enteral feeding. Growth was recorded by anthropometric measurements with accuracy and precision for first 3 months of life. Results: Early breast feeding was found to be significantly better than late breast feeding in duration to reach full feeding (13.08 days vs. 16.70 days), time to regain enrolment weight (10.87 days vs. 13.70 days), feed tolerance (78% vs. 58%), hospital stay (13.58 days vs. 16.82 days), mean weight (3773.62 ±310.49 gm vs. 3636.91 ±340.20 gm), linear growth (53.64 ±2.26 cm vs. 52.62 ±2.04 cm) and OFC growth (35.85 ±1.50 cm vs. 35.35 ±1.40 cm) at 3 months of age. Conclusion: Early feeding with breast milk is well tolerated with less morbidity and promotes growth better than late feeding in preterm neonates. Key words: Growth pattern; preterm; breast fed DOI: 10.3329/bjch.v31i1.6071 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 26-31

Download Full-text