Longitudinal feeding patterns of infants

Objective. There are few longitudinal, prospective studies of infant feeding patterns. This paper reports on infant feeding patterns and associated demographic factors for a birth cohort of 1074 infants. Design. Longitudinal, prospective study. Methods. At recruitment, women provided information about their infant feeding plans, smoking patterns, and demographics. Detailed information regarding infants' dietary intake and use of child care was collected by mailed questionnaire at 6 weeks, 3 months, and 6 months of age. Generalized Estimating Equations (GEE) were used to determine correlates of infant feeding. Results. Sixty-three percent planned to breast-feed. The percentage of infants mostly or exclusively breast-fed declined from 36% (6 weeks) to 25% (6 months). Seventy-five percent received some formula at 6 weeks, increasing to 86% at 6 months. Breast-feeding was significantly associated with higher parental education and age, higher family income, and lack of maternal smoking in the year before pregnancy at each survey point. Formula-feeding was associated with lower parental education and age, use of child care, and maternal smoking in the year before pregnancy. After controlling for other variables, the odds of an infant being breast-fed were increased with higher maternal age and parental education, the infant not being a first-born, and no maternal smoking in the year before pregnancy. Conclusions. Certain sociodemographic characteristics were highly correlated with breast-feeding. Even in this relatively well-educated population, the percentages of infants that were mostly or exclusively breast-fed were about half of those recommended by the United States Department of Health and Human Services for the year 2000. Implications for practice. Certain sociodemographic factors were highly correlated with infant feeding practices in this and other studies. Even among women who planned to breast-feed, there was a sharp decline in breast-feeding rates in the first 6 weeks. Very few infants were exclusively breast-fed. This highlights the importance of carefully defining precise feeding categories when asking about breast-feeding. This study was not designed to assess factors impacting breast-feeding success, but meta-analysis indicates that several of the infant feeding policies recommended by the World Health Organization (WHO) can have a positive impact. It is important for health care providers to 1) Be aware of the sociodemographic risk factors for not breast-feeding and 2) Provide adequate support for breast-feeding mothers.