Development of Feeding Practices During the First 5 Years of Life

Abstract

To understand the transition from breastand bottle-feeding to solid-feeding and factors that might affect the duration of breast-and bottle-feeding. Design: Cohort followed up from birth with relatively well-educated, middle-class parents. Setting: Community sample recruited from 3 suburban newborn nurseries (a teaching hospital, community hospital, and large health maintenance organization). Participants: One hundred ninety-one healthy fullterm infants. Measures: Assessment of feeding practices through the ages of complete weaning from breast-and bottle-feeding. Results: More than 90% of participants breast-fed for at least 2 weeks. Infants of older mothers were weaned from the breast later than infants of younger mothers. First-born infants were weaned from the breast earlier than later-born infants. Eighty-four percent of infants bottle-fed at some time during the first year of life. More than 40% of the cohort was still receiving bottles at 24 months of age, 16% at 36 months, and 8% at 48 months. The duration of breast-and bottle-feeding was related to maternal work status; mothers who returned to work during the first 3 months postpartum weaned sooner from the breast and later from the bottle than women who returned to work after 3 months postpartum. Conclusions: The frequency of late bottle-weaning in this well-educated, middle-class cohort was unexpected and was related to the timing of the mother's return to work. The impact of prolonged bottle-feeding on later growth and adiposity deserves further investigation.

Predictors of the early introduction of solid foods in infants: results of a cohort study

“…A similar association has previously been reported in a study of Italian infants [ 29 ] which reported that mothers who introduced formula within 1 month were almost 3 times as likely to have introduced solid foods early compared with mothers who never supplied their infant with formula. Unlike earlier studies we found no independent association between the timing of solids and parity [ 30 , 31 ], maternal level of education [ 27 , 28 , 30 ] and mothers in this study were no more likely to introduce solids earlier to boys than girls [ 21 , 23 , 28 ]. However, we did find in the univariate analysis that women with less than 12 years of education were significantly more likely to introduce solids before 17 weeks than those with more than 12 years of education.…”

Social Determinants of Initiation, Duration and Exclusivity of Breastfeeding at the Population Level

“…Moreover, for all breastfed babies, the fact that annual family income ($40,000 and over) exerts a negative influence on breastfeeding when mothers' age and education level are equal may be related to the working situation of older and more educated mothers, as observed in other studies. [9][10][11][12] The results of this study are not entirely in accordance with those of other studies indicating a strong positive influence of income on breastfeeding, but they confirm the importance of mothers' age and education level for breastfeeding. 5,7,[13][14][15] More in line with our results, other authors reported an inconsistent relationship between socioeconomic status and breastfeeding, 15 while Riva and colleagues 12 found that income is positively related with breastfeeding but not with its duration.…”

Do early infant feeding practices vary by maternal ethnic group?

“…Other maternal socio-economic factors also have a significant bearing on infant feeding practices. Literature on maternal employment and infant feeding is sparse, but our findings are consistent with previous reports that mothers who return to work before 4 months are more likely to discontinue breast-feeding and introduce solids early 24 . We have reported previously that lone mothers are less likely to start breast-feeding 11 .…”

“…The median (interquartile range) age at first motherhood was 25 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29) years and, at birth of the cohort member, 29 (24 -33) years. A total of 4595 (43%) of the cohort babies were first born.…”