Determinants of infant formula use and relation with growth in the first 4 months

Abstract

The wide variety of infant formula available on the market can be confusing for parents and physicians. We aimed to determine associations between predominant type of formula used from birth to 4 months and parental and child characteristics and type of physician consulted, and then to describe relations between type of formula used and growth. Our analyses included 1349 infants from the EDEN mother-child cohort. Infant's feeding mode and type of formula used were assessed at 4 months by maternal self-report. Infant's weight and height from birth to 4 months, measured in routine follow-up, were documented by health professionals in the infant's personal health record. Anthropometric z-scores were calculated by using World Health Organization growth standards. Multinomial logistic regression was used to identify factors associated with the type of formula predominantly used; relations with growth were analysed by linear regressions. Partially hydrolysed formulas were more likely to be used by primiparous women (P < 0.001), those breastfeeding longer (P < 0.001) and for infants with family history of allergies (P = 0.002). Thickened formulas were more often used by mothers returning to employment in the first 4 months (P = 0.05) and breastfeeding shortly (P < 0.001). No significant relation was found between infant's growth and type of formula (P > 0.20). Infants breastfed shorter showed higher weight-for-age (P < 0.001) and length-for-age (P = 0.001) z-score changes between birth and 4 months. The use of a specific type of infant formula seems to be mainly related to parental characteristics. Infant's growth in the first 4 months is related to other factors than to the type of formula used.

Keywords: breastfeeding; formula feeding; growth; infant; longitudinal study; socio-demographic factors.

Figure 1

Types of formula used predominantly or not in the EDEN study. Includes 1354 infants exclusively formula‐fed or not in the first 4 months of life. In infants who were in the regular category, regular formulas were used 95% of the time on average. Similarly, in the other groups, pre‐ or probiotics, thickened and partially hydrolysed formulas were used, respectively, 89%, 85% and 95% of the time on average. *Regular, pre‐ or probiotic, thickened and partially hydrolysed formulas: successive or concomitant use.