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. 2017 Dec 2:12:48.
doi: 10.1186/s13006-017-0139-4. eCollection 2017.

Infant feeding pattern in the first six months of age in USA: a follow-up study

Wilfried Karmaus  1 , Nelís Soto-Ramírez  2 , Hongmei Zhang  1
Affiliations

Infant feeding pattern in the first six months of age in USA: a follow-up study

Wilfried Karmaus et al. Int Breastfeed J. .

Abstract

Background: Infant feeding may consist of direct breastfeeding (DBF), pumping and bottle feeding (P&F), formula feeding (FF), solid food feeding (SFF), and any combination. An accurate evaluation of infant feeding requires descriptions of different patterns, consistency, and transition over time.

Methods: In United States of America, the Infant Feeding Practice Study II collected information on the mode of feeding on nine occasions in 12 months. We focused on the first 6 months with six feeding occasions. To determine the longitudinal patterns of feeding the latent class transition analyses was applied and assessed the transition probabilities between these classes over time.

Results: Over 6 months, 1899 mothers provided feeding information. In month 1 the largest latent class is FF (32.9%) followed by DBF (23.8%). In month 2, a substantial proportion of the FF class included SFF; which increases over time. A not allocated class, due to missing information was identified in months 1-3, transitions to SFF starting in month 4 (8.9%). In month 1, two mixed patterns exist: DBF and P&F combined with FF (13.9%) and DBF combined with P&F (18.7%). The triple combination of DBF, P&F, and FF (13.9%) became FF in month 2 (transition probability: 24.8%), and DBF in combination with P&F (transition probability: 49.1%). The pattern of DBF combined with P&F is relatively stable until month 4, when at least 50% of these infants receive solid food. Only 23-26% of the infants receive direct breastfeeding (DBF) in months 1-4, in month 5-6 SFF is added. Mothers who used FF were less educated and employed fulltime. Mothers who smoke and not residing in the west of the United States were also more likely to practice formula feeding.

Conclusion: Infant feeding is complex. Breastfeeding is not predominant and we additionally considered the mixed patterns of feeding. To facilitate direct breastfeeding, a substantial increase in the duration of maternal leave is necessary in the United States.

Keywords: Breastfeeding; Formula feeding; Infant feeding; Pumping and feeding; Solid food feeding; United States of America.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was conceived by the Food and Drug Administration (FDA) and the Centers of Disease Control (CDC) before conducting the survey. The secondary data analysis was approved by the University of Memphis (IRB Determination Protocol #4099).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Proportion and transition probabilities of infant feeding practice (n = 1899) in the US. Figure shows the development of infant feeding in the first 6 months. Direct breastfeeding (DBF - blue) was practiced in the first month by 23.8% of the women. In the second month, a few women (23.3% from DBF and pumping and feeding [P&F] group) moved to the DBF group. In month 5, nearly all infants from the DBF group were introduced to solid food feeding (SFF). The same pattern is seen for the mix of direct DBF and P&F (green). The group of women with a mixed feeding combination (DBF, P&F, FF - violet) dissolved into either formula feeding (FF) or the combination of DBF + P&F in month 2. Formula-feed (FF) infants (32.9%, dark red) experience increasing introduction of solid food (SF-pink) from month 2-5
See this image and copyright information in PMC

References

    1. Karp SM, Lutenbacher M. Infant feeding practices of young mothers. MCN Am J Matern Child Nurs. 2011;36:98–103. doi: 10.1097/NMC.0b013e31820558bf. - DOI - PubMed
    1. Soto-Ramirez N, Karmaus W, Zhang H, Davis S, Agarwal S, Albergottie A. Modes of infant feeding and the occurrence of coughing/wheezing in the first year of life. J Hum Lact. 2013;29:71–80. doi: 10.1177/0890334412453083. - DOI - PubMed
    1. Section on Breastfeeding Executive Committee. American Academy of Pediatrics Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827–e841. doi: 10.1542/peds.2011-3552. - DOI - PubMed
    1. Maria-Mengel MR, Martins Linhares MB: Risk factors for infant developmental problems. Rev Lat Am Enfermagem 2007, 15 Spec No:837-842. - PubMed
    1. Koletzko B, Baker S, Cleghorn G, Neto UF, Gopalan S, Hernell O, et al. Global standard for the composition of infant formula: recommendations of an ESPGHAN coordinated international expert group. J Pediatr Gastroenterol Nutr. 2005;41:584–599. doi: 10.1097/01.mpg.0000187817.38836.42. - DOI - PubMed

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