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Predictors of early feeding practices in the STRONG Kids 2 cohort
Author(s) -
Donovan Sharon Marie,
Musaad Salma M.
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.1150.20
Subject(s) - breastfeeding , overweight , medicine , cohort , psychosocial , obstetrics , vaginal delivery , pediatrics , pregnancy , infant feeding , breast feeding , demography , weight gain , cohort study , birth weight , obesity , body weight , endocrinology , psychiatry , sociology , biology , genetics
Human milk is the ideal form of nutrition for the developing infant, however, current rates of breastfeeding in the U.S. do not meet public health recommendations. The decision to breastfeed (BF) is influenced by physiological and psychosocial factors. Herein, the factors that contribute to early infant feeding decisions were investigated in STRONG Kids 2 (SK2), a 3‐year longitudinal birth cohort in Champaign County, Illinois. Analyses were restricted to mothers who have data at 12 months (n=212), of which 83% are White, 4% are Hispanic or Latino and 5% are Black. Maternal prepregnancy weight, child birthweight and route of delivery are obtained by parental report. Mother and infant weight and length were measured at week 6 and months 3 and 12. Married women comprised 83% of mothers, 7% were cohabiting and 8% were single. Prior to pregnancy, 24% and 26% of women were overweight or obese, respectively. 29% of infants were delivered by C‐section (planned or unplanned). Vaginal delivery was highest among those who were under/normal weight (80%) vs. overweight (71%) or obese (56%) prepregnancy (P=0.006). At 6 weeks, 68% of infants were BF, 13% were formula‐fed (FF) and 18% were fed both human milk and infant formula (CF). BF was 67% at 3 mos and 41% at 12 mos. The % BF increased with maternal education from high school (43%) to some college (53%) to college graduate/post graduate work (77%) (P<0.001). The % BF was higher for under/normal weight (78%) and overweight (73%) mothers than for mothers who were obese at prepregnancy (56%) (P=0.0249). BF rate was also higher in mothers who delivered vaginally (75%) compared to planned (57%) or unplanned C section (50%) (P=0.0141). Single mothers were more likely to formula feed than breastfeed (50% vs. 39%), while the reverse was seen among married mothers (9% vs. 72%) (P<0.0001). Lastly, reasons for discontinuing BF or pumping milk by week 6 were investigated. The most common stated reasons were: “I didn't have enough milk” (81%); “Breast milk alone did not satisfy my baby” (67%); and “I had trouble getting the milk flow to start” (57%). In summary, in the SK2 cohort, prepregnancy obesity, C‐section delivery, lower levels of education and being a single mother were associated with lower BF rates. The most common reasons for stopping BF prior to 6 weeks postpartum centered on perception of insufficient milk production. These modifiable factors represent targets for future educational programs and intervention studies to improve BF initiation and duration. Support or Funding Information (Supported by the Dairy Research Institute and Gerber Foundation).