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The relationship between infants' preceding appetite, illness, and growth performance and mothers' subsequent feeding
E G Piwoz1, R E Black, G Lopez de Romaña
1Department of International Health, Johns Hopkins University, Baltimore, MD.
Insights
Poor infant growth, particularly low weight gain, significantly influences infant feeding practices and changes, especially in mothers with high feeding experience. This occurs during the crucial 2-4 month period when exclusive breastfeeding is recommended.
Area of Science:
- Pediatrics
- Human Nutrition
- Maternal and Child Health
Background:
- Infant feeding practices are crucial for growth and development, especially in low-income populations.
- Understanding factors influencing feeding changes is vital for effective nutritional interventions.
- Maternal feeding exposure and experience (MFEE) may modulate infant growth-feeding practice relationships.
Purpose of the Study:
- To investigate if infant characteristics (growth, illness) predict changes in feeding practices.
- To determine if maternal characteristics (MFEE) influence the relationship between infant growth and feeding changes.
- To identify critical periods when infant growth impacts feeding decisions.
Main Methods:
- Longitudinal study of 153 low-income Peruvian infants.
- Logistic regression models analyzed predictors of feeding practice changes.
- Adjusted for infant gender, previous practices, and maternal feeding exposure and experience (MFEE).
Main Results:
- Low weight gain from 1-3 months predicted subsequent feeding practice changes.
- The relationship between low weight gain and feeding changes was significant for mothers with high MFEE, but not low MFEE.
- Infant illness, anorexia, and poor length gain did not predict feeding changes.
Conclusions:
- Poor infant growth is a significant driver of feeding practice modifications in early infancy.
- Maternal feeding experience plays a role in how infant growth influences feeding decisions.
- Findings highlight the importance of monitoring infant growth to guide appropriate feeding practices, especially during the recommended exclusive breastfeeding period (2-4 months).
Abstract:
Data from a longitudinal study of 153 low-income Peruvian infants were used to examine (i) whether infant characteristics such as appetite, illness and past growth performance are related to subsequent changes in their feeding practices (e.g. addition of non-human milks, solid foods, weaning), and (ii) whether this relationship depends on maternal characteristics such as feeding exposure and experience (MFEE). With one exception, infants were breastfed from birth. Feeding practices during the first month of life were related to practices throughout infancy. Most mothers changed their practices once (61%) or twice (34%) from birth to 6 months. Low weight gains from 1 to 2 (P < 0.003) and 2 to 3 (P < 0.04) months were identified as significant predictors of feeding changes during the following months, using logistic regression models that also adjusted for MFEE, infant gender, previous practice, and previous practice change. The interaction between past weight gain and MFEE (objective ii) was not statistically significant in the logistic regression models. However, when analyzed separately, the relationships between low weight gains and subsequent feeding changes were observed for high but not low MFEE mothers. The prevalences of anorexia and infection (diarrhea, respiratory, and/or fever), and poor length gain during the previous month were not related to subsequent changes in feeding practices. These results suggest that poor growth influences feeding practices from 2 to 4 months, when exclusive breastfeeding is recommended.