Infant Feeding Practices in the First Six Months of Life and Subsequent Growth Performance
Authors: Shinn Leila , Tangney Christy , Mullen Mary , Sharp Christine , Gelfand Amy , Busche Caitlyn 
Published: November 2023

Background and Objective

While there have been many reports in which the association between feeding type and infant growth have been explored, there is no standard definition of growth performance. Researchers use the WHO standards, CDC standards or both and growth may be measured as a static or longitudinal (across multiple time points) outcome. Without a standard growth definition, a need for further research is implicit. The purpose of this descriptive study is to determine the association between infant feeding practices (breastfeeding, formula and mixed feeding (breastfed and formula fed)) and several indicators of growth performance (weight‐for‐age, length‐for‐age, weight‐for‐length (W‐L) and head circumference percentiles from z‐scores) during the first six months of life through the use of the modified Infant Feeding Practices Study II (mIFPS II) questionnaire.

Methods

The mIFPS II questionnaire was tested for content validity and administered to a diverse group of caretakers of infants, aged 28 days to 6 months drawn from pediatric outpatient clinics at an urban medical center. We examined demographic correlates of infant feeding practices and complementary food introduction in relation to WHO growth performance using chi square, ANOVA and logistic regression models with SPSS, version 22 (IBM, Chicago, IL).

Results

Race‐ethnicity of caretakers was 21% non‐Hispanic white, 24% Hispanic, and 38% non‐Hispanic black; educational background included 22% with high school education or less, 26% with some college or an associate degree and 43% as college graduates or more. Of the 215 dyads, 51% were enrolled in WIC. Infants' age (<4 months (n=107), 4–6 months (n=56) and ≥6 months (n=52)) at time of questionnaire completion was associated with feeding type (p≤0.05). Of the infants <4 months of age, more than half consumed breast milk or mixed feedings, while 44% were fed formula. In older infants, the majority was formula fed (51%).

While in the hospital, 42% of caretakers received feeding information from a healthcare professional, 2.8% from WIC, baby care classes or support groups, 3.7% from a relative or friend and 52% from the media. Source of feeding information was not related to current feeding practice (p=0.32) but was associated with WIC enrollment (p≤0.05). For infants with growth data through 6 months of age (n=115), nearly 22% were overweight or obese by WHO standards (greater than 85th W‐L percentile).

Conclusion

No associations were observed between weight status and feeding type, or with WIC enrollment, caretaker race or education (all p >0.05). While our data suggest that there are relationships between infant age and feeding type and between source of feeding information and WIC enrollment, more growth data are needed to adequately characterize correlates of infant growth performance in this diverse sample.

Support or Funding Information

Department of Clinical Nutrition at Rush University Medical Center Chicago, IL