Infant Feeding and Feeding Transitions During the First Year of Life

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, 4770 Buford Hwy, MS K25, Atlanta, GA 30341, USA.
PEDIATRICS (Impact Factor: 5.47). 11/2008; 122 Suppl 2(Supplement 2):S36-42. DOI: 10.1542/peds.2008-1315d
Source: PubMed


Infancy is a time of rapid transition from a diet of virtually nothing but milk (either breast milk or infant formula) to a varied diet from nearly all food groups being consumed on a daily basis by most infants. Despite various recommendations about infant feeding, little is known about actual patterns of feeding among US infants. This article documents transitions in infant feeding patterns across the first year of life and determinants of key aspects of infant feeding.
Using data from the Infant Feeding Practices Study II, we analyzed responses to a 7-day food-recall chart that was administered every month. The sample size declined from 2907 at birth to 1782 at 12 months of age.
Although 83% of survey respondents initiated breastfeeding, the percentage who breastfed declined rapidly to 50% at 6 months and to 24% at 12 months. Many of the women who breastfed also fed their infants formula; 52% reported that their infants received formula while in the hospital. At 4 months, 40% of the infants had consumed infant cereal, 17% had consumed fruit or vegetable products, and <1% had consumed meat. Compared with infants who were not fed solid foods at 4 months, those who were fed solid foods were more likely to have discontinued breastfeeding at 6 months (70% vs 34%) and to have been fed fatty or sugary foods at 12 months (75% vs 62%).
Supplementing breast milk with infant formula while infants were still in the hospital was very common. Despite recommendations that complementary foods not be introduced to infants aged 4 months or younger, almost half of the infants in this study had consumed solid foods by the age of 4 months. This early introduction of complementary foods was associated with unhealthful subsequent feeding behaviors.

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    • "The consumption of high-sugar, high-fat foods increased with each age group; comparable observations have been reported in FITS [13]. Similarly, data from the 2005–2007 Infant Feeding Practices Study II (IFPS II) found that at 12 months two-thirds of infants were consuming high sugar and fat foods, including french fries, or sweetened drinks, and 77% of infants were consuming fruit juice [10]. Similarly we found that on a daily basis most toddlers consumed a dessert or snack and fruit juice more than once, and half consumed a sweetened drink. "
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    ABSTRACT: Objective To characterize food and nutrient intake and develop a population-specific food list to be used as a comprehensive dietary assessment tool for Baltimore infants and toddlers aged 0–24 months. The data were used to inform the Growing Leaps and Bounds (GLB) program, which promotes early obesity prevention among Baltimore infants and toddlers. Research methods & procedures A cross-sectional dietary survey using 24-hour recalls among randomly selected primary caregivers of infants and toddlers was conducted. Results Data were collected from 84 children, (response rate 61%) 45 boys; 39 girls. Mean daily energy intakes were 677 kcal, 988 kcal, and 1,123 kcal for children 0–6 months, 7–12 months and 13–24 months, respectively. Infants 0–6 months had higher percentage of energy from fat (48%) than infants 7–12 months (34%) and 13–24 months (31%). Mean daily intakes for all nutrients among 0–12 months old were ≥ Dietary Reference Intakes (DRI), while toddlers 13–24 months had inadequate vitamins A, D, and E intake. Breastfeeding occurred in 33% of infants and toddlers 0 to 6 months, while less than 3% of those aged 7 to 24 months were breastfed. A 104-item food list with eight food and drink categories was developed. Conclusions Infants were formula fed with a higher frequency than they were breastfed. The consumption of high-sugar and high-fat foods (e.g. sweetened drinks, French fries) increased with each age group, which can increase the risk of childhood obesity.
    Nutrition Journal 04/2013; 12(1):52. DOI:10.1186/1475-2891-12-52 · 2.60 Impact Factor
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    • "The U.S., Healthy People 2020 objectives for exclusive breastfeeding through 3 and 6 months of age are 46% and 25%, respectively, yet nearly 25% [60] to 42% [140] of breastfed infants in some cohorts receive formula while still in the hospital (before two days of age), decreasing the likelihood of development of a full milk supply by the mother. Moreover, recent survey data [61] indicate that 8% of mothers offered infants a combination of breastmilk and formula, from birth, during the first week of life. "
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    ABSTRACT: Childhood obesity is currently one of the most prevailing and challenging public health issues among industrialized countries and of international priority. The global prevalence of obesity poses such a serious concern that the World Health Organization (WHO) has described it as a "global epidemic." Recent literature suggests that the genesis of the problem occurs in the first years of life as feeding patterns, dietary habits, and parental feeding practices are established. Obesity prevention evidence points to specific dietary factors, such as the promotion of breastfeeding and appropriate introduction of nutritious complementary foods, but also calls for attention to parental feeding practices, awareness of appropriate responses to infant hunger and satiety cues, physical activity/inactivity behaviors, infant sleep duration, and family meals. Interventions that begin at birth, targeting multiple factors related to healthy growth, have not been adequately studied. Due to the overwhelming importance and global significance of excess weight within pediatric populations, this narrative review was undertaken to summarize factors associated with overweight and obesity among infants and toddlers, with focus on potentially modifiable risk factors beginning at birth, and to address the need for early intervention prevention.
    Journal of obesity 05/2012; 2012(6):123023. DOI:10.1155/2012/123023
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    • "Initially most of the Japanese and the American mothers chose breastfeeding, and the percentages gradually decreased over 1 year (92.26% and 93.69% at 1 month, 60.97% and 60.82% at 6 months, and 36.00% and 23.56% at 12 months for Japan and the US, respectively). National statistics in 2005 show a similar trend in Japan (96.6% at 0 month and 60.6% at 6 months; Health Policy Bureau, 2007), but in the US the figures were a little lower in 2005–2007 (83.3%, 50.1%, and 25.9% at 0, 6, and 12 months, respectively; Grummer-Strawn, Scanlon, & Fein, 2008). "
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    ABSTRACT: Background: Breastfeeding and weaning are strongly connected with infant-mother mutual autonomy, and hence are good touchstones to examine the characteristics of the mother-child relationship. Comparison of the weaning practice gives a framework to understand characteristics of the mother-infant relationship. Objective: The purpose of this study was to compare three industrialised countries concerning the relationship between feeding and weaning practices and its reasons, mother's perception of child care, and of breast milk and formula. Methods: A questionnaire study on weaning practice was conducted for 310 Japanese, 756 French, and 222 American mothers with 4- to 20-month-old infants. Results: French mothers expected and had accomplished weaning at an earlier age of the infant, compared to Japanese and American mothers. Perceived insufficiency of breast milk was the leading reason for the termination of breastfeeding for Japanese mothers at the earlier stages, whereas back to work was the more important reason for French mothers. Japanese mothers were more negative in their image of themselves as mothers, whereas French mothers felt more burdened by child-care. Japanese mothers who terminated breastfeeding because of perceived breast milk insufficiency were also those who were less motivated to breastfeed. Conclusion: Weaning is a significant framework to interpret cultural differences in mother-infant relationship. The perceived insufficiency is interpreted as a solution of conflict between the social pressure to breastfeed and its burden.
    Journal of Reproductive and Infant Psychology 02/2012; 30(1):77-91. DOI:10.1080/02646838.2011.649473 · 0.67 Impact Factor
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