Abstract
BackgroundWhile exclusive breastfeeding is recommended to 6 months of age, just 15% of mothers in Australia achieve this. The rate appears to be even lower among mothers born in China, where 90% have introduced infant formula by this time. This study aimed to examine infant feeding patterns in the first 12 months of life and the factors associated with exclusive breastfeeding at 4 months of age and infant formula introduction by 1 month of age among Chinese Australian mothers.MethodsChinese Australian women with a child aged 1 to 4 years born in Australia were recruited through social media and asked to complete an online survey. Chinese ethnicity was defined as the mother or her parents having been born in mainland China, Taiwan or Hong Kong. Infant feeding practices since birth and a range of psychosocial and cultural factors were assessed. A total of 289 Chinese Australian mothers completed the survey. The relationships between exposure variables and exclusive breastfeeding at 4 months or infant formula use by 1 month were examined using multivariable logistic regression.ResultsAlmost all (93%) mothers initiated breastfeeding, however by 1 month of age exclusive breastfeeding rates reduced to 44%, with a further decline to 33 and 18% at 4 and 6 months respectively. Concurrently, 7% of parents reported infant formula feeding at birth increasing to 55 and 63% at 1 and 6 months of age respectively. The rates of any breastfeeding were 81% at 6 months and 50% at 12 months of age. Breastfeeding intention, self-efficacy and awareness of the infant feeding guidelines were key factors associated with sustained exclusive breastfeeding to 4 months.ConclusionsWhile Chinese Australian mothers had comparable exclusive breastfeeding rates at 6 months to the general Australian population, twice as many had introduced infant formula by 1 month of age. There is an urgent need to support Chinese Australian mothers in the perinatal period to strengthen their knowledge, intention and confidence to delay early introduction of infant formula and promote exclusive breastfeeding in the early postpartum period.
Highlights
While exclusive breastfeeding is recommended to 6 months of age, just 15% of mothers in Australia achieve this
The Australian National Infant Feeding Survey in 2010 showed that the breastfeeding initiation rate in Australia is high at 96%, at 6 months of age Exclusive breastfeeding (EBF) rate reduced to 15%, and at 12 months only 18% of mothers offer any breastfeeding [7]
A secondary analysis of the survey showed that a greater proportion of Chinese born mothers have used infant formula (90% vs. 81%), and on average introduced it at an earlier age than Australian born mothers (1.2 compared to 1.7 months) [8]
Summary
While exclusive breastfeeding is recommended to 6 months of age, just 15% of mothers in Australia achieve this. The Australian Infant Feeding Guidelines, consistent with the World Health Organization, recommend infants be exclusively breastfed for around 6 months when solid foods are introduced. Consistent with this, in a secondary analysis of data from a clinical trial at two hospitals in Sydney, Dahlen and Homer [9] reported that Asian born mothers (including Chinese born) were more likely to be partially breastfeeding in the first 12 weeks than non-Asian mothers in Australia Both studies reported that Chinese born (and other Asian ethnicities) mothers were more likely to be breastfeeding across the first year of life than Australian born mothers [8, 9]. The wide adoption of infant formula, referred to as ‘formula’ from hereon, at an early age in this population group is not consistent with the infant feeding guidelines and warrants further investigation
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