Abstract

The Australian Feeding Infants and Toddler Study 2021 (OzFITS 2021) is a nationwide survey of Australian caregivers’ infant and toddler feeding practices. Here, we describe breastfeeding rates and duration, use of breastmilk substitutes, and introduction of complementary (solid) foods, including common food allergens. Caregivers (n = 1140) were recruited by a digital marketing company and were interviewed using a structured telephone questionnaire to obtain information. Breastfeeding was initiated in 98% of infants, but the duration of exclusive breastfeeding to six months was less than 1%. Nearly 40% of children continued to receive breastmilk beyond one year, with 10% of toddlers receiving breastmilk at two years. One-quarter of infants were introduced to solid foods between 4 to 5 months, and nearly all infants had received solid foods by 7 months. New guidelines encourage the early introduction of potential food allergens to reduce the risk of allergy, and by 12 months, over 90% of children had been given eggs and peanuts. One-third of children received no breastmilk substitutes during their first year. One-third of infants first received breastmilk substitutes following birth and before discharge from the hospital. Of these infants, 30% ceased breastmilk substitute use after discharge. Our findings suggest a high rate of continued breastfeeding with 44% receiving breastmilk beyond 1 year. One approach to increase the duration of exclusive breastfeeding is to reduce breastmilk substitute use while in hospital.

Highlights

  • The Australian National Health and Medical Research Council (NHMRC) Infant Feeding Guidelines recommend exclusive breastfeeding for the first six months to optimize infant growth, development, and health [1,2,3]

  • Exclusive breastfeeding was initiated in 93% of infants; only 59% were exclusively breastfed to one month, and 39% were exclusively breastfed to four months

  • We found that the duration of exclusive breastfeeding to 4 months was 40%, falling to less than 1% at 6 months

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Summary

Introduction

The Australian National Health and Medical Research Council (NHMRC) Infant Feeding Guidelines recommend exclusive breastfeeding for the first six months to optimize infant growth, development, and health [1,2,3]. Infants should be given nutritious complementary (solid) foods with continued breastfeeding to 12 months and beyond. Solid foods should be introduced at around six months because breastmilk alone does not meet infant requirements for energy and select nutrients, iron [3]. By six months of age, just over half of the infants had been given breastmilk substitutes, with 40% of infants introduced during the first month of life. 35% of children had never received breastmilk substitutes (Table 3). Of the 40% (n = 455) of infants consuming breastmilk substitutes in their first month of life, 78% (350/455) received these in hospital soon after birth. Around 95% of children had been exposed to the common food allergens hen’s egg and peanut, 76% of the children had consumed tree nuts, and 82% had consumed sesame (Table 4). 0 (0, 0) 0 (0, 0) 0 (0, 0) 0 (0, 1) 3 (2, 4) 12 (10, 14) 54 (50, 57) 71 (68, 74) 82 (79, 85) 87 (85, 90) 92 (90, 94) 93 (91, 95) 97 (95, 98) 98 (97, 99) Peanut Tree Nuts

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