Toddler Feeding Research Articles

Positive Deviance in Nutritional Practices for Two-Year-Olds in Poor Fisherman Families in the Belawan Health Center Area, 2022

The problem of malnutrition is still the main problem faced in human resource development. The problem of growth and development of Baduta is a serious problem because at this age the process of physical and intellectual growth and development is critical. Malnutrition problems mostly occur in poor families but are not caused by poor families who have well-nourished children. The Belawan Community Health Center working area is one of the community health centers with the highest number of cases of malnutrition in Medan City. To overcome this, a program is needed that is believed to be effective and sustainable. One of the existing programs to overcome the problem of malnutrition and malnutrition is positive deviation. This research aims to identify positive behavior in feeding (type of food, processing of food ingredients, mealtimes and method of feeding) of toddlers who are well-nourished in poor fishing families in the Belawan Community Health Center Working Area in 2022. This research method is qualitative research with a narrative approach. Researchers studied individual lives by asking one or several individuals to tell stories about their lives related to positive behavior in feeding well-nourished animals. This information is then retold by the researcher in a narrative chronology. The findings of this research indicate that addressing nutritional challenges in children can be effectively achieved by leveraging the potential and resources within the community. This is done through the identification of positive deviant behaviors, particularly those related to beneficial feeding practices. These practices encompass aspects such as the types of food provided, the methods of food preparation, the timing of meals, and the approach to food administration. Keep up the great work! The way you’re thinking about integrating community strengths is spot-on for creating sustainable solutions.

Infant diet quality index predicts nutrients of concern and ultraprocessed food intake in low-income children in the United States

BackgroundDiet quality during infancy can influence nutrient intake and ultraprocessed foods (UPFs) consumption throughout later childhood. ObjectivesThis study investigated the predictive validity of Infant Diet Quality Index (IDQI) scores from 0 to 1 y of age and consumption of select nutrients and UPFs at different time points in low-income children aged 2–5 y. MethodsDietary surveys and 24-h dietary recalls collected between ages 0 and 12 months from 2613 Special Supplemental Women, Infants, and Children Infant Toddler Feeding Practices Study-2 participants were used to assess infant diet quality by final IDQI score ranging from 0 (nonadherence to dietary guidelines) to 1 (complete adherence to guidelines). Single 24-h recalls collected across multiple time points per child aged between 2 and 5 y were used to determine nutrient intakes: vitamin B12 (μg), vitamin D (μg), calcium (mg), iron (mg), zinc (mg), potassium (mg), saturated fat (g), and dietary fiber (g), and added sugars (g). Likewise, Nova was used to classify foods (to estimate the percentage of energy from foods) by level of industrial processing at each point in time across ages 2–5 y. Survey-weighted regression analyses estimated associations between total IDQI score and nutrient intake and percentage of energy consumption from each Nova food group at each age between 2–5 y. ResultsIDQI scores based on diet quality from 0–1 y of age were positively associated with children’s dietary fiber and potassium intake at ages 2–5 y. Additionally, IDQI was negatively associated with added sugar intake. No associations were observed between IDQI and saturated fat consumption. IDQI scores at age 1 were positively associated with the percentage of energy attributed to unprocessed/minimally processed foods (20%–23%) and negatively associated with UPF consumption at ages 2–5 y (−24% to −29%). ConclusionsIDQI predicts intake of select nutrients and UPF consumption among low-income US children aged 2–5 y.This trial was registered at https://clinicaltrials.gov/study/NCT02031978 as “Feeding My Baby – A National WIC Study,” NCT02031978.

The Influence of Emo Demo on Mother’s Knowledge and Attitudes in Providing Infant Feeding

Children under two years old are a critical period in child development, characterized by rapid growth and development. One nutritional issue, stunting, can arise from inappropriate feeding practices and leads to impaired brain development, intelligence, physical growth, and metabolic function. To address this, we implemented Emotional Demonstration education on baby and child feeding schedules for young mothers. This study aimed to analyze the impact of Emotional Demonstration education on mothers’ knowledge and attitudes regarding toddler feeding practices at Dahlia Posyandu, Pabuaran Village, Bogor Regency. A Pre-Experimental One Group Pre-Test Post-Test design was employed involving 32 young women from the Bojonggede Community Health Center. Data were collected through pre-test and post-test questionnaires, analyzed using the Wilcoxon test. Results indicate a significant improvement in mothers’ knowledge following Emotional Demonstration education. However, no significant change was observed in their attitudes. In conclusion, Emotional Demonstration education effectively enhances maternal knowledge about baby and child feeding schedules but does not influence their attitudes

Psychometric properties of the toddler feeding style questionnaire in fathers and its gender invariance

Parental feeding practices and behaviours are closely related to a number of child outcomes, including eating behaviour and health. The Toddler Feeding Style Questionnaire (TFSQ) was developed to provide an accurate instrument for evaluating parental feeding practices for toddlers by assessing two dimensions: responsiveness and demandingness. As the initial validation study was conducted in a sample of mothers only, the aims of this study are: a) to validate the TFSQ in fathers, b) to analyse its measurement invariance as a function of gender and parenting experience and c) to explore associations between socio-demographic variables and both dimensions. The TFSQ was completed by 377 fathers and 583 mothers. CFA confirmed the two-factor structure within the same items as the initial validation study, with good model fit indices (X2 = 230.089; TLI = 0.883; CFI = 0.91; RMSEA = 0.08 (90% CI 0.068–0.092), SRMR = 0.070). Strict invariance measurement in terms of gender and parenting experience was achieved. Overall, fathers scored higher than mothers on demandingness, regardless of their parenting experience. Primiparous mothers scored higher than multiparous mothers and primiparous fathers on the responsiveness dimension. However, there were no gender-based differences on this dimension for parents with more than one child. These results confirm that the TFSQ is an adequate and validated instrument for assessing parenting dimensions, as it performs equally well for mothers and fathers, regardless of their parenting experience. There is also support for the notion that parental attitudes to feeding may be related to their socio-economic background.

Obesity and Severe Obesity Among Children Aged 24 to 48 Months Participating in the WIC Infant and Toddler Feeding Practices Study-2 by Race/Ethnicity

Obesity and Severe Obesity Among Children Aged 24 to 48 Months Participating in the WIC Infant and Toddler Feeding Practices Study-2 by Race/Ethnicity

Breastfeeding Patterns in Stunted and Not Stunted Toddlers Using Infant Feeding Area Graphs in the Working Area of the Pagambiran Health Center, Padang

One of the nutritional problems of children in Indonesia is stunting. Fulfillment of nutrition in the first 1,000 days of life is related to stunting. WHO recommends breastfeeding and breastfeeding as a method of feeding babies to achieve optimal growth and development. This descriptive study aims to provide an overview of the feeding practices of stunted and non-stunting toddlers as seen in the feeding history included in the Toddler Feeding Area Chart from 0-6 months of age. This research found that giving breast milk alone to stunted toddlers (52.17%) was lower than non-stunting toddlers (66.67%), and the most common feeding pattern for stunted toddlers was formula milk.

THE RELATIONSHIP BETWEEN MATERNAL NUTRITIONAL KNOWLEDGE AND FEEDING PATTERNS IN STUNTED TODDLERS

The nutrients in the food consumed play a role in determining a person's condition and nutritional status. This research aims to determine the description and relationship between the level of maternal nutritional knowledge and the feeding patterns of mothers who have stunted toddlers in Desa Sumorame Candi Sidoarjo. This research method is analytical observational with a cross sectional approach. The research subjects were 40 mothers of stunted toddlers in Sumorame Candi Sidoarjo Village. Data collection used a questionnaire with guided interviews. Data were analyzed using the Chi-square test (significance ?<0.05). Data shows the percentage of mothers with high levels of knowledge about nutrition (5%), medium (27.5%), and low (67.5%) while mothers with appropriate (47.5%) and inappropriate feeding patterns (52, 5%). The chi-square statistical test results showed a relationship between the mother's level of knowledge and toddler feeding patterns (p=0.027). The research concludes that the mother's level of knowledge about nutrition influences the mother's feeding pattern for her toddler.

Toddler Stunting Consulting Chatbot using Rasa Framework

Chatbots are artificial intelligence software that can communicate with users to assist them in certain tasks or provide information. They can reduce the need for human interaction and make processes more efficient. However, when it comes to more specific tasks related to handling the problem of stunting in toddlers these services are usually unable to provide an appropriate response. Chatbots were created with the help of the Rasa framework, which was designed to adapt the various components of natural language understanding (NLU). This adjustment allows him to understand more complex questions from respondents such as those related to healthy feeding of toddlers. This research explained the use of the Rasa framework to enhance their capabilities, describe the testing and evaluation process, and present the performance results of the chatbot model in addressing the issue of stunting in toddlers. The model is then tested using a confusion matrix, precision, accuracy, and F1 score, which measures how accurate the chatbot's responses are to the user's input. The model had a precision, accuracy, and F1 score of 0.928, 0.932 and 0.930, respectively.

Dominant Factors in Complementary Food Feeding in Babies and Toddlers

During the first two years of their lives, 52.8% of Indonesian children aged 6–23 months did not receive the nutrition they needed to grow and develop optimally. In 2019, Tulang Bawang Regency was one of the areas in Lampung province with the most significant percentage of very underweight toddlers (BB/TB) at 7.7%. Of the nine health centers, the lowest infant health service coverage was at the Banjar Baru Health Centre, Tulang Bawang Regency. The research aims to determine the dominant factors in giving MP-ASI to babies and toddlers in Tulang Bawang Regency in 2021. This research is correlational-analytic with a cross-sectional approach. Sampling used a stratified random sample of 132 mothers with babies and toddlers aged 6–24 months. Bivariate analysis uses the chi-square test, and multivariate analysis uses the logistic regression test. The results show that internal factors (age familiarity with food, child activity, and child health history) and some external factors (type of food, frequency of feeding, number of feedings, and community culture) have a significant relationship with MP-ASI feeding behavior in babies and toddlers (p

Differences in Infant Diet Quality Index by Race and Ethnicity Predict Differences in Later Diet Quality

BackgroundRacial and ethnic disparities in infant-feeding practices may negatively influence diet quality and health. ObjectivesThis study investigated the racial, ethnic, and language (English or Spanish) differences in infant diet quality, later diet quality, and weight status at 2–5 y, and whether these differences were explained through infant diet quality among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). MethodsUsing the WIC Infant and Toddler Feeding Practices Study-2 (unweighted n = 2663; weighted n = 362,712), relationships between the Infant Dietary Quality Index (IDQI; range 0–1) and Healthy Eating Index-2020 (HEI-2020; range 0–100) and BMI z-score (BMIz) at 2–5 y were analyzed by race, ethnicity, and language preference [Hispanic Spanish-speaking, Hispanic English-speaking, non-Hispanic (NH) White, and NH Black participants]. Statistical interaction between IDQI and each group was evaluated in multivariable models. The mediation of each group through the IDQI was assessed using causal mediation methods. ResultsDifferences in IDQI [mean (standard deviation)] were observed between Hispanic Spanish-speaking participants [0.41 (0.10)], Hispanic English-speaking participants [0.37 (0.10)], NH White participants [0.36 (0.10)], and NH Black participants [0.35 (0.09)], P < 0.001. Differences in HEI-2020 occurred at 2–5 y, with the Hispanic Spanish-speaking participants having consistently higher HEI-2020 scores. Differences in BMIz were observed at 5 y, with higher scores among Hispanic Spanish-speaking participants. Interaction between race, ethnicity, and IDQI was observed for all outcomes except for BMIz at 3 y. Through mediation, IDQI explained 13%–20% of the difference in HEI-2020 scores between Hispanic Spanish-speaking and NH White participants at 2–5 y. IDQI explained 22%–25% of the difference in HEI-2020 scores between the Hispanic Spanish-speaking and NH Black participants at 4 y and 5 y. ConclusionsHigher infant diet quality scores observed in Hispanic Spanish-speaking participants explain some of the racial and ethnic differences observed in later diet quality, suggesting that improving infant diet quality may help reduce diet disparities during early childhood.

Relationship between Socio-Economic with Parent’s Knowledge of Toddler Feeding Patterns

Parental knowledge about toddler feeding patterns is one of the factors that can affect the incidence of stunting. Knowledge about toddlers' feeding patterns can be influenced by socioeconomic factors such as education level, occupation, and income. This study analyzed the relationship between education level, occupation, and income with parental knowledge of toddler feeding patterns in the stunting locus. This study used a quantitative correlation design with a secondary data approach. The population is the respondent from secondary data, parents with toddlers in Sukamulya Village. The samples were taken using the total sampling technique of 76 people. The variables in the study were education level, occupation, income, and knowledge of child nutrition patterns. The instrument consisted of questions on education level, employment status, income level, and 14 toddler feeding patterns knowledge questions. Statistical test using Chi-square with 5% significance level. The results of the study found that there was no relationship between education level (p-value=0.282), occupation (p-value=0.717), and income (p-value=1.000) with toddler feeding patterns knowledge. It is due to other factors that influence the knowledge of children's eating habits. More research is needed to determine the factors that influence knowledge of children's feeding patterns.

Early introduction of complementaryfoods/drinks and milk feeding type in the Special Supplemental Nutrition Program for Women, Infantsand Children (WIC).

Infants younger than 4 months are not ready for complementary foods/drinks (any solid or liquid other than breast milk or infant formula). Almost half of USinfants participate in the Special Supplemental Nutrition Program for Women, Infantsand Children (WIC), which provides nutrition education and support to low-income families. We describe the prevalence of early introduction (<4 months) of complementary foods/drinks and examine the association of milk feeding type (fully breastfed, partially breastfedor fully formula fed) with early introduction of complementary foods/drinks. We used data from 3310 families in the longitudinal WIC Infant and Toddler Feeding Practices Study-2.We described the prevalence of early introduction of complementary foods/drinks and modeled the association of milk feeding type at Month 1 with early introduction of complementary foods/drinks using multi-variable logistic regression. Thirty-eight percent of infants were introduced early to complementary foods/drinks (<4 months). In adjusted models, infants who were fully formula fed or partially breastfed at Month 1 were 75% and 57%, respectively, more likely to be introduced early to complementary foods/drinks compared with fully breastfed infants. Almost twoin fiveinfants were given complementary foods/drinks early. Formula feeding at Month 1 was associated with higher odds of early introduction of complementary foods/drinks. There are opportunities to support families participating in WIC to prevent early introduction of complementary foods/drinks and promote child health.

Implementation of a sample design for a survey of program participants using time-location sampling.

To assess the feeding practices and behaviors of women and young children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), USDA currently funds the longitudinal WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2). In 2013, the study used time-location sampling (TLS) to enroll a cohort of infants who participated in WIC around birth. The children are subsequently followed across their first six years of life, regardless of their participation in WIC, with an additional follow-up at age nine years. A woman may enroll her child in WIC either during pregnancy or postpartum. For this study, a representative sample of infants enrolled in WIC was desired. Because the associations between WIC prenatal support and education and feeding practices and behaviors are substantively important to this study, the sample needed to include both women enrolling their children prenatally and women enrolling their children postnatally. For prenatal WIC enrollees, we attempted to complete a prenatal interview with the mother prior to the child's birth. This paper describes the TLS approach used and the challenges addressed in implementation of the sample design and selection for the WIC ITFPS-2. Our approach generated a probability sample (subject to site geographic and size exclusions) using a stratified, multistage design, but there were challenges at each stage of selection. First, a WIC site was selected, and then newly enrolled WIC participants were sampled within selected sites during predetermined recruitment windows based on the site's average flow of new WIC enrollees. We discuss issues faced, including overcoming incomplete lists of individual WIC sites and discrepancies between projected new WIC enrollment counts and actual flow of new WIC enrollments during the recruitment period.

Familial Sources of Encouragement and Breastfeeding Practices Among Women Participating in the United States Special Supplemental Nutrition Program for Women, Infants, and Children.

To explore how sources of familial encouragement are associated with breastfeeding initiation and duration among a national sample participating in the United States Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This study uses the 2013-2015 WIC Infant and Toddler Feeding Practices Study 2 (WIC ITFPS-2) data. Breastfeeding initiation was measured at the first month while duration was derived from a composite of the first 13 months. The analysis used logistic and linear regression to explore the association between encouragement sources and breastfeeding outcomes. A nationally representative sample of WIC participants in the United States. WIC participants who completed the 13-month interview of the WIC ITFPS-2 (n=2,807). Encouragement was significantly associated with both initiation and duration. Each source of encouragement was associated with a 3.2 (95% CI 2.8-3.8) increase in odds of initiating breastfeeding in the unadjusted model and 3.0 (95% CI 2.5-3.6) increased odds, controlling for age, education, nativity, poverty status, race, and ethnicity (<0.0001). When predicting log duration, each percent increase in source of encouragement was associated with an increasing duration on average by 0.003 days (95% CI 0.2-0.3, <0.0001). When controls were added, it was associated with an increase of an average of 0.002 days (95% CI 0.2-0.3) days per percent increase in encouragement source (<0.0001). Women who receive encouragement appear to be more likely to breastfeed. Additional work is needed to explore sources of encouragement and how to include them in intervention work.

Preventing malnutrition within the first 1000 days of life in under-resourced communities: An integrative literature review.

This integrative review aimed to summarise existing best evidence practice for preventing malnutrition within the First 1000Days of Life in under-resourced communities. BioMed Central, EBSCOHOST (Academic Search Complete, CINAHL and MEDLINE), Cochrane Library, JSTOR, Science Direct and Scopus were searched as well as Google Scholar and relevant websites for grey literature. Most recent versions of strategies, guidelines, interventions and policies; published in English, focussing on preventing malnutrition in pregnant women and in children less than 2years old in under-resourced communities, from January 2015 to November 2021 were searched for. Initial searches yielded 119 citations of which 19 studies met inclusion criteria. Johns Hopkins Nursing Evidenced-Based Practice Evidence Rating Scales for appraising research evidence and non-research evidence were used. Extracted data were synthesised using thematic data analysis. Five themes were derived from extracted data: 1. Improving social determinants of health using a multisector approach; 2. Enhancing infant and toddler feeding; 3. Managing healthy nutrition and lifestyle choices in pregnancy; 4. Improving personal and environmental health practices; and 5. Reducing low-birthweight incidence. Further exploration regarding preventing malnutrition in the First 1000Days in under-resourced communities is required using high-quality studies. Systematic review registration number: H18-HEA-NUR-001 (Nelson Mandela University).

Maternal feeding styles and the risk of overweight in a cohort of Caribbean infants

AbstractIntroductionParental feeding styles in the first years of life may increase childhood overweight risk. There are few studies on this association in children under 2 years. The current study aimed to investigate the association between maternal feeding styles and Caribbean infants’ risk of overweight at 18 months and determine whether maternal depression is an important confounder in the association.MethodsIt is a prospective study of mother–child dyads that participated in a three‐island parenting trial. Maternal and infant characteristics were collected at infant age 6–10 weeks with maternal depression assessed using the Center for Epidemiologic Studies Depression (CES‐D) scale questionnaire. Feeding styles were measured using items from the Toddler Feeding Behaviour Questionnaire at 12 months. Infant weight and length were measured at 18 months, and infants at risk of overweight were defined as weight‐for‐length z‐scores (WLZ) &gt; 1. Factor analysis was used to identify feeding styles and associations with overweight risk assessed using multilevel logistic regression accounting for country and health clinic. Logistic regression models were adjusted for infant and maternal covariates, with a final model including depressive symptom scores.ResultsOf 366 infants assessed, 18.9% were affected by the risk of overweight. Five feeding styles were identified—uninvolved, indulgent, forceful, restrictive and responsive. Only restrictive feeding was associated with an increased risk of overweight (OR [95% CI], 1.61 [1.22, 2.13]). The association strengthened after adjusting for maternal depressive symptoms (OR [95% CI], 1.79 [1.30, 2.30]), representing an 11.18% increase in the risk of overweight odds.ConclusionInterventions that address restrictive feeding may be one strategy to reduce overweight risk among Caribbean maternal–infant dyads.

The Infant Diet Quality Index Predicts Dietary and Adiposity Outcomes in US Children 2 to 4 years old

BackgroundHealthy nutrition during the first year of life is critical for optimal growth and development. Limited techniques are available to assess diet quality in infancy, and few have been shown to be predictive of dietary and adiposity outcomes in low-income children. ObjectiveThe objectives of this study were to construct an Infant Diet Quality Index (IDQI) to assess the diet quality from birth to 12 mo and to determine whether the IDQI exhibits predictive validity by estimating the longitudinal associations of IDQI scores with diet quality and weight status at 2 to 4 y. DesignData were analyzed from the longitudinal Women, Infants, and Children Infant and Toddler Feeding Practices Study-2 (unweighted, n = 2858; weighted. N = 392,439) using one 24-h dietary recall and survey responses during infancy. The newly constructed IDQI consists of 16 equally-weighted components: 1) breastfeeding duration; 2) exclusive breastfeeding; age of first introduction of: 3) solids, 4) iron-rich cereals, 5) cow milk, 6) sugar-sweetened beverages, 7) salty/sweet snacks, 8) other drinks/liquids, and 9) textured foods; frequency of consuming 10) fruit or 11) vegetables; frequency of consuming different 12) fruit or 13) vegetables; 14) nonrecommended bottle-feeding practices; 15) use of commercial baby foods; and 16) number of meals and snacks. Regression analysis was used to estimate associations between the total IDQI score (range, 0–1) and Healthy Eating Index-2015 (HEI-2015) scores and body mass index z-scores (BMIz) at 2 to 4 y of age, adjusted for covariates (e.g., child age, sex and race/ethnicity; maternal education level, etc.) ResultsThe total IDQI score was positively associated with HEI-2015 at the age of 2 y (β = 16.7; 95% CI: 12.6, 20.9; P < 0.001), 3 y (β = 14.5; 95% CI: 8.1, 21.0; P < 0.001), and 4 y (β = 15.4; 95% CI: 8.4, 22.4; P < 0.001); and negatively associated with BMIz at the age of 2 y (β = -1.24; 95% CI: -2.01, -0.47; P = 0.002) and 4 y (β = -0.92; 95% CI: -1.53, -0.30; P = 0.003). ConclusionsThe IDQI has predictive validity for diet quality and weight status in low-income US children.

Comparing Diet Quality Indices for Low-Income 24-Month-Old Toddlers: Exploring Changes Driven by 2020–2025 Dietary Guidelines for Americans

BackgroundAccurate assessment of toddler diet quality is essential for understanding current intakes and evaluating the effect of interventions and programs to promote healthy eating and prevent chronic disease. ObjectivesThe goal of this article was to assess the diet quality among toddlers using two different indices appropriate for 24-mo-old toddlers and compare differences in scoring between the measures by race and Hispanic origin. MethodsWe used cross-sectional data from 24-mo-old toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a national study that includes 24-hour dietary recall information from children enrolled in WIC at birth. The main outcome measure was diet quality using both the toddler diet quality index (TDQI) and the healthy eating index (HEI)-2015. We derived mean scores for overall diet quality and for each component. We examined associations between the distribution of diet quality scores across terciles and by race and Hispanic origin using Rao-Scott chi-square tests of association. ResultsNearly half of the mothers and caregivers self-identified as Hispanic (49%). Diet quality scores were higher when using the HEI-2015 compared with the TDQI (56.4 vs. 49.9, respectively). The difference in component scores was largest for refined grains, followed by sodium, added sugars, and dairy. Toddlers from Hispanic mothers and caregivers had significantly higher component scores for greens and beans and dairy but had lower scores for whole grains (P < 0.05) than those for the other racial and ethnic subgroups assessed. ConclusionsWe found noteworthy differences in toddler diet quality depending on whether the HEI-2015 or TDQI is used, and children of different racial and ethnic subgroups may be differentially classified as having high or low diet quality depending on which index is used. This may have important implications for understanding which populations are at risk of future diet-related diseases.

Perinatal Hospital Practices Are Associated with Breastfeeding through 5 Months Postpartum among Women and Infants from Low-Income Households

BackgroundBreastfeeding (BF) provides optimal nutrition during the first 6 mo of life and is associated with reduced infant mortality and several health benefits for children and mothers. However, not all infants in the United States are breastfed, and sociodemographic disparities exist in BF rates. Experiencing more BF-friendly maternity care practices at the hospital is associated with better BF outcomes, but limited research has examined this association among mothers enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk of low BF rates. ObjectivesWe assessed the association between BF-related hospital practices (rooming-in, support from hospital staff, and provision of a pro-formula gift pack) and the odds of any or exclusive BF through 5 mo among infants and mothers enrolled in WIC. MethodsWe analyzed data from the WIC Infant and Toddler Feeding Practices Study II, a nationally representative cohort of children and caregivers enrolled in WIC. Exposures included maternal experience of hospital practices reported at 1 mo postpartum, and BF outcomes were surveyed at 1, 3, and 5 mo. ORs and 95% CIs were obtained using survey-weighted logistic regression, adjusting for covariates. ResultsRooming-in and strong hospital staff support were associated with higher odds of any BF at 1, 3, and 5 mo postpartum. Provision of a pro-formula gift pack was negatively associated with any BF at all time points and with exclusive BF at 1 mo. Each additional BF-friendly hospital practice experienced was associated with 47% to 85% higher odds of any BF over the first 5 mo and 31% to 36% higher odds of exclusive BF over the first 3 mo. ConclusionsExposure to BF-friendly hospital practices was associated with BF beyond the hospital stay. Expanding BF-friendly policies at the hospital could increase BF rates in the United States WIC-served population.

Prenatal Perception of WIC Breastfeeding Recommendations Predicts Breastfeeding Exclusivity and Duration in the Infants’ First Year

Pregnant participants who perceived that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) recommends breastfeeding only were more likely to have better early breastfeeding outcomes. Our objective was to examine the association between prenatal perception of WIC's breastfeeding recommendations and breastfeeding duration through the first year of infant life. This observational study used a national longitudinal sample of 1594 pregnant participants in the WIC Infant and Toddler Feeding Practices Study-2 in 2013. Four measures of breastfeeding duration were used: 1) a discrete measure of exclusive breastfeeding through 5 mo; 2) a continuous measure of exclusive breastfeeding (in days up to 7 mo); 3) a discrete measure of any breastfeeding through 11 mo; and 4) a continuous measure of any breastfeeding (in days up to 13 mo). The primary explanatory variable was the participant's prenatal perception of whether WIC recommended breastfeeding only. The univariate analyses of time to breastfeeding cessation were performed using Kaplan-Meier curves. The Cox regression model was adopted to estimate the likelihood of breastfeeding outcomes over time. All analyses accounted for complex survey design effects. Compared with their peers who perceived WIC to recommend formula only or both breastfeeding and formula equally, participants who perceived WIC as recommending breastfeeding only were less likely to stop exclusive breastfeeding through 5 mo (HR = 0.83; 95% CI: 0.69, 0.99) or to stop any breastfeeding through 11 mo (HR = 0.80; 95% CI: 0.69, 0.92), without controlling for prenatal infant feeding intentions. Similar patterns were observed in the 2 continuous measures, as they were also less likely to stop exclusive breastfeeding by 7 mo (HR = 0.78; 95% CI: 0.69, 0.90) or to stop any breastfeeding by 13 mo (HR = 0.82; 95% CI: 0.71, 0.95). Prenatal perception of WIC's breastfeeding recommendation can be a useful predictor of breastfeeding duration in WIC participants.