Feeding Practice And Related Factors In Infants During 0~6 Months In Wuhan

Objective: The aim of this study is to identify the feeding patterns of infant during 0~6 months and the factors associated with breastfeeding practice and to provide guidance for improving China's breastfeeding rate.Methods: 2202 mother-infant pairs were recruited from the Tongji Maternal and Child Health Cohort(TMCHC)study between January 2014 and December 2015.The questionnaire was used to collect sociodemographic data and detailed information on mother's characteristics(age,occupation,education,height,weight,etc.),birth record of infants(gender,weight,the mode of delivery)and feeding practice(breast milk,formula,complementary food,etc)in the neonatal period as well as at 3 and 6 months postpartum.The chi-square test(or Fisher exact probability method)and the Logistic multi-regression were used to analyze the factors that had significant effects on breastfeeding initiation and feeding practice.Results:1.The breastfeeding in infants was initiated by 41.6 % of mothers within the first day after childbirth,the rates of exclusive breastfeeding in the neonatal period was 31.3%,while 3 and 6 months postpartum was 54.3%,12.4% respectively.2.The results of univariate analysis showed that the pre-pregnancy BMI,parity,condition of liver disease,pregnancy induced hypertension,mode of delivery had a significant effect on breastfeeding initiation(p< 0.05).The mother's age,the BMI of postpartum mother,parity,condition of liver disease,infant's gender,mode of delivery,infant's birth weight had a significant influence on the feeding practice in neonatal period(p< 0.05).The mother's age,the BMI of postpartum mother,condition of liver disease,infant's gender,mode of delivery,and gestational weeks had a significant effect on feeding practice at 3 months postpartum(p< 0.05).The BMI of postpartum mother,complementary foods introduction,liver disease,infant's mode of delivery and gestational weeks had an effect on feeding practice at 6 months postpartum(p< 0.05).3.In multivariable logistic analyses,after adjusting for potential confounders,breastfeeding initiation within the first day of childbirth was delayed in women who had pregnancy induced hypertension or gave birth by caesarean section(OR:1.56,95%CI:1.28,1.89).The mothers who were older,or gave birth to a male infant,or gave birth by cesarean delivery(OR:1.65,95%CI:1.35,2.01),were associated with significantly higher risk of an inability to sustain exclusive breastfeeding in the neonatal period.The mothers who had liver disease,or gave birth to a male infant,or gave birth by cesarean delivery(OR:1.46,95%CI:1.21,1.77)had higher risk of an inability to sustain exclusive breastfeeding at 3 months postpartum.The mothers who gave birth by caesarean delivery had higher risk of an inability to sustain exclusive breastfeeding at 6 months postpartum(OR:1.83,95%CI:1.21,2.76).Conclusion:1.In our study,the rate of exclusive breastfeeding at 6 months postpartum is only 12.4%,which is lower than the goal of above 50% recommended by WHO.2.Our results suggest that caesarean delivery is an important risk factor for the inability to sustain exclusive breastfeeding as well as a delay in the initiation of breastfeeding.To improve the rate of exclusive breastfeeding in the first 6 months postpartum,we should take effective measures to reduce the caesarean section rate and encourage the mother to select the vaginal delivery.