January 28, 2011
A new study by researchers at the University of North Carolina at Chapel Hill offers reasons why some mothers feed their infants complementary foods (juice, solids) before the infants are four months old, including the mothers’ perception that the infants are “fussy” and would be soothed by the introduction of complementary food.
 
The American Academy of Pediatrics and the World Health Organization, among other children’s health agencies, recommend exclusive breastfeeding for the first six months of life. Exclusive breastfeeding has been shown to protect infants and mothers against disease and offer other health benefits.
 
Heather Wasser, MPH

Heather Wasser, MPH

Heather Wasser, MPH, RD, nutrition doctoral student at UNC Gillings School of Global Public Health, is lead author of the study, which was published online Jan. 10 in the journal Pediatrics.

 
Data were from the Infant Care, Feeding and Risk of Obesity Study, which collected information from a group of 217 low-income, black, first-time mothers (ages 18 to 35) recruited through the Special Supplemental Nutrition Program for Women, Infants and Children, more commonly known as WIC. Mothers were assessed during in-home visits when their infants were 3, 6, 9, 12 and 18 months of age. Information for this study primarily was drawn from the 3-month home visit.
 
Mothers were asked to complete an infant diet history and to relate what their infants had eaten over the previous 24-hour period. They also were asked to describe their child’s temperament using six subscales from the Infant Behavior Questionnaire – Revised, a reliable instrument for measuring caregiver perceptions.
 
Researchers found that about 70 percent of the infants were fed some breast milk during the first month; about 20 percent were breastfed exclusively. However, by the third month, these percentages decreased dramatically (25 and 5 percent, respectively). By the third month, three-quarters of infants were fed either solids or juice.
 
“This shows we have a lot of work to do to help mothers delay the introduction of these foods,” Wasser said. “Otherwise, we will continue to have trouble meeting national health objectives for exclusive breastfeeding.”
 
Infants perceived to be fussy were nearly twice as likely to be fed solid food before age 4 months. Obese mothers were even likelier to feed their young infants solid foods. Mothers with college-level education and those who tried breastfeeding were less likely to begin complementary feeding early.
 
Among formula-fed infants, those given either solids or juice had an average daily energy intake 100 calories greater than infants given only formula. This finding is particularly troubling, given statistics on childhood obesity, the authors note. The number of overweight infants and toddlers in the U.S. has increased by 60 percent in the last 30 years; large infant size and rapid postnatal growth are associated with child and adult overweight; and the obesity epidemic is disproportionately affecting blacks, as compared to whites.
 
UNC study co-authors are Margaret Bentley, PhD, and Linda Adair, PhD, nutrition professors, and Meghan Slining, PhD, assistant nutrition professor, in the Gillings School of Global Public Health; Barbara Davis Goldman, PhD, research associate professor of psychology and scientist at the Frank Porter Graham Child Development Institute; and Amanda Thompson, PhD, assistant professor of anthropology. Bentley, Thompson, Slining and Adair also are fellows at the Carolina Population Center.
 
Judith Borja, PhD, from the Office of Population Studies at the University of San Carlos in Cebu City, Philippines, is also a co-author.
 
The authors call for development of counseling methods to help low-income, black, first-time mothers respond to infant behavior in ways that are supportive of optimal feeding and for breastfeeding interventions targeted to this group.
 
Goldman spoke about age-appropriate ways parents can soothe babies that do not involve food.
 
“Babies don’t have too many ways to tell us that they aren’t happy. [When they are fussy,] We have to think about whether they are bored, tired, hungry, lonely, uncomfortable, or are just having a bad day,” Goldman said.
 
For babies around three months old, Goldman suggests comforting techniques including swaddling, shushing, singing, dancing with the baby, rocking, patting or gently rubbing the baby’s body, going for a ride in a stroller or car, or giving the baby something interesting to play with or observe.
 
The study was funded by the National Institutes of Health.
 
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UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.
 

 

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