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Purpose: Inadequate infant feeding practices are known to impact on a child’s lifetime health trajectory. However, few longitudinal studies have investigated the determinants of overall feeding practices during the first year of life. We created an infant feeding index (IFI) to measure overall adherence to national infant feeding guidelines and examined associations with maternal sociodemographic and health behaviour characteristics.
Methods: Data were from 6,435 infants born in 2009-10, whose mothers participated in the 9-month face-to-face interview. Based on the Ministry of Health’s Food and Nutrition Guidelines (2008), the IFI included 12 indicators covering breastfeeding, introduction to complementary foods, and food/drinks intake at 9-months assessed with a food frequency questionnaire (score range 0-12). Associations of child and mother characteristics with IFI scores were examined using multivariable linear regression models (p<0.05), adjusted for maternal antenatal age, ethnicity, deprivation, diet, smoking, physical activity and pre-pregnancy BMI.
Results: Individual indicators with lowest adherence were exclusive breastfeeding to 6-months (32.8%), any breastfeeding to 12-months (36.3%), vegetables 2xdaily (32.8%) and fruit 2xdaily at 9-months (37.0%). The mean IFI score was 8.2 (SD: 2.1). In the fully adjusted model, compared to reference groups, infants of mothers aged under
20 years (β1.39, 95%CI:1.66-1.11), with no secondary school qualification (β1.19, 95%CI:1.45-0.93), who smoked before and during pregnancy (β1.03, 95%CI:1.22-0.84), or lived in a deprived neighbourhood (β 0.91, 95%CI:1.08-0.74) scored lower on the IFI. Compared to European infants, Māori, Pacific and Asian infants scored on average 0.62 (β, 95%CI:0.80-0.44); 0.89 (β, 95%CI:0.07-0.71), 0.46 (β, 95%CI:0.63-0.29) adjusted points lower on the IFI, respectively.
Conclusions: This study highlights the impact maternal education, neighbourhood deprivation and ethnicity have on infant feeding practices in New Zealand. Culturally appropriate policies are needed that specifically address infant nutrition inequities (particularly, to support breastfeeding, introduction of complementary foods, and increased
fruit and vegetable intake). Additionally, policies that support women to be well educated and smokefree may help to improve infant nutrition. |
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