(SDAS) Multiple modes of infant feeding and trajectories influencing infant health
Grantee: University of South Carolina Research Foundation
Principal Investigator: Wilfried JJ Karmaus
Project Number: R40MC17165
Project Date: 02/1/2010
Final Report
Age group(s)
- Perinatal/Infancy (0-12 months)
Abstract
Breastfeeding is considered to protect mother and child against a variety of diseases. Recent approaches, however, have confined breastfeeding to breast milk feeding. In contrast to this restriction, we have demonstrated that duration of breastfeeding is related to increased lung volume in children and adolescents, which can be explained by lung growth due to the exercise related to direct breastfeeding imposed on the newborn. In addition, recently it has been demonstrated that breast milk changes its constitution, when it is stored and provided in a bottle. The lack of specification of the mode of breastfeeding' (direct vs. indirect breastfeeding) together with an increasing proportion indirect feeding is likely to have contributed to increasingly contradictory findings on beneficial health effects of breastfeeding. Direct breastfeeding refers to putting the baby to the breast while indirect breastfeeding signifies pumping and feeding. The latter is also called breast milk feeding. The critical overall question is therefore whether pumping and feeding provides less health benefits than direct breastfeeding. If so, mothers are misguided if pumping and feeding is promoted as a healthy way of breastfeeding. However, no study has yet compared the effects of various modes of breastfeeding on offspring health. The Pregnancy Risk Assessment Monitoring System does not provide information on the mode of breastfeeding. Since breastfeeding and breast milk feeding are not distinguished, the latter is considered as breastfeeding. However, recently the U.S. Food and Drug Administration has conducted a follow-up study of nursing mothers and collected monthly questionnaire data on various modes of feeding and on child health (prenatal to month 12). The Infant Feeding Practices Study II includes data on growth, infections, allergies and asthma. The actual sample size was 2,907 at birth and 1,782 at month 12. Data was collected in months 2-7, 9, 10.5, and 12. Each questionnaire includes a food-frequency table on which each mother were asked to indicate how often their infants were fed various food in the 7 days before completing the questionnaire. Health outcomes were inquired for the last two weeks before filling the questionnaire. We propose to re-analyze this unique data-set to test whether mode of feeding is related to offspring health. The re-analyses will provide answers to critical maternal child health questions: Are there typical feeding patterns over time or trajectories? What are prevalent switches from one mode of feeding to another? Which mode is stable? Which factors influence typical feeding trajectories and switches, in particular in month 1 to 6? Does indirect breastfeeding provide immediate protection for the infant against infections, allergy, and increased weight gain? Finally, do specific feeding trajectories in the first six months provide sustained health protection in months 6 to 12? Using the longitudinal study Infant Feeding Practices Study II, we will apply latent class analyses, repeated measurement models, and multinomial models to determine which factors are associated with specific feeding trajectories and which feeding modes/trajectories pose a risk for infant's health. The explanatory models will control for confounders, which have been carefully determined in the Infant Feeding Practices Study II. We have an ongoing local project on breastfeeding supported by the Thrasher Research Fund and collaborate in the analysis of early life factor (including breastfeeding) in the Isle of Wight birth cohort study supported by the National Institutes of Health. Based on our expertise, we are confident that we will successfully complete the proposed secondary analyses in one year and submit three papers for publication.Publications
Listed is descending order by year published.
Soto-Ramirez N, Kar S, Zhang H, Karmaus W. Infant feeding patterns and eczema in children in the first 6 years of life. Clin Exp Allergy. 2017;47(10):1285-1298.
Soto-Ramírez N, Karmaus W, Zhang H, Davis S, Agarwal S, Albergottie A. Modes of infant feeding and the occurrence of coughing/wheezing in the first year of life. J Hum Lact. 2013 Feb;29(1):71-80.
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