Infant feeding practices among macrosomic infants: A prospective cohort study

TY - JOUR

T1 - Infant feeding practices among macrosomic infants: A prospective cohort study

AU - Davie, Philippa

AU - Bick, Debra

AU - Pasupathy, Dharmintra

AU - Norton, Sam

AU - Chilcot, Joseph

N1 - Funding Information: The authors wish to extend their thanks and gratitude to all the women enrolled in the PIPINS Study for their time and contribution to this research. The authors also wish to thank Ms. Manuela Tedeschi for her contributions to study organisation and data collection. This research study was funded as part of a PhD studentship stipend awarded to PD (King's College London IoPPN Studentship Prize 2016/17) and funding awarded to the PIPINS Study (Ref: 18/LO/0740) from Guy's and St Thomas' Charity, London, UK (Grant Reference EIC181002). Funders (GSTC) of a grant awarded to support this study did not have any permissions or influence over study design, methodology (including data collection), data analysis, data interpretation or manuscript preparation. Data from the study will be used in collaborative work to inform local health care provision aimed at improving healthy eating in the early years. Funding Information: Research grant (EIC181002) awarded by Guy's and St Thomas' Charity (London, UK) supported PD for a period of 4 months (part‐time) to conduct the work as part of this study. Publisher Copyright: © 2021 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

PY - 2021/10

Y1 - 2021/10

N2 - The health benefits of breastfeeding are well recognised, but breastfeeding rates worldwide remain suboptimal. Breastfeeding outcomes have yet to be explored among women who give birth to macrosomic (birthweight ≥4000 g) infants, a cohort for whom the benefits of breastfeeding may be particularly valuable, offering protection against later-life morbidity associated with macrosomia. This longitudinal prospective cohort study aimed to identify whether women who give birth to macrosomic infants are at greater risk of breastfeeding non-initiation or exclusive breastfeeding (EBF) cessation. A total of 328 women in their third trimester were recruited from hospital and community settings and followed to 4 months post-partum. Women gave birth to 104 macrosomic and 224 non-macrosomic (<4000 g) infants between 2018 and 2020. Longitudinal logistic regression models calculated odds ratios (ORs) and 95% confidence intervals (CIs) to assess likelihood of EBF at four timepoints post-partum (birth, 2 weeks, 8 weeks, and 4 months) between women who gave birth to macrosomic and non-macrosomic infants, adjusted for maternal risk (obesity and/or diabetes), ethnicity and mode of birth. Macrosomic infants were more likely to be exclusively breastfed at birth and 2 weeks post-partum than non-macrosomic infants with adjusted OR = 1.94 (95% CI: 0.90, 4.18; p = 0.089) and 2.13 (95% CI: 1.11, 4.06; p = 0.022), respectively. There were no statistically significant associations between macrosomia and EBF at 8 weeks or 4 months post-partum. Macrosomia may act as a protective factor against early formula-milk supplementation, increasing the likelihood of EBF in the early post-partum period, but rates of exclusive breastfeeding continued to decline over the first 4 months post-partum.

AB - The health benefits of breastfeeding are well recognised, but breastfeeding rates worldwide remain suboptimal. Breastfeeding outcomes have yet to be explored among women who give birth to macrosomic (birthweight ≥4000 g) infants, a cohort for whom the benefits of breastfeeding may be particularly valuable, offering protection against later-life morbidity associated with macrosomia. This longitudinal prospective cohort study aimed to identify whether women who give birth to macrosomic infants are at greater risk of breastfeeding non-initiation or exclusive breastfeeding (EBF) cessation. A total of 328 women in their third trimester were recruited from hospital and community settings and followed to 4 months post-partum. Women gave birth to 104 macrosomic and 224 non-macrosomic (<4000 g) infants between 2018 and 2020. Longitudinal logistic regression models calculated odds ratios (ORs) and 95% confidence intervals (CIs) to assess likelihood of EBF at four timepoints post-partum (birth, 2 weeks, 8 weeks, and 4 months) between women who gave birth to macrosomic and non-macrosomic infants, adjusted for maternal risk (obesity and/or diabetes), ethnicity and mode of birth. Macrosomic infants were more likely to be exclusively breastfed at birth and 2 weeks post-partum than non-macrosomic infants with adjusted OR = 1.94 (95% CI: 0.90, 4.18; p = 0.089) and 2.13 (95% CI: 1.11, 4.06; p = 0.022), respectively. There were no statistically significant associations between macrosomia and EBF at 8 weeks or 4 months post-partum. Macrosomia may act as a protective factor against early formula-milk supplementation, increasing the likelihood of EBF in the early post-partum period, but rates of exclusive breastfeeding continued to decline over the first 4 months post-partum.

UR - http://www.scopus.com/inward/record.url?scp=85107317733&partnerID=8YFLogxK

U2 - 10.1111/mcn.13222

DO - 10.1111/mcn.13222

M3 - Article

SN - 1740-8709

VL - 17

JO - Maternal & Child Nutrition

JF - Maternal & Child Nutrition

IS - 4

M1 - e13222

ER -