The American Academy of Pediatrics recommends exclusive breastfeeding until 6 months- of-age. The authors examined prevalence and risk factors for use of infant formulas, water, and teas at 4–6 weeks in Latino infants in the San Francisco Bay Area, a group at high risk for future obesity. They recruited a cohort of pregnant Latina women (N = 201). Infant dietary recall and postpartum depressive symptoms were assessed at 4–6 weeks. The authors found that 105 women (53.1%) were feeding infant formulas and 48 (25.4%) were supplementing with tea or water. Of those providing water or tea, 60.0% were providing daily supplementation. In multivariate analyses, risk for infant supplementation with water or tea was associated with postpartum depressive symptoms (relative risk, 1.8; 95% confidence interval, 1.1–3.0), cesarean delivery (relative risk, 1.9; 95% confidence interval, 1.3–2.9), and infant formula use (relative risk, 1.3; 95% confidence interval, 1.1–1.6). Early supplementation with water or teas and infant formulas should be discouraged in Latinos, given the high frequency observed in this population. J Hum Lact. 27(2):122–130.

Background

Latino children are at increased risk for mirconutrient deficiencies and problems of overweight and obesity. Exposures in pregnancy and early postpartum may impact future growth trajectories.

Objectives

To evaluate the relationship between prenatal and postnatal maternal depressive symptoms experienced in pregnancy and infant growth from birth to 2 years of age in a cohort of Latino infants.

Methods

We recruited pregnant Latina mothers at two San Francisco hospitals and followed their healthy infants to 24 months of age. At 6, 12 and 24 months of age, infants were weighed and measured. Maternal depressive symptoms were assessed prenatally and at 4-6 weeks postpartum. Women who had high depressive symptoms at both time periods were defined as having chronic depression. Logistic mixed models were applied to compare growth curves and risk for overweight and underweight based on exposure to maternal depression.

Results

We followed 181 infants to 24 months. At 12 and 24 months, respectively, 27.4% and 40.5% were overweight, and 5.6% and 2.2% were underweight. Exposure to chronic maternal depression was associated with underweight (OR = 12.12, 95%CI 1.86-78.78) and with reduced weight gain in the first 2 years of life (Coef = -0.48, 95% CI -0.94—0.01) compared with unexposed infants or infants exposed to episodic depression (depression at one time point). Exposure to chronic depression was also associated with reduced risk for overweight in the first 2 years of life (OR 0.28, 95%CI 0.03-0.92).

Conclusions

Exposure to chronic maternal depression in the pre- and postnatal period was associated with reduced weight gain in the first two years of life and greater risk for failure to thrive, in comparison with unexposed infants or those exposed episodically. The infants of mothers with chronic depression may need additional nutritional monitoring and intervention.

Abstract

Background

Positive parental attitudes towards infant feeding are an important component in child nutritional health. Previous studies have found that participants in the Special Supplemental Women, Infants, and Children (WIC) Program have lower breastfeeding rates and attitudes that do not contribute towards healthy infant feeding in spite of breastfeeding and nutrition education programs targeting WIC participants. The objective of this study was to assess the frequency of exclusive breastfeeding in the early postpartum period and maternal attitudes towards breastfeeding in a population of mothers at two San Francisco hospitals and in relation to WIC participation status.

Methods

We interviewed women who had recently delivered a healthy newborn using a structured interview.

Results

A high percentage (79.8%) of our sample was exclusively breastfeeding at 1–4 days postpartum. We did not find any significant differences in rates of formula or mixed feeding by WIC participant status. Independent risk factors for mixed or formula feeding at 1–3 days postpartum included Asian/Pacific Islander ethnicity (odds ratio [OR] 2.90, 95% confidence interval [CI] 1.17–7.19). Being a college graduate was associated with a decreased risk of formula/mixed feeding (OR 0.28, 95% CI 0.10–0.79). We also found that thinking breastfeeding was physically painful and uncomfortable was independently associated with not breastfeeding (OR 1.41, 95% CI 1.06–1.89).

Conclusions

Future studies should be conducted with Asian-Americans and Pacific Islanders to better understand the lower rates of exclusive breastfeeding in this population and should address negative attitudes towards breastfeeding such as the idea that breastfeeding is painful or uncomfortable.