Associations among feeding behaviors during infancy and child illness at two years

Matern Child Health J. 2009 Nov;13(6):795-805. doi: 10.1007/s10995-008-0401-x. Epub 2008 Oct 7.


Objectives: To explore the different combinations of early feeding practices and their association with child illness in toddlerhood (i.e., asthma, respiratory infections, gastrointestinal infections, and ear infections).

Methods: The Early Child Longitudinal Study-Birth Cohort (ECLS-B) offers a unique opportunity to address this issue, as the study features a nationally representative sample of children and includes important questions on early feeding behaviors as well as an extensive list of background characteristics on the families. Using a subsample of approximately 7,900 children from the ECLS-B, data from the 9 month and 2 year collections were analyzed to define the occurrence of three feeding practices during infancy (i.e., by age 6 months) identify the key combinations of these practices, and examine associations between these combinations and child illness via logistic regression.

Results: Results indicate that 70% of parents initiated breastfeeding, 78% introduced formula and/or solid food before 6 months, 74% introduced solid food, and 15% introduced finger foods before 6 months. The most frequent feeding combinations were: breast milk with formula and solid/finger food (36%), formula with solid/finger food (24%), breast milk with formula (11%), breast milk with solid/finger food (14%), exclusive breast milk (8%), and exclusive formula (7%). After controlling for key demographic and family characteristics, results indicated that children who were exclusively breastfed were less likely to experience respiratory or ear infections than those experiencing other feeding combinations. No differences were found in rates of asthma or gastrointestinal infections.

Conclusions: This study provides insights for parents, medical professionals, and policy makers on the typical feeding practices and best practices for positive health outcomes in early childhood.

MeSH terms

  • Adult
  • Breast Feeding / epidemiology*
  • Child, Preschool
  • Feeding Behavior*
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / prevention & control
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hypersensitivity / epidemiology*
  • Infant Formula
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mother-Child Relations
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / prevention & control
  • Risk Factors
  • United States / epidemiology
  • Young Adult