Clinical practice guidelines for feeding behaviors and weight-for-age at 12 months: a secondary analysis of the Infant Feeding Practices Study II

Worldviews Evid Based Nurs. 2012 Dec;9(4):234-42. doi: 10.1111/j.1741-6787.2011.00236.x. Epub 2012 Jan 10.


Background: The World Health Organization has identified childhood obesity as a major threat to global health. Accumulating evidence indicates that excess weight early in life is predictive of later childhood and adolescent obesity. Clinical practice guidelines for infant feeding behaviors have been developed by national and international health organizations. The relationship between these guidelines and infant weight status has not been established.

Aim: To examine the relationship between weight-for-age at 1 year and adherence to four clinical practice guidelines for feeding behaviors: no bottle-to-bed, minimal juice consumption, breastfeeding throughout the first year of life, and introduction to solid food no earlier than age 4-6 months.

Methods: Data were obtained from the Infant Feeding Practices Study II, a longitudinal, national survey administered by the U.S. Food and Drug Administration and Centers for Disease Control and Prevention that followed mother-infant dyads from pregnancy through 1 year postpartum. The sample was comprised of 691 infants for whom 12-month survey data were available.

Results: Significant associations with weight-for-age were found for juice consumption (p= 0.003), breastfeeding during the second half of infancy (p < 0.001), and introduction to solid foods prior to age 4 months (p < 0.001). A regression model that controlled for infant and maternal characteristics demonstrated that these feeding behaviors remained significant predictors of weight-for-age at 12 months.

Conclusions and implications: Modifiable infant feeding behaviors contributed to weight-for-age at 1 year. Replication studies with economically and culturally diverse samples are needed. Further, testing longitudinal interventions that address infant feeding practices is likely to yield the evidence needed for shaping future clinical practice guidelines that reduce the risk for childhood obesity and related pediatric comorbidities.

MeSH terms

  • Adolescent
  • Adult
  • Body Weight
  • Bottle Feeding / standards
  • Breast Feeding
  • Child Development
  • Data Collection
  • Evidence-Based Nursing / standards*
  • Feeding Behavior*
  • Female
  • Global Health / standards
  • Humans
  • Infant
  • Infant Food / standards*
  • Longitudinal Studies
  • Male
  • Mothers
  • Pediatric Nursing / standards*
  • Practice Guidelines as Topic / standards*
  • Young Adult