Document Type

Theses, Ph.D

Rights

This item is available under a Creative Commons License for non-commercial use only

Publication Details

Successfully submitted for the award of Doctor of Philosophy (Ph.D) to the Dublin Institute of Technology, 2008.

Abstract

Appropriate infant feeding practices play a crucial part in achieving optimal health outcomes. It is well established that the protection, promotion and support of exclusive breastfeeding during the first 6-months of life would decrease the health inequalities experienced by mothers and infants (WHO/UNICEF, 2003c). Optimal weaning practices also have significant implications for infant health, notably in relation to normal development, mineral balance and the development of obesity (Department of Health, 1994). Historically, Ireland has one of the lowest breastfeeding rates in Europe. Furthermore, prior Irish-based research indicates significant deficiencies relating to weaning practices among mothers during the first year of life. The present study was designed to investigate the diets of infants born in Ireland and assess compliance with infant feeding recommendations. This cross-sectional prospective study involved the recruitment of 561 pregnant women during the ante-natal period, with subsequent follow-up of mothers who bore term, healthy, singleton infants, at 6-weeks and 6-months post partum. The final sample that met the study criteria consisted of 401 national and 49 non-national mothers. Detailed information on breastfeeding initiation and prevalence rates among national and non-national mothers was elicited, using specific well-defined breastfeeding definitions. A subsequent analysis was undertaken to comprehensively identify the predictors of breastfeeding initiation and duration among national mothers, as well as the barriers that prevent them from attempting the practice. Data are also presented on the weaning practices of national mothers specifically pertaining to the time of weaning, as well as dietary and snacking patterns. A further in-depth analysis was performed to determine the factors associated with the occurrence of sub-optimal weaning practices. In summary, this study highlights significant deviations from current infant feeding recommendations. Importantly, 47.1% of national and 79.6% of non-national mothers initiated breastfeeding (p=0.000) indicating that little improvement has been achieved in terms of increasing breastfeeding rates over the former decade. Of further concern, high early discontinuation rates were observed among the national, compared with the non-national population of mothers, however, the exclusive breastfeeding rates remained low in both populations. In addition, a high prevalence of negative weaning practices was observed, including the finding that 23% of infants were prematurely weaned onto solids by 12-weeks. Mothers who weaned early were significantly more likely to carry out other sub-optimal feeding practices, suggesting that an overall deficiency in weaning information may exist among these mothers. This study provided a greater understanding of how infants are fed during the first 6-months of life in Ireland, adding to our paediatric knowledge base. To attenuate the health inequalities between lower and higher socio-economic groups in our society, results suggest that increased resources and more effective public health education should be apportioned to improve infants’ diets. As the early years represent a time win which disease prevention may be most effective (Campbell et al., 2008), there should be no delay in developing national strategies that encourage increased compliance with infant feeding recommendations at a population level.