Development of feeding practices during the first 5 years of life

Objective: To understand the transition from breast- and bottle-feeding to solid-feeding and factors that might affect the duration of breast- and bottle-feeding. Design: Cohort followed up from birth with relatively well-educated, middle-class parents. Setting: Community sample recruited from 3 suburban newborn nurseries (a teaching hospital, community hospital, and large health maintenance organization). Participants: One hundred ninety-one healthy fullterm infants. Measures: Assessment of feeding practices through the ages of complete weaning from breast- and bottle-feeding. Results: More than 90% of participants breast-fed for at least 2 weeks. Infants of older mothers were weaned from the breast later than infants of younger mothers. First-born infants were weaned from the breast earlier than later-born infants. Eighty-four percent of infants bottle-fed at some time during the first year of life. More than 40% of the cohort was still receiving bottles at 24 months of age, 16% at 36 months, and 8% at 48 months. The duration of breast- and bottle-feeding was related to maternal work status; mothers who returned to work during the first 3 months postpartum weaned sooner from the breast and later from the bottle than women who returned to work after 3 months postpartum. Conclusions: The frequency of late bottle-weaning in this well-educated, middle-class cohort was unexpected and was related to the timing of the mother's return to work. The impact of prolonged bottle-feeding on later growth and adiposity deserves further investigation.