Maternal postpartum feeding anxiety was associated with infant feeding practices: results from the mother-infant cohort study of China

Background: Maternal feeding anxiety (FA) was prevalent during puerperium and might affect infant feeding practices. This study was aimed to investigate the FA status in Chinese postpartum women and its relationship with infant feeding practices (FPs). Methods: Participants were from the Mother-Infant Cohort Study of China, in which the dietary and feeding practices, physical and psychiatric health for both mothers and infants were followed up from childbirth to next 2years. In this study the maternal feeding anxiety (FA) status at 0-3months postpartum was assessed by Li's Self-rating Feeding Anxiety Scale (SFAS). Infant feeding practices (FPs) at 0-3months, including breastfeeding-related behaviors, responsive feeding and infant food refusal were investigated by self-designed questionnaire. Results: In total 456 mothers the average feeding anxiety scores (FAS) was 41.028.02 (mean +/- SD), and maternal FA prevalence were 61.4% (FAS>38) with severe FA being 8.6% (FAS>52) at 0-3months postpartum. The FAS was related with infant FPs, and lower maternal FAS was significantly related with infant colostrum feeding (40.86 +/- 8.02 vs 44.74 +/- 11.33, P <0.05), but higher FAS was related with bottle feeding (41.95 +/- 8.28 vs 39.69 +/- 7.92, P <0.05). The mothers with severe feeding anxiety (FAS>53) were more likely to feed infants with bottle (ORs, 95%CI: 2.41, 1.11 similar to 5.19). There were not significant association between FAS and exclusive breastfeeding and responsive feeding practices (P >0.05). The higher FAS was associated with infant food refusal behaviors, the maternal scores whose infant "never", "rarely", "sometimes" and "often" spat out food when feeding were 39.86 +/- 8.02, 41.47 +/- 8.18, 41.36 +/- 7.44 and 42.14 +/- 12.03 increasingly (P >0.05), and the FA prevalence was significantly different among groups (P <0.05). The infants whose mother was identified as feeding anxiety were more likely to refuse opening the mouth when feeding (P <0.05). Multivariate analysis indicated maternal FAS was positively related to infant bottle feeding (beta i=2.487, P <0.05) and outdoor sunshine exposure practice (beta i=1.787, P <0.05), and negatively related to household income level (beta i=-0.118, P <0.05). Conclusions: Maternal postpartum feeding anxiety was associated with some infant feeding practices, including bottle feeding and infant food refusal behaviors.