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Does early introduction of solid feeding lead to early cessation of breastfeeding?

Does early introduction of solid feeding lead to early cessation of breastfeeding?
Does early introduction of solid feeding lead to early cessation of breastfeeding?
Mixed milk feeding increases the likelihood of breastfeeding cessation, but it is not known if solid feeding (SF) has the same effect. We have identified 10,407 infants breastfed for at least 8–10 weeks from three large U.K. studies (Avon Longitudinal Study of Parents and Children [ALSPAC; born 1990–1991], Southampton Woman's Survey [SWS; 1998–2008], and Infant Feeding Survey 2010 [IFS 2010]) to investigate the associations between early SF and breastfeeding cessation. In the earliest study (ALSPAC), 67% had started SF before the age of 4 months, but in the latest (IFS), only 23% had started before 4 months. Solid food introduction before 4 months was associated with stopping breastfeeding before 6 months in all three cohorts, with little effect of adjustment for maternal sociodemographic characteristics (Poisson regression, adjusted prevalence ratios: ALSPAC 1.55, [95% confidence interval 1.4, 1.8], SWS 1.13 [1.0, 1.3], IFS 1.10 [1.1, 1.3]). Using Cox regression, adjusted hazard ratios for breastfeeding cessation compared with SF after 5 months were 2.07 (1.8, 2.4) for SF before 4 and 1.51 (1.3, 1.8) at 4–5 months for ALSPAC and 1.25 (1.1, 1.5) and 1.15 (1.0, 1.3) for SWS. Earlier introduction of solids was associated with a shorter duration of breastfeeding, particularly in cohorts where earlier introduction of solids was the norm, with a dose–response relationship, which was not explained by background social characteristics. As mothers most commonly introduced solids in the month prior to the then recommended age, continuing to recommend deferring solids to the age of 6 months is important to support sustained breastfeeding.
ALSPAC, breastfeeding, cohort study, complementary feeding, infant, lactation
1740-8695
Lessa, Angelina
751d0242-0f95-435f-b8f0-01e81282bd87
Garcia, Ada
a9142efc-e2ff-4c10-bcbd-d5d7b12cc1c4
Emmett, Pauline
86f5a1b8-8ab0-418c-b0fd-1726a8a60116
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Robinson, Sian M
ba591c98-4380-456a-be8a-c452f992b69b
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Wright, Charlotte M.
de197a0b-9db2-40e1-91dc-8d2d3e1606b9
Lessa, Angelina
751d0242-0f95-435f-b8f0-01e81282bd87
Garcia, Ada
a9142efc-e2ff-4c10-bcbd-d5d7b12cc1c4
Emmett, Pauline
86f5a1b8-8ab0-418c-b0fd-1726a8a60116
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Robinson, Sian M
ba591c98-4380-456a-be8a-c452f992b69b
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Wright, Charlotte M.
de197a0b-9db2-40e1-91dc-8d2d3e1606b9

Lessa, Angelina, Garcia, Ada, Emmett, Pauline, Crozier, Sarah, Robinson, Sian M, Godfrey, Keith and Wright, Charlotte M. (2020) Does early introduction of solid feeding lead to early cessation of breastfeeding? Maternal & Child Nutrition, 16 (4), [e12944]. (doi:10.1111/mcn.12944).

Record type: Article

Abstract

Mixed milk feeding increases the likelihood of breastfeeding cessation, but it is not known if solid feeding (SF) has the same effect. We have identified 10,407 infants breastfed for at least 8–10 weeks from three large U.K. studies (Avon Longitudinal Study of Parents and Children [ALSPAC; born 1990–1991], Southampton Woman's Survey [SWS; 1998–2008], and Infant Feeding Survey 2010 [IFS 2010]) to investigate the associations between early SF and breastfeeding cessation. In the earliest study (ALSPAC), 67% had started SF before the age of 4 months, but in the latest (IFS), only 23% had started before 4 months. Solid food introduction before 4 months was associated with stopping breastfeeding before 6 months in all three cohorts, with little effect of adjustment for maternal sociodemographic characteristics (Poisson regression, adjusted prevalence ratios: ALSPAC 1.55, [95% confidence interval 1.4, 1.8], SWS 1.13 [1.0, 1.3], IFS 1.10 [1.1, 1.3]). Using Cox regression, adjusted hazard ratios for breastfeeding cessation compared with SF after 5 months were 2.07 (1.8, 2.4) for SF before 4 and 1.51 (1.3, 1.8) at 4–5 months for ALSPAC and 1.25 (1.1, 1.5) and 1.15 (1.0, 1.3) for SWS. Earlier introduction of solids was associated with a shorter duration of breastfeeding, particularly in cohorts where earlier introduction of solids was the norm, with a dose–response relationship, which was not explained by background social characteristics. As mothers most commonly introduced solids in the month prior to the then recommended age, continuing to recommend deferring solids to the age of 6 months is important to support sustained breastfeeding.

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Accepted/In Press date: 15 December 2019
e-pub ahead of print date: 29 January 2020
Published date: 1 October 2020
Additional Information: Funding Information: There was no specific grant funding for this project. The Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil funded AGs postdoctoral fellowship at Glasgow. The UK Medical Research Council and Wellcome (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. UK Medical Research Council (MC_UU_12011/4), British Heart Foundation, Food Standards Agency, European Union's Seventh Framework Programme (FP7/2007‐2013, project EarlyNutrition under grant agreement n°289346) and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust have provided support for aspects of the SWS included in this report. KMG is a National Institute for Health Research (NIHR) Senior Investigator (NF‐SI‐0515‐10042). The views expressed in this article are those of the author(s) and not necessarily those of the NIHR, or the Department of Health and Social Care. Publisher Copyright: © 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd
Keywords: ALSPAC, breastfeeding, cohort study, complementary feeding, infant, lactation

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Local EPrints ID: 436714
URI: http://eprints.soton.ac.uk/id/eprint/436714
ISSN: 1740-8695
PURE UUID: 110128a8-3ad2-474d-8275-32cb776f62e6
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Sian M Robinson: ORCID iD orcid.org/0000-0003-1766-7269
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 03 Jan 2020 11:02
Last modified: 10 Aug 2022 04:01

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Contributors

Author: Angelina Lessa
Author: Ada Garcia
Author: Pauline Emmett
Author: Sarah Crozier ORCID iD
Author: Sian M Robinson ORCID iD
Author: Keith Godfrey ORCID iD
Author: Charlotte M. Wright

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