(P27-049-25) Adherence to Infant Feeding and Supplementation Guidelines in the Michigan Archive for Research on Child Health (MARCH) Cohort

Objectives: The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding (BF) for the first 6mos of life, 400 IU/d vitamin D (Vit D) supplementation (supp) unless consuming >27 oz/d of formula, and 1 mg iron supp/kg body weight/d at 4mos, continuing until iron-containing foods are consumed. Here, adherence to infant feeding and supp guidelines in a Michigan cohort are described. 

Methods: Data are from the 3mos infancy survey of the MARCH cohort. Participants (n=427) who submitted infant stool samples and completed questionnaires asking about infant nutritional exposures in the past 24 h, prior week, and since birth were included. 

Results: Infants were female (49%) with a median age of 3.7mos (IQR: 3.4-4.1). In the week prior to survey completion, 205 (48%) infants met the recommendation for exclusive human milk (HM) at their current age; whereas, 138 (32.3%) consumed 100% formula (FM) and/or other foods, 36 (8.4%) had 80% human milk (HM) and 20% FM and/or other foods, and the remaining had various combinations of HM, FM, and/or other foods. In the 24 h prior to survey completion, 140 (33%) infants received FM only. Of infants who consumed only HM in the 24h prior to survey completion, 103 (24.2%) drank from breast and bottle, 93 (21.9%) from breast, and 17 (4%) from bottle. Further, 19 (4.5%) received HM from the breast and FM, 14 (3.3%) received HM from the bottle and FM, and 39 (9.2%) received HM from breast and bottle as well as FM. Of exclusively BF infants, 102 (49.8%) met the Vit D supp recommendation. Current supp use was reported in 144 (33.7%), previous (but not current) in 11 (2.6%), and no supp use in 272 (63.7%) infants. Vit D was the most common supp. (134, 93.1%), then probiotics (20, 13.9%), prebiotics (5, 3.5%), multivitamins/vitamins (5, 3.5%), and zinc (1, 0.7%). One (0.2%) reported current iron use, meeting the AAP recommendation.

Conclusions: Though established guidelines for BF and supp exist, less than half of the infants, aged 3-6mos, in this cohort met the AAP BF guidelines for their age. Future work should investigate underlying motivations and hesitations.  

Funding Sources: This research was funded in part by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the Office of the Director at the National Institutes of Health, the Michigan Health Endowment Fund as well as a CHARM (Child Health Advances from Research with Mothers) small grant.