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Breast-Feeding and Weaning Practices in the DONALD Study: Age and Time Trends

Foterek, Kristina*; Hilbig, Annett; Alexy, Ute*

Journal of Pediatric Gastroenterology and Nutrition: March 2014 - Volume 58 - Issue 3 - p 361–367
doi: 10.1097/MPG.0000000000000202
Original Articles: Hepatology and Nutrition

Objectives: Besides influencing short- and long-term health status, infant feeding practices are known to have an effect on later food preferences. This study aimed to identify present trends in breast-feeding duration and weaning practices with special focus on preparation methods of complementary food (CF), that is, homemade and commercial CF.

Methods: In total, 1419 three-day weighed diet records collected between 2004 and 2012 from 366 children of the German DOrtmund Nutritional and Anthropometric Longitudinally Designed study ages 6 to 24 months were analysed. Full (n = 339) and total breast-feeding duration (n = 344) was collected by questionnaire. To investigate age and time trends, logistic regression and polynomial mixed regression models were used.

Results: Infants born between 2008 and 2012 were 3.3-fold less likely to be fully breast-fed for ≥4 months than those born before 2004 (P < 0.0001). Overall, 59.3% commercial, 21.1% homemade, and 19.6% combined CF was consumed by the study sample. Subjects with high commercial CF consumption (percentage of commercial CF > median 62%) were significantly older (P < 0.0001), showed shorter full and total breast-feeding duration (P < 0.0001), and were more likely to have mothers with a lower educational status (P = 0.01). Both commercial and homemade CF showed opposing, nonlinear age trends. No time trends could be found.

Conclusions: Decreasing duration of full breast-feeding should encourage health care providers to further promote longer breast-feeding duration. With the constantly high consumption of commercial CF at all ages, nutritional adequacy of both homemade and commercial CF needs to be investigated closer, as does their long-term influence on health and dietary habits, for example, fruit and vegetable intake.

*IEL-Nutritional Epidemiology, University of Bonn

Research Institute of Child Nutrition (FKE), Dortmund, Germany.

Address correspondence and reprint requests to Kristina Foterek, IEL-Nutritional Epidemiology, University of Bonn, Heinstueck 11, 44225 Dortmund, Germany (e-mail:

Received 5 October, 2013

Accepted 5 October, 2013

The DONALD Study is supported by the Ministry of Science and Research of North Rhine Westphalia, Germany.

The authors report no conflicts of interest.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,