Modelling consultation rates in infancy: influence of maternal and infant characteristics, feeding type and consultation history.
BACKGROUND
Severity of illness, sociodemographic factors, and breastfeeding have been identified as predictors of consultation rates in infants, and prescriptions for antibiotics have been found to increase future consultation rates in older children. The Baby Check trial (1996-1998) provided detailed information about consultations for 935 babies during their first 6 months.


OBJECTIVE
To investigate potential predictors of consultation rates in babies.


METHODS
A 6-month cohort study of newborn babies originally enrolled into a randomised controlled trial. Maternal and infant characteristics were collected from hospital discharge records. Primary care consultation data for each baby were collected by case note review.


METHODS
Thirteen general practices in Glasgow.


METHODS
Multilevel models were used to analyse the number of consultations for each baby during its first 26 weeks, dependent upon the baby's age, the calendar month, maternal and infant characteristics, and previous consultations.


RESULTS
The strongest predictors of consultation rates were previous consultations, particularly during the preceding week. Breastfed babies and those with older mothers consulted less often. A multilevel model was better than a fixed effects model, with considerable variation in consultation rates between babies.


CONCLUSIONS
Infants' consultation rates over time can be analysed using multilevel models, if details of primary care consultations are available. These models can incorporate the effects of fixed variables and those that change during the follow-up period. Our findings add to previous research linking breastfeeding with reduced morbidity in infancy, and for that reason breastfeeding should continue to be promoted in primary care.
General Practice and Primary Care, Division of Community Based Sciences, University of Glasgow, UK. amc@stats.gla.ac.uk
Alex
A
McConnachie
Phil
P
Wilson
Hilary
H
Thomson
Sue
S
Ross
Richard
R
Watson
Patricia
P
Muirhead
Andrew
A
Munley
D000328:Adult; D001942:Breast Feeding; D002662:Child Health Services / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005194:Family Practice / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors