Influences on infant feeding decisions of first-time mothers in five European countries.
OBJECTIVE
Infant feeding decisions made by new parents have significant health implications. The study aimed to investigate: influences on infant feeding decisions; characteristics of mothers reporting reliance on alternative information sources; associations between reliance on different sources and intentions to exclusively breastfeed and introduce complementary foods later; and subsequent breastfeeding and weaning behaviours.


METHODS
First-time mothers in five European countries (England, Finland, Germany, Hungary, Spain) completed questionnaires about the importance of 17 influences on infant feeding choices at birth and 8 months later, during 2007-2008. Use of individual sources and reliance on four categories (family and friends, health professionals, written materials, audio-visual media) were compared between countries. Associations between information sources used and mother characteristics, feeding intentions and behaviours were investigated using appropriate statistical tests.


RESULTS
In all, 2071 first-time mothers provided baseline data; 78% at 8 months. Variation exists between countries in the influence of different sources on feeding decisions of first-time mothers. Across all countries, the most important influences at both time points were books, partner and antenatal midwife. Mothers in higher income quintiles and remaining at school beyond age 16 years reported greater reliance on written sources (P<0.0005). Mothers relying most on written sources reported longer exclusive breastfeeding (P=0.002), and a tendency to introduce foods other than milk later (P=0.079) than mothers relying most on personal or professional contacts.


CONCLUSIONS
Further research is required about which dissemination strategies are most effective at improving infant feeding behaviours in varied cultural settings, and for different socio-economic groups.
Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey, UK. h.gage@surrey.ac.uk
H
H
Gage
P
P
Williams
J
J
Von Rosen-Von Hoewel
K
K
Laitinen
V
V
Jakobik
E
E
Martin-Bautista
M
M
Schmid
B
B
Egan
J
J
Morgan
T
T
Decsi
C
C
Campoy
B
B
Koletzko
M
M
Raats
D000328:Adult; D001942:Breast Feeding / Q000379:methods / Q000706:statistics & numerical data*; D002755:Choice Behavior; D004739:England; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006814:Hungary; D007223:Infant; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology*; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires; D014886:Weaning; D055815:Young Adult