title: Breast-feeding and weaning practices in the DONALD study: age and time trends.
abstract: OBJECTIVE
  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.
authors.affiliation: *IEL-Nutritional Epidemiology, University of Bonn †Research Institute of Child Nutrition (FKE), Dortmund, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Foterek
authors.forename: Annett
authors.initials: A
authors.lastname: Hilbig
authors.forename: Ute
authors.initials: U
authors.lastname: Alexy
mesh_terms: D001942:Breast Feeding / Q000639:trends*; D002675:Child, Preschool; D003132:Commerce; D004032:Diet; D015930:Diet Records; D005260:Female; D005511:Food Handling; D005858:Germany; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000592:standards; D007227:Infant Nutritional Physiological Phenomena; D009035:Mothers; D014886:Weaning