title: Breastfeeding Rates and Growth Charts--the Zhejiang Infant Feeding Trial.
abstract: A randomised control trial was undertaken in Hangzhou, China, to study the influence of the growth chart used on breastfeeding rates. Mothers with infants who were being fully breastfed at 6 weeks after birth (n = 1602) were invited to participate in the trial; 1415 agreed to participate and 1295 completed the study. Two growth charts were used, one that was heavier for the first six months of life (Chart A, n = 686) and a lighter growth chart (Chart B, n = 609). Mothers were interviewed and infants measured at 6 weeks and 3, 4, 5 and 6 months after delivery. At 6 months the full breastfeeding rates were 18.1% in the group using the heavier growth chart compared to 22.8% in the lighter growth chart group. After adjusting for potential confounders this difference remained significant (aOR 1.41, 95% confidence intervals 1.02, 1.93). These results suggest that breastfeeding rates may be influenced by the type of growth chart used. Mothers who perceive that their infants are not growing adequately (i.e., using the heavier charts) may introduce other foods to their infants earlier than mothers using the lighter chart. While a larger trial is required to confirm the results, in the interim it is suggested that if heavier growth charts are used, a lower percentile line could be used to assess adequacy of growth.
authors.affiliation: Children's Hospital, Zhejiang University, Hangzhou, Zhejiang 310006 China.
authors.forename: Bingquan
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Children's Hospital, Zhejiang University, Hangzhou, Zhejiang 310006 China. zhangj@zju.edu.cn.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China. qiulq@zju.edu.cn.
authors.forename: Liqian
authors.initials: L
authors.lastname: Qiu
authors.affiliation: School of Public Health, Curtin University, Perth 6102, Australia. C.Binns@curtin.edu.au.
authors.forename: Colin
authors.initials: C
authors.lastname: Binns
authors.affiliation: Children's Hospital, Zhejiang University, Hangzhou, Zhejiang 310006 China. shaojie@zju.edu.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Shao
authors.affiliation: School of Public Health, Curtin University, Perth 6102, Australia. Y.Zhao@exchange.curtin.edu.au.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Children's Hospital, Zhejiang University, Hangzhou, Zhejiang 310006 China. zhaozy@zju.edu.cn.
authors.forename: Zhengyan
authors.initials: Z
authors.lastname: Zhao
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D002657:Child Development / Q000502:physiology*; D002681:China; D005247:Feeding Behavior / Q000502:physiology* / Q000523:psychology*; D005260:Female; D057238:Growth Charts; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000523:psychology*; D012959:Socioeconomic Factors
keywords: China; breastfeeding rates; growth chart; mother’s perceptions; percentiles