title: Infant feeding and health-related quality of life in healthy Chinese infants: results from a prospective, observational cohort study.
abstract: BACKGROUND
  Infant feeding regimens, including breastfeeding, formula-feeding, or a combination of the two, may influence infant health-related quality of life (HRQOL). However, few studies have examined this association.
  
  
  METHODS
  This prospective cohort study assessed HRQOL in relation to three parent-selected feeding regimens: exclusively breastfed (n = 136), exclusively study formula-fed (n = 140), and mixed-fed with study formula and breast milk (n = 151). Healthy Chinese infants were enrolled at their first normally scheduled well infant clinic visit at age 42 days (study day 1). Parents independently chose their infants' feeding regimens prior to recruitment into the study, with infants in the formula and mixed-fed groups already consuming an infant formula enriched with α-lactalbumin and increased sn-2 palmitate and oligofructose. The Infant and Toddler Quality of Life Questionnaire, which includes six infant-focused and three parent-focused concepts, was used to assess HRQOL at day 1 and at a follow-up visit 48 days later. Scores for each concept ranged from 0 to 100. Parent quality of life (assessed using the Mental Component Summary score of the SF-12v2 Health Survey) was included in the ANCOVA model to adjust for its potential effect on parent's perception of infant HRQOL.
  
  
  RESULTS
  HRQOL concept scores were high in all three study groups at both visits (mean scores 71-95). Day 1 HRQOL scores were not significantly different between groups. At day 48, 5 of 9 HRQOL scores were not significantly different between groups. However, scores for Temperament and Moods, General Health Perceptions and Parent Impact-Time were slightly but statistically significantly lower in the formula-fed group (mean scores 75-86; all p ≤ 0.01) compared to the breastfed (78-90) and mixed-fed (77-91) groups. Day 48 Parent Impact-Emotional scores were also significantly lower by a small margin (4 points; p = 0.003) in the formula-fed group compared with the breastfed group.
  
  
  CONCLUSIONS
  HRQOL was high in this population of healthy infants, with only a few small differences in HRQOL concept scores observed between breastfed, formula-fed and mixed-fed infants. These results indicate favorable physical, mental, and social well-being in these infants and parents. Assessment of infant HRQOL is therefore feasible and provides valuable insight into parental perceptions of their child's health and well-being.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT01370967 .
authors: Nestlé Nutrition R&D, King of Prussia, PA, USA. nicholas.hays@rd.nestle.com.
authors: Nicholas P
authors: NP
authors: Hays
authors: Chengdu Women's and Children's Central Hospital, Chengdu, China.
authors: Meng
authors: M
authors: Mao
authors: Chengdu Women's and Children's Central Hospital, Chengdu, China.
authors: Lan
authors: L
authors: Zhang
authors: Wyeth Nutritional Company Ltd, Shanghai, China.
authors: John
authors: J
authors: Ge
authors: Nestlé Nutrition R&D, King of Prussia, PA, USA.
authors: Robert
authors: R
authors: Northington
authors: Nestlé Nutrition R&D, King of Prussia, PA, USA.
authors: Manjiang
authors: M
authors: Yao
authors: Nestlé Nutrition R&D, King of Prussia, PA, USA.
authors: Sheri
authors: S
authors: Volger
mesh_terms: D001942:Breast Feeding; D002681:China; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life
keywords: Breastfeeding; Infant and Toddler Quality of Life Questionnaire (ITQOL); Infant formula; Patient outcome assessment; Short Form 12 Health Survey, version 2 (SF-12v2)