title: Breastfeeding practices, timing of introduction of complementary beverages and foods and weight status in infants and toddlers participants of a WIC clinic in Puerto Rico.
abstract: BACKGROUND
  Breastfeeding is associated with lower rates of obesity; in addition, it is also associated with later introduction of beverages and foods; however, this has not been well studied among Hispanics. The objective was to assess breastfeeding practices and timing of introduction of beverages and solid foods in a sample of Hispanic infants and their association with weight status.
  
  
  METHODS
  Cross-sectional study in 296 caregivers of infants and toddlers 0-24 months of age participants of a WIC clinic in Puerto Rico. Participants completed several questionnaires and anthropometrics were taken in infants and toddlers. Statistical analysis included correlations, comparison between groups and logistic regression.
  
  
  RESULTS
  A total of 189 participants older than 6 months completed the study. Most infants were breastfed immediately after birth (63.5 %), at the hospital (80.0 %), and at least once (92.3 %) but only 31 % were exclusively breastfed. Median duration of any breastfeeding was 5.0 months and exclusive breastfeeding was 0 months. Excessive weight was found in 22.8 %. Breastfeeding duration was positively associated with caregiver's educational level and age of introduction of water, formula, juice and cow's milk (p < 0.05). Exclusively breastfed infants were introduced water and formula at a later age compared to non-exclusively breastfed and never breastfed infants (p < 0.01). No significant associations were found between breastfeeding practices and duration or age of introduction of beverages and foods with weight status, even after adjusting for potential confounders.
  
  
  CONCLUSIONS
  Breastfeeding duration was in general low. Water, formula and juice were introduced later in breastfed infants compared to non-exclusively breastfed or never breastfed infants. Breastfeeding practices or timing of introduction of beverages and solid foods were not significantly associated with weight status. Strategies to support mothers on continuing breastfeeding beyond the hospital and for longer periods are needed among WIC participants to benefit of the protective effect on childhood obesity.
authors.affiliation: Nutrition Program, Department of Human Development, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936-5067 USA.
authors.forename: Olga E
authors.initials: OE
authors.lastname: Sinigaglia
authors.affiliation: Nutrition Program, Department of Human Development, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936-5067 USA.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Ríos
authors.affiliation: Undergraduate Department, School of Nursing, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936-5067 USA.
authors.forename: Maribel
authors.initials: M
authors.lastname: Campos
authors.affiliation: Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936-5067 USA.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Díaz
authors.affiliation: Nutrition Program, Department of Human Development, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936-5067 USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Palacios
keywords: Breastfeeding; Hispanics; Infants; Introduction of beverages and foods; Obesity