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Determinants of infant behavior and growth in breastfed late preterm and early term infants: a secondary data analysis

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Abstract

Background

Late preterm and early term infants are at increased risk of poor growth, behavioral problems, and developmental delays. This study aimed to investigate the impact of maternal and infant characteristics, feeding practices, and breastmilk composition on infant behavior following late preterm and early term delivery, and to evaluate the association between infant behavior and growth.

Methods

Data from 52 Chinese mothers and their late preterm/early term infants participating in the Breastfeed a Better Youngster study were used. Maternal and infant characteristics were collected using questionnaires at 1 week postpartum. Breastmilk macronutrient content was measured using a human milk analyzer, and infant behavior was assessed using a 3-day infant behavior diary at 8 weeks postpartum. Feeding practices were collected at both time points using questionnaires. Multivariate models were used to assess associations between potential predictors and infant behavior and between infant behavior and growth.

Results

Exclusive breastfeeding was associated with greater sleep duration (P = 0.02) and shorter crying duration (P = 0.01). Mothers with a vocational education reported greater distress duration (P = 0.006). Greater colic duration was associated with higher maternal annual income (P = 0.004). There was no significant association between infant behavior and growth (all P > 0.05).

Conclusions

Exclusive breastfeeding might promote more favorable infant behaviors in late preterm/early term infants, while the development of infant distress behaviors was associated with some maternal characteristics (maternal education and annual income). However, due to the limitations of diary methods, determinants of infant behavior should ideally be assessed using more objective measures in larger samples.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to express our sincere gratitude to all the investigators and participants who contributed to this study.

Funding

The research was conducted as part of a PhD and expenses were covered from the research group’s funds. All research at Great Ormond Street Hospital NHS Foundation Trust and UCL Great Ormond Street Institute of Child Health is made possible by the NIHR Great Ormond Street Hospital Biomedical Research Center. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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Authors and Affiliations

  1. Division of Medicine, University College London, London, UK

    Xinzhuo Zhang

  2. Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK

    Jinyue Yu & Mary Fewtrell

  3. Department of Child Healthcare, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China

    Zhuang Wei

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  1. Xinzhuo Zhang
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  4. Mary Fewtrell
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Contributions

ZX identified the research question, established the hypothesis, contributed to the drafting of the study protocol, performed the data analyses, and drafted the manuscript with input from the co-authors. YJ and FM identified the research question, established the hypothesis, contributed to the drafting of the study protocol, and established the study location for recruitment and data collection. WZ established the study location for recruitment and data collection. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zhuang Wei.

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Ethical approval

Ethical approval was obtained from the Research Ethics Committee of Beijing Children’s Hospital (ID: 2018-167) and University College London (ID: 12681/002). All participants provided written informed consent at recruitment.

Conflict of interest

FM receives an unrestricted donation from Philips for research on infant nutrition. All other authors declare no conflicts of interest.

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Zhang, X., Yu, J., Wei, Z. et al. Determinants of infant behavior and growth in breastfed late preterm and early term infants: a secondary data analysis. World J Pediatr 19, 983–991 (2023). https://doi.org/10.1007/s12519-023-00696-9

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  • DOI: https://doi.org/10.1007/s12519-023-00696-9

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