Breastfeeding and infant feeding guidelines: dietary patterns and potential effects on the health and nutrition of children under two years

Vasconcelos, Isadora Nogueira; Brito, Ilanna Maria Vieira de Paula de; Arruda, Soraia Pinheiro Machado; Azevedo, Daniela Vasconcelos de

doi:10.1590/1806-93042021000200005

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Revista Brasileira de Saúde Materno Infantil

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ORIGINAL ARTICLES • Instituto de Medicina Integral Prof. Fernando Figueira 21 (2) • Apr-Jun 2021 • https://doi.org/10.1590/1806-93042021000200005 copy

Breastfeeding and infant feeding guidelines: dietary patterns and potential effects on the health and nutrition of children under two years

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to identify dietary patterns of children under two years of age in primary care, associating them with maternal variables.

Methods:

cross-sectional study carried out in basic health units. Sample selected for convenience with 321 children under two years old and their mothers. Food consumption was obtained through a 24-hour food record. The method of factor analysis by main components was used to determine dietary patterns. Associations between maternal variables and dietary patterns were tested.

Results:

“mixed”, “porridge” and “snacks” patterns were identified. Receiving guidance on infant feeding was related to greater adherence to the “mixed” (p = 0.02; PR = 2.98; 95% CI95% = 1.49-5.96) and “porridge” (p = 0.026; PR = 2.10; CI95% = 1.09-4.02) patterns. Experience with breastfeeding showed greater adherence to the "porridge" standards (p=0.038; PR = 1.78; CI95%= 1.03-3.08) and "snacks" (p = 0.026; PR = 1.09; CI95% = 1.01-1.18) and children of overweight mothers showed less adherence to the “snacks” pattern (p = 0.042; PR = 0.51; CI95%= 0.26-0.98).

Conclusions:

patterns found were associated with guidance on infant feeding and breastfeeding, previous experience with breastfeeding, as well as with maternal excess weight, emphasizing the importance of professional guidance for greater adherence to more varied and healthy consumption patterns and that include the different food groups.

Key words
Food patterns; Child feeding; Mothers; Factor analysis

Group	Foods
Fruit	Avocado, acerola, fresh plum, banana, hog plum, cashew, guava, soursop, orange, apple, papaya, mango, passion fruit, watermelon, melon, pear and grape.
Vegetables	Pumpkin, zucchini, beets, broccoli, carrots, chayote, kale, spinach and tomatoes.
Bakery	Sweet cookies, stuffed cookies, savory cookies, cakes and breads.
Cereals	Rice, sweet potatoes, potatoes, couscous, popcorn, pasta and wheat flour.
Flours for porridge preparation	Corn starch and cereal based flours and oat.
Artificial milks	Powdered and liquid cow milk, soy "milk" and infant formula.
Legumes	Bean and bean broth.
Fats	Olive oil, butter and margarine.
Sugars	Crystal sugar and glucose syrup.
Ultra-processed foods	Powdered and liquid chocolate, chocolate, calf's foot jelly, yoghurts and sweetened and flavored dairy drinks, soda, instant noodles and industrialized juices.
Coffee	Coffee and teas

Food groups	Mixed	Porridge	Snacks
Cereals and tubers	0.86	-	-
Meat, chicken, fish and eggs	0.80	-	-
Vegetable	0.76	-	-
Fruit	0.74	-	-
Sugar	0.44	0.37	-
Ultra-processed products	0.35	-	-
Flours for porridge	-	0.88	-
Artificial milk	-	0.88	-
Breast milk	-	-0.65	-
Fats	-	-	0.72
Coffee	-	-	0.66
Bakery	-	-	0.63
Legumes	-	-	0.37
Explained variance (%)	27.35	10.96	10.15
Eigenvalue	4.10	1.64	1.52

Variable			Mixed
Variable	Unadjusted PR		CI95%	Adjusted PR		CI95%
Education		p= 0.952			p= 0.573
Elementary school	Refer.		---	Refer.		---
High school and university	1.00		0.93-1.07	0.82		0.41-1.63
Number of children		p= 0.784			p= 0.360
≤ 3	Refer.		---	Refer.		---
> 3	1.01		0.95-1.07	1.66		0.56-4.95
Age (years)		p= 0.897			p= 0.902
< 35	Refer.		---	Refer.		---
≥ 35	1.01		0.93-1,09	0.94		0.37-2.39
BMI		p= 0.318			p= 0.163
< 25 Kg/m²	Refer.		---	Refer.		---
≥25 Kg/m²	0.94		0.82-1.07	0.62		0.31-1.22
Experience with BF		p= 0.821			p= 0.435
No	Refer.		---	Refer.		---
Yes	0.99		0.91-1.08	1.26		0.70-2.27
Guidance on BF		p= 0.695			p= 0.218
No	Refer.		---	Refer.		---
Yes	1.01		0.95-1.07	0.63		0.30-1.31
Guidance on IF		p< 0.001			p= 0.002
No	Refer.		---	Refer.		---
Yes	1.16		1.08-1.25	2.98		1.49-5.96

Variable			Porridge
Variable	Unadjusted PR		CI95%	Adjusted PR		CI95%
Education		p= 0.138			p= 0.245
Elementary school	Refer.		---	Refer.		---
High school and university	1.05		0.99-1.11	1.68		0.70-4.02
Number of children		p= 0.814			p= 0.667
≤ 3	Refer.		---	Refer.		---
> 3	0.99		0.94-1.05	0.78		0.26-2.39
Age (years)		p= 0.830			p= 0.942
< 35	Refer.		---	Refer.		---
≥ 35	0.99		0.91-1.08	0.97		0.48-1.99
BMI		p= 0.889			p= 0.875
< 25 Kg/m²	Refer.		---	Refer.		---
≥25 Kg/m²	1.01		0.89-1.14	0.96		0.54-1.69
Experience with BF		p= 0.772			p= 0.038
No	Refer.		---	Refer.		---
Yes	1.01		0.93-1.10	1.78		1.03-3.08
Guidance on BF		p= 0.513			p= 0.778
No	Refer.		---	Refer.		---
Yes	1.02		0.96-1.08	0.90		0.43-1.89
Guidance on IF		p= 0.120			p= 0.026
No	Refer.		---	Refer.		---
Yes	1.07		0.98-1.16	2.10		1.09-4.02

Variable	Snacks
Variable	Unadjusted PR		CI95%	Adjusted PR		CI95%
Education		p= 0.153			p= 0.258
Elementary school	Refer.		---	Refer.		---
High school and university	0,95		0.89-1.02	0.69		0.36-1.32
Number of children		p= 0.019			p= 0.180
≤ 3	Refer.		---	Refer.		---
> 3	1.09		1.01-1.17	1.91		0.74-4.90
Age (years)		p= 0.830			p= 0.734
< 35	Refer.		---	Refer.		---
≥ 35	0.99		0.91-1.08	0.86		0.35-2.09
BMI		p= 0.305			p= 0.042
< 25 Kg/m²	Refer.		---	Refer.		---
≥25 Kg/m²	0.93		0.82-1.06	0.51		0.26-0.98
Experience with BF		p= 0.026			p= 0.223
No	Refer.		---	Refer.		---
Yes	1.09		1.01-1.18	1.46		0.79-2.71
Guidance on BF		p= 0.371			p= 0.014
No	Refer.		---	Refer.		---
Yes	0.97		0.91-1.03	0.44		0.22-0.85
Guidance on IF		p= 0.089			p= 0.074
No	Refer.		---	Refer.		---
Yes	1.07		0.99-1.16	1.91		0.94-3.89

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
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[1] Authors' contribution

Vasconcelos IN: contributed to data collection, literature review and manuscript writing. Brito IMVP: contributed with suggestions and critical review in the writing of the manuscript. Arruda SPM: performed the statistical analysis of the results and contributed with suggestions and critical review in the writing of the manuscript. Azevedo DV: oriented and coordinated the research project that gave rise to this work, being responsible for creating the original idea and guiding the writing of the manuscript; he coordinated the group that performed the data collection and tabulation. All authors approved the final version of the article.