Applying suggested new terminology and definitions for human milk feeding in the Alberta Pregnancy Outcomes and Nutrition (APrON) longitudinal pregnancy cohort

Abstract

The complexity of human milk feeding behaviours may not be captured using simpler definitions of ‘exclusive’ and ‘non-exclusive’ breastfeeding. New definitions have been suggested to describe variation in these behaviours more fully but have not been widely applied. We applied the new definitions to data derived from 3-day human milk feeding diaries. Participants (n=1091) recorded the number, beginning/end time, and modes of feeding of infants aged 3 months. Data were used to create six exclusive groups according to feeding mode(s): 1) human milk at-breast only; 2) human milk at-breast and human milk in a bottle; 3) human milk at-breast and infant formula in a bottle; 4) human milk at-breast and human milk and infant formula mixed in the same bottle; 5) human milk at-breast, human milk in a bottle, and infant formula in a bottle (not mixed); 6) a bottle that sometimes contained human milk and sometimes infant formula (not mixed); never at-breast. Differences in maternal and infant characteristics were examined among groups. Fifty-seven percent fed at-breast only (Group 1). Those in Group 1 spent a similar amount of time feeding directly at-breast (median 132 (IQR 98-172 ) min/day) as those in Groups 2 (124 (95-158)), 3 (143 (100-190)) and 5 (114 (84-142)) (p>0.05) indicating that adding bottle-feeding did not always reduce the time infants were fed at-breast. Applying new suggested definitions to describe human milk feeding behaviours from the mothers’ perspective highlights the complexity of patterns used and warrants further application and research to explore impacts on health outcomes.