An index measuring adherence to New Zealand Infant Feeding Guidelines has convergent validity with maternal socio-demographic and health behaviours and with children's body size

Using data from a nationally generalisable birth cohort, we aimed to: (i) describe the cohort's adherence to national evidence-based dietary guidelines using an Infant Feeding Index (IFI) and (ii) assess the IFI's convergent construct validity, by exploring associations with antenatal maternal socio-demographic and health behaviours and with child overweight/obesity and central adiposity at age 54 months. Data were from the Growing Up in New Zealand cohort (n 6343). The IFI scores ranged from zero to twelve points, with twelve representing full adherence to the guidelines. Overweight/obesity was defined by BMI-for-age (based on the WHO Growth Standards). Central adiposity was defined as waist-to-height ratio > 90th percentile. Associations were tested using multiple linear regression and Poisson regression with robust variance (risk ratios, 95 % CI). Mean IFI score was 8 center dot 2 (sd 2 center dot 1). Maternal characteristics explained 29 center dot 1 % of variation in the IFI score. Maternal age, education and smoking had the strongest independent relationships with IFI scores. Compared with children in the highest IFI tertile, girls in the lowest and middle tertiles were more likely to be overweight/obese (1 center dot 46, 1 center dot 03, 2 center dot 06 and 1 center dot 56, 1 center dot 09, 2 center dot 23, respectively) and boys in the lowest tertile were more likely to have central adiposity (1 center dot 53, 1 center dot 02, 2 center dot 30) at age 54 months. Most infants fell short of meeting national Infant Feeding Guidelines. The associations between IFI score and maternal characteristics, and children's overweight/obesity/central adiposity, were in the expected directions and confirm the IFI's convergent construct validity.

Automated summary

This study used a nationally generalisable birth cohort data to investigate the adherence to dietary guidelines among infants, and found that most infants did not meet the national Infant Feeding Guidelines. Maternal characteristics were found to have strong associations with children's overweight/obesity/central adiposity, confirming the construct validity of the Infant Feeding Index.