Cross-cutting research

Infant formula

de Lauzon-Guillain B., Davisse-Paturet C., Lioret S., Ksiazek E., Bois C., Dufourg M.-N., Bournez M., Nicklaus S., Wagner S., Charles M.-A., “Use of infant formula in the Elfe study: the association with social and health related factors”, Mat Child Nutr 2018; 14 (1)

Mothers are recommended to exclusively breastfeed their infant for the first 6 months. When breastfeeding is not desired or not possible, or when mothers need to find a complement or follow-on, there is a vast array of infant formulas to choose from, in the form of either powdered or liquid milk. Parents enrolled in the Elfe birth cohort answered questions once a month about their infant’s diet between the ages of 2 and 10 months, indicating which formula was most frequently given, where relevant. Data analysis revealed that in 2012, more than 50% of bottlefed infants received formula fortified with pre- or probiotics. As recommended, extensively hydrolysed (i.e. hypoallergenic) formulas were more often used when either the parents or siblings had allergic diseases such as asthma or eczema. The longer-term benefits of these two specific types of formula need to be documented, and the data collected during the follow-up of the Elfe children will provide just such an opportunity.

Thickened formula was more often given to the 12% of infants with regurgitation problems, as well as to boys rather than girls, and when the mother had gone back to work early. By contrast, they were used less for children who were mainly breastfed over a long period. [Link to the article]

Determinants of dietary diversification

Bournez M., Ksiazek E., Wagner S., Kersuzan C., Tichit C., Gojard S., Thierry X., Charles M.-A., Lioret S., de Lauzon-Guillain B., Nicklaus S., “Factors associated with the introduction of complementary feeding in the French ELFE cohort study”, Maternal & Child Nutrition, October 2017.

The National Nutrition and Health Programme (PNNS) recommends that dietary diversification, with the gradual introduction of different food groups, should begin at 6 months and not before 4 months. However, little is yet known about what actually happens in France. By analysing Elfe parents’ responses to questionnaires about the introduction of 28 food groups between the ages of 3 and 10 months, researchers have been able to identify the factors influencing the initiation of dietary diversification, and in particular the characteristics of families where new foods are introduced before the age of 4 months.
Infants’ mean age at the start of this process is 5.3 months. Infants given a diversified diet before 4 months (21%) are more often boys, come from families where both parents were born abroad, or have a mother who is aged below 25 years, smokes, is overweight, or does not have a high-school diploma. The food groups most often introduced before 4 months are cereals, vegetables, fruit and potatoes. [Link to article]

Duration of breastfeeding in France

Wagner S., Kersuzan C., Gojard S., Tichit C., Nicklaus S., Geay B., Humeau P., Thierry X., Charles M.-A., Lioret S., Lauzon-Guillain B. (de), “Durée de l’allaitement en France selon les caractéristiques des parents et de la naissance. Résultats de l’étude longitudinale française Elfe, 2011”, BEH no. 29, p. 522-532, October 2015.

For the 70% of mothers who start breastfeeding at the maternity unit, the median duration of breastfeeding is 17 weeks, and the median duration of predominant breastfeeding is 7 weeks. Only 19% of infants are still being breastfed at 6 months. Total breastfeeding duration is shorter for mothers aged below 30 years, who live alone, have a low education level or who go back to work less than 10 weeks after giving birth. Breastfeeding lasts longer among women in managerial positions (compared with employees), on parental leave (compared with those back at work) or who attended antenatal classes. Breastfeeding also lasts for longer when the father was present at the birth. [Link to article]

Breastfeeding practices

Kersuzan C., Gojard S., Tichit C., Thierry X., Wagner S., Nicklaus S., Geay B., Charles M.-A., Lioret S., Lauzon-Guillain B. (de). “Prévalence de l’allaitement à la maternité selon les caractéristiques des parents et les conditions de l’accouchement. Résultats de l’enquête Elfe maternité, France métropolitaine, 2011”, BEH no. 27, p. 440-449, October 2014.

The results of the Elfe study confirm a well documented trend over recent years towards more mothers starting to breastfeed at the maternity unit, in parallel with numerous public health initiatives designed to promote breastfeeding.
The Elfe study has revealed that 70% of mothers breastfeed while they are at the maternity unit – a figure that has risen substantially since the 1970s (59% of mothers exclusively breastfeed and 11% supplement with bottlefeeding). The mothers who breastfeed most frequently are older, of normal build, or belong to a higher socio-occupational category. Mothers born abroad also breastfeed more often, as do mothers who attended antenatal classes or who did not smoke during pregnancy.
Moreover, breastfeeding is more frequent when fathers are involved, having been present at the birth, and when the parents are married.
Lastly, breastfeeding at the maternity unit varies across regions, being more frequent in eastern France and the Ile-de-France region, and less frequent in western and northern France. [Link to article]

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