am j clin nutr 1963 hillman 326 30

8/11/2019 Am j Clin Nutr 1963 Hillman 326 30

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* W eaning re fe rs to age a t d iscon tinua tion of b reas t o r bo ttle feed ing . (B o ttle w ean ing n o t rep resen ted fo r b reast

fe d s ub je ct s.)

In fan t F eedin g P attern s an d O ra l H a b its 32 7

T A B L E I

Freq uency of B reast F eed in g an d of D em and Feed ing in C h ild ren C las sif ied A cc ord ing to R e lative B ody W eig ht*

P atie n t G ro u p

Overweight

U nde r w e i g ht

N o r m a l w e i g ht

Total

A ll P a t ien ts W h ite P a t ien ts N eg ro P a tie n ts P u e rto R ica n P a tien ts

B r ea st D em a n d B re a st J)ern;nd B r ea st D e m a nd

N o . F ed F e d N o . F e d F e d N o . F e d F ed

(% ) ( 7 0 ) (% ) (% ) (% ) (% )

219 29 2 45 8 34 55 9 48 5 13 61 5 38 5

1 0 8 3 2 .4 5 3 .3 5 4 4 0 .7 3 1 .9 8 2 4 3 .9 5 5 .3

2 6 3 0 .8 2 4 .0 5 40 .0 8 0 .0 8

37. 5

50.0

353 30 3 46 5 93 46 2 52 2 103 45 6 52 11

-:;:::-

N o . F ed

(.4)

267 34 5

2 4 6 3 8 .2

4 0 3 2 .5

553 36 0

D e m a n d

Fe d

(% )

46 2

5 2 . 9

3 5 . 9

48 4

* D em a n d d a ta b a sed o n 5 4 1 pa t ien ts .

appro pria te in th is stud y s in ce 8 1 .2 per cen t o f these T ab les i th roug h v i. In g ene ra l, s ign ifican t d if-

sub jects (82 .6 p er cen t o f overw eigh t and 80 .4 per fe rences, i.e ., a t the 5 per cen t leve l, w ere n o t

cen t o f un derw e igh t c h ild re n) w e re co ntinue d on

observed be tw een overw eig h t and un derw eigh t

th e

breas t fo r a p eriod o f at le ast on e m on th .

pa tien ts in re spec t to in fan t feed ing p rac tice s

Sched u le fed in fan ts w ere th ose fed e ithe r

a d lib itu m

or curren t o ra l a ttribu tes . V aria tion s am on g

or w ith o nly tok en o r inco ns tan t adh ere nce to a n

estab l ish ed rou tine . T he d ura tio n o f b rea st o r o f th e princ ipa l e th n ic g rou ps often w ere g reate r,

if no m ore cons isten t, than tho se be tw een

b o ttle feed in g w as designa ted th ro ugh th at age a t

w hich the ch ild last suck led or drank m ilk fro m the

w eigh t g rou ps. H ow eve r, ove r-a ll b rea st feed -

b ott le ( w ean ing ag e ) . Curren t d aily m ilk con - in g pa tte rns w ere com p arab le to those re -

su m p tion w a s e stim ated to ti le c losest (8 oun ce) ported fo r o ther popu la tions in th is and o ther

cu p . P resen t candy and chew ing

g um con sum ption

w este rn /1

243o

and th e d ata fo r th e

w as cla ssif ied as oc cu rrin g frequ en tly , oc cas ion ally sub group of w hite ch ild ren w ere la rge ly in

or (p rac tica lly ) no t at all. T hu m b-suck ing w as accord w ith tho se fo r the to ta l pa tien t sam ple .

jud ge d to h ave b een pre sen t, i.e . , m e an ingfu l, O ve rw eig h t patien ts con sum ed

break fast

w he n the ha b it p ers iste d thro ugh the firs t y ear . le ss regu la rly than und erw eigh t ch ild ren (65 .0

v ersus 8 5 .8 per cen t, P < 0 .00 01), a d ifferen ce

R E S U L T S

w hich w as a lso no ted in the sam p le of w hite

T he princ ipa l observa tion s a re sum m arized

in

sub jec ts alo ne (63 .3 v ersus 84 .8 per cen t,

P < 0 .0001 ) and even fo r w h ite g irls a lone

A T he b ott le w ean ing pa ttern of tho se su b je cts w h o

w ere bre ast fed in it ia lly w as sim ila r to the pa ttern o f

(60 .6 v ersus 80 .3 per cen t, P < 0 .01). N on -

tho se sub jec ts W h o w ere b ottle fed fro m b irth . w hite ch ild ren in bo th w eigh t g roup s a te b reak-

T A B L E II

W eaning P a tte rn s o f B reas t an d B ottle Fed C hild ren C lassified A ccord in g to R ela tiv e B o th- W eigh t*

Al l Patien ts

B rea st F e d B ottle F ed

P a tien t G ro up

I

W eaned W eaned

N o .


3/5

3 2 8 H ilim an

9

T he f requ en cy o f ex pre sse d p ref eren ce f o r so f t, in c om itrast to hard , c antly w as s ign if ic antly gre ate r P < 0.0 5)

am ison g w h ite than am on g no nw hite childre n .

T A B L E

III

A v erage C urrent M ilk C on sum ption o f C h ild ren

C lass if ie d A c cordin g to R elativ e B od y cight

M ilk In ta k e

Patien t G rou p

N o .

1 .

u p s,

D a y 9

6

I

O v erw eig ht

2 64 2 9.2

6 2. 1 7 .9

0. 8

U nd erw eig ht

24 2

22.3

67.4

7. 8

2. 5

N orm al w e igh t . . .

T o ta l

4 1) 2 5

.

0

5 4 6 2 5 .8

65 . 0

6 4 .7

5

.

0

7. 7

5. 0

1. 8

S tatid ard 8 o u n ce C U J) 1 glass.

f ast m o re reg u larly th an w h ite ch ild ren ( 52 . 6

v ersu s 7 0 .5 p er cen t, P


4/5

* D ifferenc e l im ited to c h ild ren w ith b irth w eig h ts abo ve th e

p remature

leve l of 5 .5 p ou nds show ed P < 0.01 .

In fan t F eed ing Pa tte rns an d O ra l H ab its 3 29

T A B L E V

F requ enc y of P ersiste n t T hu m b -S u cking A m ong C hild re n C lass ifie d A c cord in g to R ela tiv e B o dy \V eigh t an d

A cco rd in g to Infa n t F ee d in g P attern fo r W hite P at ien t S ubg rou p

All Patien ts \V h ite C hild ren

B rea st B o ttle D em an d S ch edu le

P atien t G ro up T hum b- T h un m b - F e d F ed F ed F ed

N o. suc kers N o. su cke rs T hu m b - T hu m b - T hu m b - T hum b-

( ) ( ) su ck ers su cke rs su cke rs suc kers

fC\ { 1 4 9 } fU /\ IC \

c1

I/C l ./

iO

O ve rw eig h t 2 63 24 .3 219 23 .3 2 1 .9 23 .9 26 .5 20 .7

U nd erw eigh t 2 42 20 .7 10 8 20 .4 2 2 .9 19 .2 1 7 .9 22 .4

No r ma l we i g h t 4 0 1 5 . 0 2 6 2 3 . 1 2 5 . 1 2 2 . 2 5 0 . 0 1 5 . 8

T ota l 54 5 21 .7 353 22 .4 22 .4 22 .4 24 .4 20 .7

* T h rou gh firs t ye ar.

larg e r, separa te g rou p of w ell no urished ch il- T hese o bserv ations , even th ough and per-

d ren w ou ld h ave b een des irab le . A lth ough haps because , they are inconc lus ive , m ay

overw eig h t an d und erw eigh t sub jec ts com prise se rv e to em phas ize d ifficu lties encou n tered in

h ysica lly an tithe tic sam p les , bo th rep resen t a ttem p ts to id en tify spec ific d eve lo pm enta l

fo rm s o f m a lnu trit ion w h ich , m an ife sted in ac- facto rs-apa rt from e nergy b ala nce as su ch-

cordance w ith cons titu tiona l and env iron - invo lv ed in the pa thogenes is o f abno rm al body

m ental de term in an ts , m ay w ell have com m on w eig h t pa tte rns . H op efu lly , they m ay a lso

ca use s. A pro spec tive stud y , inv o lv ing ch il- und erscore th e need fo r m ore ob jec tiv e ev i-

d ren from schoo l o r o ther nonc lin ic so urces, d eu ce w h en ever in fan t feed ing prac tices a re

m igh t have grea te r va lid ity althou gh here too , im plica ted in th e cau se of o besity .

sus ta in ed un ifo rm ity of m anag em ent cou ld

scarce ly be in su red a t the exp en se of in te r- SU M M A R Y

curren t, ind iv id ua l hea lth n eed s. Idea lly , In fan t feed ing pa tte rns an d re la ted o ra l

standard s su itab le fo r the nu tritio na l assess- a ttribu tes

w ere stu d ied in ove rw e igh t an d

m e n t of he te ro geneous pop u la tion s a lso sho u ld u nedrw eigh t ch ild ren a tten d ing a p ub lic hea lth

be ava ilab le to im p rove on th is and sim ilar n u trition c lin ic .

stud ies w here in th e com m on h eresy of equa ting O v erw eigh t an d u nderw eig h t ch ild ren d id

overw eig h t and o besity is com po unded by no t d iffe r sign ifican tly in respec t to the fo llo w -

ques tion ab le ex trapo la tio ns from norm s d e- in g : (1 ) the frequency of b reas t feed in g or de-

rived from a s in g le e thn ic g roup .3 in an d feed ing ; (2 ) age o f w ean in g ; (3 ) m ilk ,

T A B L E V I

M ean B irth W e igh ts o f C hild re n C la ssified A c co rd in g to R ela tive B o dy W eig h t by E th n ic G ro up

O v erw eigh t U nd erw eigh t

. -- - - -- -- Difference

P atie n t G ro up . . .

W e igh t l ,k e igh t P ro bab illtv

N o . (lb .) N o . ( lb .)

W h ite m a le 84 7 .

4 9 3 5 6

. 7 8 < 0 . 05 *

W hite f em ale 129 7

.

1 9 7 0 6

.

8 4 0 .05

N o nw hite fem ale 32 7 . 1 4 7 0 6 .

1 0


5/5

33 0

Hil lma n

can d y an d ch ew in g g u m c o n s u mp t i o mi ; o r (4 )

persistence o f thum b-suck in g .

In f an t f eed in g p atte rn s in so m e in s tan ces

ap p eared m o re c lo sely re lated to e th n ic g ro u p

th an to b o d y w e ig h t statu s d u rin g ch ild h o o d .

D if f eren ces b etw een o v erw e ig h t an d u n d er-

w eig h t ch ild ren w ere su g g es ted in re sp ec t to

b reak f ast eatin g h ab its , b irth w e ig h t am id b irth

ran k b ut no t to m o nth to b irth .

R E F E R E N C E S

1. S E N N , M . J. E . In f luen ce of psy cho log ical f acto rs

oil

th e

nu trit ion of ch ild ren . A,,,, J. P ub. H ealth,

35:211 1945.

2. (a)

BRU cH

H . T he Im portan ce o f O v erw eight .

N e w Y ork , 195 7. W .

W .

Nor ton .

(b) B R U cH , H . O be sity . P ediat. Cl in. No rth

America, 5:613 1958.

;3. (a ) SA LBER E. J. , S T I T T P. G . an d BABBOTT J. G .

Patte rns of breas t f ee din g .

I.

Facto rs af fec ting

th e f re qu enc y of breas t f e eding in the ne w bo rn

per iod . New England J. Med., 2 59 : 7 0 7, 1 95 8.

(b) S A L B E R , E . J. , S T I T T P. G . and BABBOTT J. G .

Patterns

I)f

bre ast f eed ing

in a

f am ily cl in ic . ii.

D u ration of f e eding an d re aso ns f or w eanin g .

Ne w Engla nd J. Me d., 26 0: 31 0, 195 9.

4. (a ) B R O W N , F. . L I E B E R M A N ,

J. ,

WIN S TON

J. an d

1L E S H E T T E N. S tud ies in c hoice of in f ant f ee d-

in g by p rin hip arac. I. A tt itud inal f acto rs and

e x traneo us in f lue nce s.

P syc hosomat. l lcd. ,

22 :

4 21, 1 96 0.

(b)

B R O W N ,

F.

,

C H A S E ,

J. am i(l WIN S TON J. S tu d ie s

in

in f ant f eed ing c hoices o f prim ip arae.

ii.

Coin-

p arison of R o rsc hac h determ inants o f acce pto rs

and re jectors o f b reast f eed ing .

J. P ro je ctive

Techniques,

25 : 412 , 19 61.

5. K A P L A N , H . I. aiid K A PL A N , H . S . T he psy cho so -

m atic co nce pt o f o bes ity . J. Ne rv. 1 ent. D is .,

1 2 5 : 1 8 1 , 1 9 5 7 .

6. H IL L , L . F. In f an t nu tri tiom i. .1 , ,:. J. (un. Na /ri-

tion, 3 : 75, 195 5.

7 . B UR CH IN A L,

L . G .

and E PPR IG H T , E . S . T est o f the

p sy c hog en ic theo ry of o bes ity in a sam ple o f rural

girls. Am. J. C/in. Nutrition, 7 : 2 8 8 , 1 9 5 9 .

F R E E D ,

S . C .

Psy ch ic f acto rs in

th e

d e v e l o p me n t

an d treatm e nt o f ob esity . J.A . 11f.A

1 3 3 : 3 6 9 ,

1947.

9. H AMBU RG E R W . W . Psy ch olo gic al aspe cts o f

obes i ty . Bull. New Yo rk Ac ad. lie d., 33 : 7 71 .

1 9 5 7 .

10 .

B R 0 sIN . J. T h e p sy ch o lo g y o f o v ereatin g . Ne w

England J. Med., 248 : 974 , 19 53.

1 1. S C H w A R T z . A .

S . E atin g p ro b lem s . P ediat. Cli;z.

No rth Ame rica ,

5 : 5 9 5 , 1 9 5 8 .

12 .

P A L E R M O

D . S . T lium nb suc k im ig-a learned re -

sponse. Pediatrics, 17: 392 , 1 956 .

1 3 . B R A Z E T T O N , T . B . S uc k in g in in f an cy .

Pediatrics,

1 7:4 00 , 19 56 .

1 4 . H 0N z IK , M . P. an d M C K E E ,

J. P.

T he se x dif f er-

ence

in

t h u mb s u c k i n g . J. P edia t.

.

61 : 7 26 , 19 62.

15 .

E A R N S H A W ,

J)#{149}. T he b aby s b irth righ t : a ple a

f o r a retu rn to e x terio r ges tation

and b reast f eed -

in g . .1 . J . . lu str al za , 4 8: 23 8, 19 61.

16 . J o N E s , W . 0 . O ii f ee d ing at

the b reasts. Pedi-

atrics, 28 : 851 , 196 1.

17 . DAVIS H . V ., S E A R S , R . R . , M I L L E R H . C . af l( l

B RO D B E CK P. J. E f f ects o f cu p , b ottle am id

b reast f ee din g o n oral activ ities of ne w b orn in-

fants . l ediatrics , 3 : 54 9, 194 8.

18 . S TUNKARD .\. J. Phy s ical ac tiv i ty , em otions aiid

h uim ian o be sity .

P svcho so ma t. Med. ,

20 : 36 6,

1958.

19 . I L L I N G S \ V 0 R T I I , it. S . O b esity . J. P edia tri cs , 53 :

11 7, 19 58.

20 . \ V O L F F , 0. H . O be sity in childhood.

Quart.

J.

Me d 2 4: 1 09 19 55 .

21 . BALDW IN B . T . T he Phy sical G ro w th of C hild ren

from B irth to M atu rity . Io w a C ity , 1 922 .

U niv ers ity o f Iow a Press .

22 . FABER H . K . A w eight rang e f o r c hildre n 5-15

years . Am. J. D is. Child., 3 8: 75 8, 1 92 9.

23 . S T U A R T , H . C . an d ME R E D I T H H . V . U se of body

m easure m e nts in the sch ool he alth pro grani.

Am. J. P ub. He alth, 36: 1 365 , 1 94 6.

24 .

BA I N K . T h e in c id en ce o f b reas t f e ed in g iii

hos -

p itals in the U nite d S tates. Pediatrics, 9 : 3 13,

1948.

25 MEY E R H . F. B reas t f eed ing in th e U nite d S tate s.

E x ten t an d p o ss ib le

tr end . Pediatrics, 22 : 11 6,

1 9 5 8 .

26 . J A CK SON E . B . , WI LK I N L . C . an d AUERBA dH H .

S tatistic al repo rt on inciden ce and du ration of

b reast f ee din g in relation to pe rso nal, soc ial am id

h osp ital m ate rnity f acto rs.

Pediatrics,

17 : 70 0,

1 9 5 6 .

27 . VANKAUER A ., B O E K , W . E . , LAWSON E . D . an d

I A N N I , F. A . J. S o c ial stratif ication and he alth

p rac tice s in c hild-b earing and child-rearing .

m

J. P ub. H ea lth, 48 : 73 2, 1 958 .

28 . B O E K , W . E . and YANKAUER A . V ariatio ns in

b reast f ee din g . A . Times, 8 9 : 1 9 2 , 1 9 6 1 .

29 . RO B E R T S O N \V . 0 . B reast f e eding practices : so m e

im plication s of regional v ariatio ns . A ni. J. P ub.

Health, 51: 103 5, 196 1.

30 . N E W S O N , L . J. an d N E W S O N , E . B reast

f e eding itm

decline. Brit. M. J., 2 : 1 74 4 1 96 2.

31 . FA LK N ER ,

F. T h e

p hy sical d ev e lop m e nt o f ch ild -

ren . A g u id e to in terp retatio n of gro w th -ch arts

an d de v elopm en t o f assessm e nts ; an d a c om m e n-

tary on co nte m p orary and f u ture pro ble m s.

Pediatrics, 29 :44 8. 19 62.

am j clin nutr 1963 hillman 326 30

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