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Development and Validation of Infant Feeding Algorithms Used to Identify Factors Associated with Infant Feeding Practices

The objective of this study was to develop and validate infant feeding (IF) algorithms, and identify factors associated with IF practices among 1452 mother‐child pairs from 9 study centers in the National Children's Study Formative Research in Physical Measurements. A test set (N=300) was randomly selected using the remainder as a re‐test set. IF practices including exclusive breastfeeding (XBR), breast‐bottle feeding (BrBot), and exclusive bottle feeding (XBot) were categorized based on maternal recalls for children under six years of age. BrBot was further classified as formula and breast milk (BM) equally, more formula than BM, or more BM than formula. The distribution of XBR, BrBot and XBot did not differ between the test and re‐test sets by age, gender, or ethnicity but differed in one study center. A discriminant function analysis using child and maternal characteristics predicted 89% and 73% of the IF categories in the test and re‐test sets, respectively. Multinomial logistic regression showed mothers born outside the U.S. were more likely to feed by XBR and BrBot than XBot, compared to those U.S. born, adjusted for study centers (N=1452). For BrBot mothers, Non‐Hispanic Whites were more likely to feed more BM than formula than Non‐Hispanic Blacks. The developed and validated algorithms provide unique opportunities to assess associations between these IF practices and health outcomes.