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Int. J. Environ. Res. Public Health 2015, 12, 7337-7347; doi:10.3390/ijerph120707337
International Journal of
Environmental Research and
Public Health
ISSN 1660-4601
Breastfeeding Rates and Growth Charts—the Zhejiang Infant
Feeding Trial
Bingquan Zhu
, Jian Zhang
, Liqian Qiu
, Colin Binns
*, Jie Shao
, Yun Zhao
Zhengyan Zhao
Children’s Hospital, Zhejiang University, Hangzhou, Zhejiang 310006 China;
E-Mails: ispring2003@ (B.Z.); [email protected] (J.Z.); [email protected] (J.S.)
Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China;
School of Public Health, Curtin University, Perth 6102, Australia;
These authors contributed equally to this work.
* Authors to whom correspondence should be addressed; E-Mails: [email protected] (Z.Y.Z.);
[email protected] (C.B.); Tel.: +86-138-057-223-51 (Z.Y.Z.); +61-8-9266-2952 (C.B.);
Fax: +86-571-8703-3296 (Z.Y.Z.); +61-8-9266-2958 (C.B.).
Academic Editor: Paul B. Tchounwou
Received: 28 March 2015 / Accepted: 23 June 2015 / Published: 30 June 2015
Abstract: A randomised control trial was undertaken in Hangzhou, China, to study the
influence of the growth chart used on breastfeeding rates. Mothers with infants who were
being fully breastfed at 6 weeks after birth (n = 1602) were invited to participate in the
trial; 1415 agreed to participate and 1295 completed the study. Two growth charts were
used, one that was heavier for the first six months of life (Chart A, n = 686) and a lighter
growth chart (Chart B, n = 609). Mothers were interviewed and infants measured at
6 weeks and 3, 4, 5 and 6 months after delivery. At 6 months the full breastfeeding rates
were 18.1% in the group using the heavier growth chart compared to 22.8% in the lighter
growth chart group. After adjusting for potential confounders this difference remained
significant (aOR 1.41, 95% confidence intervals 1.02, 1.93). These results suggest that
breastfeeding rates may be influenced by the type of growth chart used. Mothers who
perceive that their infants are not growing adequately (i.e., using the heavier charts) may
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