Factors influencing milk insufficiency and its long-term health effects: the Bedouin Infant Feeding Study.

Women who breastfeed have frequently reported milk insufficiency as the reason for introducing the bottle, but no one has addressed its potential long-term health effects. This paper described the factors associated with milk insufficiency versus another reason for introducing the bottle and its potential health effects based on an analysis of a prospective cohort study of 1005 Bedouin Arab women who delivered healthy newborns in 1981 and 1982. By two months postpartum, 72% introduced the infant to the bottle with 72% reporting milk insufficiency as the reason for introducing the bottle. The percentage of milk insufficiency declined with increasing age of the infant. Based on multiple logistic regression analyses, birth season was statistically significantly associated with the odds ratio (OR) of milk insufficiency versus another reason for introducing the bottle during the first two months. Women who delivered in the spring-summer had an increased OR = 1.65 of reported milk insufficiency compared with those who delivered during the rest of the year. Parity was directly related to the OR = 1.04 of milk insufficiency (but just missed significance) during one to two months and was statistically significantly associated with the OR = 1.12 of reported milk insufficiency during 3-18 months. The rates of stunting after the infant was introduced to the bottle and the duration of breastfeeding did not differ by reason for introducing the bottle. Thus the high frequency of reported milk insufficiency was not associated with adverse health effects.