Maternal health behaviours during pregnancy and associations with infant feeding factors Roslyn Tarrant 1, Katherine Younger 2, Margaret Sheridan-Pereira 3 and John Kearney 2 1 Our Lady’s Children’s Hospital, Crumlin, Dublin 12; 2 Dublin Institute of Technology, Kevins Street, Dublin 8; 3 Coombe Women and Infants University Hospital, Dublin 12 Introduction Optimal pregnancy and infant health outcomes are associated with non-smoking 1 and avoidance of alcohol consumption during pregnancy 2, in addition to compliance with peri- conceptional folic acid supplementation (PCFAS) 3. However, data are lacking on the associations between such health behaviours and postnatal infant feeding factors. Objectives  To examine the prevalence of maternal health behaviours during pregnancy, including PCFAS use as well as smoking and alcohol consumption patterns, and to relate these behaviours to selected infant feeding factors. Methods  A prospective observational study ( ) involved the recruitment of 539 pregnant women from antenatal clinics in the Coombe Women and Infants University Hospital (CWIUH) in Dublin, Ireland.  From the 491 women who agreed to study participation (91%), 450 (83%) eligible mother- term infant pairs were followed up at 6 weeks and 6 months postpartum.  Quantitative data on folic acid use, smoking and alcohol consumption patterns during pregnancy were collected from the antenatal patient-administered questionnaire.  Maternal postnatal infant feeding practices were elicited from the 6 week and 6 month interviewer-administered questionnaires. Statistical analyses  SPSS ® (version 17) was used to analyse the data. Categorical data were compared using the χ 2 statistics test or Fisher’s exact test, and significance levels were set at P<0.05. Binary logistic regression analysis was used to determine the factors associated with selected maternal health behaviours during pregnancy. Results  After adjustment, lack of breastfeeding initiation (OR 3.04, 95% CI: ) (P=0.001) and younger maternal age ≤ 24 years (OR 3.56, 95% CI ) (P=0.011) were independently associated with smoking during pregnancy.  Mothers who did not take PCFAS at the recommended time/no folic acid were 82% (adjusted OR 1.82, 95% CI: ) (P=0.03) more likely to have added unsuitable condiments to their infants’ weaning foods at 6 months postpartum. References 1 Kramer MS (2003). The epidemiology of adverse pregnancy outcomes: An Overview. J Nutr 133, World Health Organisation (2006). Framework for alcohol policy in the WHO European Region. 3 Kirke PN, Daly LE, Elwood JH (1992). A randomised trial of low dose folic acid to prevent neural tube defects. The Irish Vitamin Study Group. Arch Dis Child 67, Results  In all, 94 (20.9%) mothers smoked and 159 (35.3%) consumed alcohol during pregnancy. Less than half of the sample (44.4%) complied with PCFAS at the recommended time.  Univariately, smoking during pregnancy and non-compliance with PCFAS at the recommended time/no folic acid were strongly associated (P=0.000) with lack of breastfeeding initiation, early weaning onto solids (≤ 12 vs > 12 weeks), and maternal addition of non-recommended condiments (e.g. gravy) to infants’ weaning foods.  Smokers during pregnancy (vs non-smokers and quitters) were least likely to have intended to breastfeed antenatally, initiated or continued breastfeeding to 16 weeks postpartum, and to have complied with recommended weaning practices at 6 months (P=0.000) (see Table 1). Acknowledgements The authors are very grateful to 491 mothers who participated in this study. A special thanks is also extended to the staff in the CWIUH for their support during the study, and to the DIT for funding for the study. Conclusion  Smoking during pregnancy and non- compliance with PCFAS at the recommended time/no folic acid were both strongly associated with low breastfeeding initiation and duration rates, as well as non-compliance with recommended weaning practices postpartum.  Interventions to increase maternal compliance with optimal infant feeding practices, and hence, improve infants’ diets, should consider the antenatal provision of infant feeding advice targeted towards these high-risk groups. Table 1 Smoking status during pregnancy by selected infant feeding factors Infant feeding factor Non-smokers (n=295) n (%) Quitters (n=61) n (%) Smokers (n=94) n (%) Positive antenatal intention to breastfeed* 185 (62.7)29 (47.5)17 (18) Initiated breastfeeding* 183 (62)29 (47.5)16 (17) ‘Any’ breastfeeding at 16 weeks postpartum* 83 (28.1)8 (13.1)3 (3.2) Early weaning onto solids at ≤ 12 weeks* 37 (12.5)18 (29.5)39 (41.5) Maternal additions of unsuitable condiments † to infants’ foods* 71 (24)24 (39.3)52 (55.3) Maternal provision of non-recommended snacks ‡ to infants* 27 (9.2)6 (9.8)35 (37.2) *P=0.000: difference between smoking status during pregnancy and infant feeding factor under study. † includes: gravy, salt, sauces, vegetable stock, sugar/honey. ‡ includes: chocolate, biscuits, crisps, ice-cream.