Abstract
The revision to infant feeding recommendations internationally, and nationally, stimulated interest in infant feeding practices in Singapore. Three independent cross-sectional studies were conducted to explore different aspects of this issue. (1) Three hundred and ten mothers (61% Chinese; 31% Malay; 8% Indian) were interviewed on their milk and complementary feeding practices of their infants from birth. At birth, exclusive breastfeeding was uncommon (11%) and rarely continued beyond the first 6 months. The majority of infants (77%) started complementary (solid) foods by 4 months of age. Chinese mothers had a significantly lower (p = 0.002) rate of breastfeeding (76%) than the other 2 groups (92%). Length was observed to be influenced by the type of milk fed, and not the age of introduction of solid food. (2) Total daily energy and selected nutrient intake of a cohort (n=30) of Chinese infants (aged 9-11 mo) was estimated using the 24-hour dietary recall method. Infants showed good growth performance when assessed against growth reference, despite total daily energy intake (808kcal/d) being lower than the Singapore Recommended Daily Dietary Allowance. The nutritional composition of home-prepared meals was comparatively inferior to the equivalent profile of a commercial cereal. (3) Two hundred and twenty healthcare professionals in the primary care completed a questionnaire on their proficiency and practices in infant feeding. Their understanding of infant feeding recommendations was below expectations and there were also inconsistencies in their advice on complementary feeding. There is a disparity between the infant feeding recommendations (theory) and the reality (practice), implying difficulties in the implementation of a global recommendation. Wide-scale surveys are needed to collect data that is generalisable to the Singapore infant population. Attention to the development of evidence-based infant feeding guidelines is a priority with the emergence of the concept of nutritional programming in later life.