Breast milk feeding practices and frequencies among complementary-fed children: a cross-sectional study in Northern Thailand.

Background: The available data on milk feeding patterns and feeding frequency during the complementary feeding phase are limited. This study aimed to examine breastfeeding practices and assess the associations between milk feeding type, feeding method, and feeding frequency among complementary-fed children.

Methods: This cross-sectional study was conducted between January and May 2024 at well-baby clinics in Chiang Mai, Thailand, and included 1,122 parents of children aged 6-24 months. Milk feeding practices were assessed through 24-hour recall interviews and categorized by feeding type and feeding method. Subgroup analyses were conducted for bottle-fed and breastfed children. Poisson regression was used to evaluate the effect modifications of child age on daytime and nighttime feeding frequency across different feeding methods and types.

Results: The overall prevalence of breastfeeding was 46.3%, whereas bottle feeding was reported in 76.5% of the children. The average feeding frequency was 5.8 times per 24 h, with 2.1 feedings occurring at night. Among children who exclusively consumed breast milk until 18-24 months, 95.2% were fed directly from the breast. Compared with a single milk type or a single feeding method, the trend of partial breastfeeding and combined feeding methods was associated with significantly higher feeding frequencies. At night, children who were exclusively formula-fed or bottle-fed had fewer nighttime feedings than those who were exclusively breastfed or directly breastfed at 12, 18, and 24 months. However, subgroup analysis revealed minimal differences in nighttime feeding frequency between the feeding groups.

Conclusions: This study revealed a high prevalence of discontinued breastfeeding and bottle feeding among young children. For those who continued exclusive breast milk consumption until nearly two years of age, direct breastfeeding remained the predominant feeding method. The associations between feeding method and milk type with feeding frequency were more pronounced during the daytime. However, at night, the relationships between feeding frequency and these factors were less consistent in both the overall and subgroup analyses, suggesting that nighttime feeding frequency is likely influenced by multiple factors beyond milk type and feeding method. Future longitudinal studies are needed to identify additional determinants of feeding frequency and their implications for child health.