Background: The association between infant formula feeding at birth and subsequent feeding patterns in a low- or middleincome
context is not clear.
Objective: We examined the association of infant formula feeding during the first 3 d after birth with subsequent infant
formula feeding and early breastfeeding cessation in Vietnam.
Methods: In a cross-sectional survey, we interviewed 10,681 mothers with children aged 0223 mo (mean age: 8.2 mo;
52% boys) about their feeding practices during the first 3 d after birth and on the previous day. We used stratified analysis,
multiple logistic regression, propensity score-matching analysis, and structural equation modeling to minimize the
limitation of the cross-sectional design and to ensure the consistency of the findings.
Results: Infant formula feeding during the first 3 d after birth (50%) was associated with a higher prevalence of
subsequent infant formula feeding [stratified analysis: 7228% higher (nonoverlapping 95% CIs for most comparisons);
propensity score-matching analysis: 13% higher (P < 0.001); multiple logistic regression: OR: 1.47 (95% CI: 1.30, 1.67)].
This practice was also associated with a higher prevalence of early breastfeeding cessation (e.g., <24 mo) [propensity
score-matching analysis: 2% (P = 0.08); OR: 1.33 (95% CI: 1.12, 1.59)]. Structural equation modeling showed that infant
formula feeding during the first 3 d after birth was associated with a higher prevalence of subsequent infant formula
feeding (b: 0.244; P < 0.001), which in turn was linked to early breastfeeding cessation (b: 0.285; P < 0.001).
Conclusions: Infant formula feeding during the first 3 d after birth was associated with increased subsequent infant
formula feeding and the early cessation of breastfeeding, which underscores the need to make early, exclusive
breastfeeding normative and to create environments that support it.