Premastication of Food for Infants: Findings from the Infant Feeding Practices Study II, United States, 2005-2007

Background: Three infants were recently reported to have been HIV-infected through eating food prechewed by HIV-infected caregivers. We examined the prevalence of and factors influencing maternal premastication feeding practices amongst U.S. mothers in the Infant Feeding Practices Study II (IFPS II). Methods: The IFPS II was a longitudinal study following women from late pregnancy through their infant's first year of life. It surveyed expectant mothers once during late pregnancy, monthly for the first seven months after birth and then every seven weeks until the infant was 12 months old. This univariate analysis includes mothers who responded to≥1 premastication-related question. Results: The prevalence of prechewing food among female caregivers was 27% (376 of 1387). Those who were black non-Hispanic (OR=10.4; 95% CI 5.1, 21.2), living in poverty (OR=1.8; 95% CI 1.2, 2.7), residing in the Western U.S. (OR=2.3; 95% CI 1.6, 3.3), or had not graduated from high school (OR=3.3; 95% CI 1.3, 7.9) had the highest likelihoods of premastication. Conclusions: Although several factors including black race were associated with prechewing, blacks may deserve targeted education around prechew-related health risks. Compared with their white counterparts, reproductive age black females not only had a 10 times greater odds of having prechewed in IFPSII, but also had an 18 times higher likelihood of being HIV-infected according to the 2007 CDC HIV Surveillance Report. This may put black infants at increased risk of prechew-related HIV transmission. Further research is needed to expand our understanding of prechewing in the context of HIV globally.