Fetal Alcohol Growth Restriction Is Not Attributable to Infant Feeding Practices in a Prospective Birth Cohort in Cape Town, South Africa

OBJECTIVES: Prenatal alcohol exposure is the most common preventable cause of neurodevelopmental deficits worldwide and causes growth restriction that worsens in the first year of life. Fetal alcohol growth restriction has been shown to be a marker for severity of alcohol-related neurocognitive deficits. However, the role of postnatal nutrition in fetal alcohol growth restriction remains unknown. The aims of this study were to compare infant feeding practices (e.g., breastfeeding, formula feeding, complementary foods) between heavy drinkers and controls and to examine whether these practices play confounding roles in fetal alcohol growth restriction. METHODS: 123 heavy drinking pregnant women and 86 controls were recruited at their first antenatal clinic visit in Cape Town, South Africa. Demographic background and alcohol, cigarette, marijuana, and methamphetamine use during pregnancy were assessed prenatally. Infant feeding practices were assessed at 6.5 mo postpartum using the USDA Infant Feeding Questionnaire. Infant weight, length and head circumference were measured at 2 wk and 6.5 and 12 mo. Potential confounders were those related to growth outcomes at p