A Comprehensive Assessment of the Environmental Impact of Different Infant Feeding Types: The Observational Study GREEN MOTHER

Aim(s): To observe and compare the environmental impacts of different types of infant feeding, considering the use of formula, infant feeding accessories, potentially increased maternal dietary intake during breastfeeding (BF) and food consumption habits.

Design: An observational cross-sectional multicentre study conducted in the Barcelona Metropolitan Area of the Catalan Institute of Health.

Methods: Data were collected from 419 postpartum women on infant feeding type (formula milk and accessories), maternal dietary intake (24-h register) and food consumption habits from November 2022 to April 2023. The environmental impacts (climate change (CC), water consumption and water scarcity) of the infant feeding types and maternal diet were calculated using the IPCC, ReCiPE and AWARE indicators, respectively. The differences in impacts were calculated by Kruskal-Wallis test.

Results: Significant differences for the three environmental impacts were observed. The CC impact of formula milk and feeding accessories was 0.01 kg CO₂eq for exclusive BF, 1.55 kg CO₂eq for mixed feeding and 4.98 kg CO₂eq for formula feeding. While BF mothers consumed an extra 238 kcal, no significant differences were found related to maternal diet across feeding types.

Conclusion: Exclusive BF was the most sustainable type of infant feeding, considering formula and infant feeding accessories. In our study, the difference between the impacts of BF and non-BF mothers' diet was insignificant.

Implications for the profession and/or patient care: Offer informative and educational support for midwives and other healthcare professionals on BF and a healthy, sustainable diet to transfer this knowledge to the general public.

Impact: Raise the general public's awareness about BF and a healthy, sustainable diet. To reduce environmental impacts through behavioural changes.

Reporting method: STROBE.

Patient or public contribution: Patients of the Catalan Health Service reviewed the content of the data collection tools.

Trial registration: (for the whole GREEN MOTHER project): NCT05729581 (https://clinicaltrials.gov).