Background

The first months of life are a critical period for a young child’s development. Nutrition during this period plays a significant role in an infant’s growth and healthy motor and cognitive development.

The recommendations of the National Nutrition and Health Program (PNNS), particularly regarding the promotion of breastfeeding and, more generally, the nutrition of young children, have led Santé publique France to establish a monitoring system for children’s nutrition and nutritional status from birth. Thus, the national Epifane study aims to describe and analyze maternal indicators and those related to the child’s health and development during the first year of life.

In 2021, Epifane will be linked with the National Perinatal Survey (ENP) to enable the collection of shared data at the maternity ward and at 2 months for all mothers, and then at 6 and 12 months for those in the Epifane subsample.

Objectives

The objectives of the 2021 Epifane survey are to describe:

• the frequency, duration, and exclusivity of breastfeeding

• the type, duration, and quantities of commercial infant formula

• the methods of introducing solid foods

• indicators of the health status of mothers and their children up to their first birthday and the factors influencing them.

Survey Procedure

Inclusion criteria

• Having participated in the 2021 ENP and having agreed to be contacted again when the child is 2 months old

• Speak French

• Have given birth in mainland France

• Be at least 18 years old at the time of delivery

• Have given birth at least 33 weeks after the last menstrual period

• the child must be alive

• that the child has not been transferred to another hospital department in the days following birth

• that the child does not have a severe prenatal condition requiring surgery, special care, or transfer

• in the case of a multiple birth, only one child will be included in the study

Sampling

Among the women included in the 2021 ENP, one in three mothers born in France will be randomly selected to participate in Epifane, and one in two among those born abroad. This random selection will allow us to reach, with an additional margin of 20%, a minimum sample size of 3,500 women for the first Epifane data collection at 2 months.

Timeline

In addition to the data collected as part of the ENP, at the maternity ward and at 2 months, women participating in the Epifane study will be interviewed:

• in May 2021 for the 2-month follow-up by phone

• in September 2021 for the 6-month follow-up via the web and by phone

• in March 2022 for the 12-month follow-up via the web and by phone

Topics Covered

These questionnaires will focus on:

• breastfeeding: their feelings during feedings and any difficulties encountered, the use of specific breastfeeding accessories, reasons for stopping breastfeeding

• consumption of commercial infant formula: difficulties encountered, brand and type of formula given to the child, water used

• introduction of solid foods: when solid foods were introduced, difficulties encountered, whether meals were homemade or store-bought, addition of salt and fats

• the mother’s relationship with her child

• the child’s health and growth

• the mother’s health and lifestyle

Results

Breastfeeding

• The percentage of children breastfed at birth now exceeds the 75% target set by the 4th National Nutrition and Health Program.

• The median duration of breastfeeding (exclusive + mixed) increased from 15 to 20 weeks between 2012 and 2021.

• At 6 months, more than a third of children were still being breastfed in 2021 (vs. less than a quarter in 2012).

Introduction of solid foods

• For 91% of children in 2021, complementary feeding began within the recommended window, between 4 and 6 months.

• Only 4% of mothers began introducing solid foods before the recommended period.

• Some foods were introduced later than recommended by a significant proportion of the mothers surveyed (added fats, legumes, eggs).