Infant growth is highly variable between and within populations. Two major factors known to influence infant growth are infant feeding practices and infection, yet these are rarely characterized together within a sociocultural context. Breast/chest-feeding has been associated with less instances of illness and enhanced cognitive development in infants, and in resource-scarce settings, with higher infant weight and length gain. Meanwhile, in affluent settings, formula-fed infants tend to gain weight faster, compared to breastfed infants; this is associated with an increased obesity risk later in life. Despite the benefits of breast/chest-feeding, globally, less than half of infants are exclusively breast/chest-fed during the first six months of life. This may happen because infant feeding practices are complex and dynamic processes. Research using a Critical Medical Anthropology (CMA) framework has reported that factors at the individual, institutional, and structural level influence breast/chest-feeding initiation, duration, and timing of introduction to commercial milk formula. From a biological perspective on infant growth, research using a Life History Theory (LHT) framework, predicts a tradeoff between the allocation of energy towards growth and immune response to fight infection, such that infants who spend more energy fighting infection will have less energy available for growth.Given the complex associations between infant growth, feeding practices, and infection, and how these associations vary in relation to sociocultural factors, this dissertation research project is composed of three interrelated studies conducted in Veracruz, Mexico. Veracruz is the fourth state in Mexico to establish a state law in support of breast/chest-feeding, making it a suitable case study to explore if efforts aimed at increasing breast/chest-feeding rates have influenced infant feeding practices. Furthermore, Veracruz is one of the states with the highest rotavirus mortality rate in the country and has high rates of stunting within rural communities, making it a fitting setting to utilize the LHT and investigate the energy tradeoffs infants face between growth and immune response to fight infection. The first two studies employ a CMA framework, and the third study uses a LHT framework. The overarching aim of this dissertation is to examine the factors that influence infant feeding practices within a specific setting, and how these practices in turn may be associated with infant growth. The aims for each respective study are: 1) Examine the experiences of healthcare providers with barriers and facilitators for breast/chest-feeding promotion; 2) Examine the experiences of first-time mothers with congruencies between planned and actual infant feeding practices; 3) Examine the associations between infant growth, infection status, and infant feeding practices. Results for this dissertation draw upon ethnographic observations and semi-structured interviews with healthcare providers (n=36) and mothers (n=25), and from infant data (n=25) on anthropometric measurements, symptoms of infection, and feeding practices. Results from healthcare providers highlight important differences between the private and public sector regarding the support of breast/chest-feeding practices; this may continue to perpetuate inequalities resulting from breast/chest-feeding benefits, as access to each type of service provider is determined along socioeconomic status. From the perspective of mothers, findings illustrate that the introduction of commercial milk formula soon after birth at hospitals is a barrier that hinders planned breastfeeding practices. Regarding infant growth, results suggest that infection impacts growth and may decrease the rate of brain growth, as indicated by head circumference. Regarding infant feeding, formula feeding impacts weight gain, meanwhile breastfeeding may decrease the risk of infection. Findings from this dissertation contribute to the growing area of biocultural anthropology interested in using qualitative and quantitative data to further examine potential pathways for the biocultural connections in relation to infant growth.
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