Dr Heather Gage, from the University of Surrey, who presented the survey findings on behalf of an international group of researchers, said: "The number of new mothers who thought that the way they fed their babies had long term health implications was quite high considering this is a new and developing area of science. Especially as we have shown previously that it is not yet reflected in official advice to parents."

The survey was carried out in five countries across Europe: England, Finland, Germany, Hungary and Spain. Around 2000 first time mothers with healthy babies were asked about the way they intended to feed their babies and what were their beliefs about the associations between infant feeding and lifelong health.

Almost all mothers (95%) agreed that the way they fed their babies was important for their health in their first year of life. However, when mothers were asked about specific long term health conditions such as obesity, high blood pressure and cancer, they tended to think early diet was less important suggesting that they are not so clear about how diet might impact later health.

Dr Gage went on to say: "Once we have looked at our results in more detail, we hope we will be able to identify gaps in new mothers' understanding of the importance of early diet in different countries and recommend guidance on what sort of advice should be given in each country."

The mothers will be followed up when their babies are 8 months old to ask them about their milk feeding and weaning experiences.

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"The study offers important insight and points to where we can intervene early, such as making sure patients with heart failure are immunized against flu and pneumonia," added Fonarow.

Non-adherence to diet and uncontrolled hypertension were associated with lower mortality rates and shorter hospital stays.

Fonarow notes that some conditions are easier to handle such as helping patients get back on their medication to lower blood pressure or following a correct diet, which may help explain the lower mortality and shorter hospital stays for patients with these precipitating factors.

After leaving the hospital, 60 to 90 day follow-up revealed the highest mortality rates occurred in patients who had ischemia or worsening kidney function upon hospital admission. The lowest mortality rates after discharge occurred in patients who had uncontrolled hypertension at admission.

"Learning how these factors influence length of hospital stay, mortality and re-hospitalization are key to helping us better manage patients and preventing future hospitalizations," said Fonarow.

Fonarow notes that higher risk patients may benefit from closer monitoring during hospitalization and frequent follow-ups once leaving the hospital. Additional patient education and disease management strategies may help patients adhere to diet and medications.

"In future studies we plan to target how specific interventions based on these precipitating factors, such as flu vaccinations, may help this high-risk heart failure population," added Fonarow.

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