Abstract
Age of complementary foods introduction is associated with childhood anemia, but the ideal age for the introduction of complementary foods to infants is a continuing topic of debate. We examined the longitudinal association between complementary foods introduction age and risk of anemia in 18,446 children from the Jiaxing Birth Cohort, who had detailed complementary feeding records at 3 and 6 months of age and had hemoglobin concentrations measured at 4–6 years. Early introduction of complementary foods at 3–6 months of age was significantly associated with a higher risk of anemia (odds ratio = 1.14; 95% confidence interval: 1.01–1.28) and a lower hemoglobin concentration of −0.84 g/L (95% confidence interval: −1.33 to −0.35) in children aged 4–6 years, compared with those fed complementary foods starting at 6 months of age. When it comes to the specific type of complementary foods, early introduction of all plant-based foods was associated with increased anemia risks and lower hemoglobin concentrations, while early introduction of most animal-based foods was not. These findings may be informative regarding the appropriate time to introduce complementary foods in infants.
Highlights
Introduction and Risk of Anemia inChildren Aged 4–6 years: A received: 31 May 2016 accepted: 14 February 2017Published: 23 March 2017Prospective Birth Cohort in ChinaFenglei Wang[1], Huijuan Liu[2], Yi Wan[1], Jing Li2, Yu Chen[2], Jusheng Zheng[3], Tao Huang4 & Duo Li1,5Age of complementary foods introduction is associated with childhood anemia, but the ideal age for the introduction of complementary foods to infants is a continuing topic of debate
Among the nine kinds of complementary foods, early introductions of bread/steamed bun/fine dried noodle, pureed noodle/cookies, tofu, and ground meat/soy product were significantly associated with anemia, whereas other foods were not found to be associated with anemia (Table 3)
Among the complementary foods commonly used, significant associations between age of the introduction of complementary foods and hemoglobin concentrations were observed for rice cereal/porridge, bread/steamed bun/fine dried noodle, pureed noodle/cookies, tofu, egg yolk, and ground meat/ soy product (Table 5). Children fed these foods at 3 to 6 months had significantly lower hemoglobin concentrations compared with those who were fed these foods after 6 months of age. In this large prospective birth cohort study, we found that early introduction of complementary foods before 6 months was significantly associated with a greater risk of anemia and a lower hemoglobin concentration in children aged 4–6 years, even after adjustment for other risk factors like birth weight and maternal hemoglobin concentration
Summary
Introduction and Risk of Anemia inChildren Aged 4–6 years: A received: 31 May 2016 accepted: 14 February 2017Published: 23 March 2017Prospective Birth Cohort in ChinaFenglei Wang[1], Huijuan Liu[2], Yi Wan[1], Jing Li2, Yu Chen[2], Jusheng Zheng[3], Tao Huang4 & Duo Li1,5Age of complementary foods introduction is associated with childhood anemia, but the ideal age for the introduction of complementary foods to infants is a continuing topic of debate. We examined the longitudinal association between complementary foods introduction age and risk of anemia in 18,446 children from the Jiaxing Birth Cohort, who had detailed complementary feeding records at 3 and 6 months of age and had hemoglobin concentrations measured at 4–6 years. Introduction of complementary foods at 3–6 months of age was significantly associated with a higher risk of anemia (odds ratio = 1.14; 95% confidence interval: 1.01–1.28) and a lower hemoglobin concentration of −0.84 g/L (95% confidence interval: −1.33 to −0.35) in children aged 4–6 years, compared with those fed complementary foods starting at 6 months of age. Addressing iron deficiency has been considered one of the most effective interventions for preventing and controlling anemia[6,7]
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