Introduction of inappropriate complementary feeding in the first year of life and associated factors in children with low socioeconomic status.

Camila Dallazen,Sandra Patricia Crispim,Júlia Dubois Moreira,Eduardo Augusto Fernandes Nilson,Sara Araújo Da Silva,Daniela Cardoso Tietzmann,Márcia Regina Vítolo,Vivian Siqueira Santos Gonçalves,Regina Maria Ferreira Lang

doi:10.1590/0102-311x00202816

Abstract

The study aimed to identify factors associated with the introduction of inappropriate complementary feeding in the first year of life in children living in municipalities (counties) with low socioeconomic statusl. This was a cross-sectional multicenter study in 1,567 children 12 to 59 months of age in 48 municipalities participating in the Brazil Without Poverty plan in the South of Brazil. A structured questionnaire was applied to the children's parents to obtain socio-demographic information and the age at which inappropriate complementary foods were introduced for the first time in complementary feeding. Prevalence of introduction of sugar before four months of age was 35.5% (n = 497; 95%CI: 33.1-38.0). The prevalence rates for the introduction of cookies/crackers, creamy yogurt, and jelly before six months of age were 20.4% (n = 287; 95%CI: 18.3-22.3), 24.8% (n = 349; 95%CI: 22.4-27.1), and 13.8% (n = 192; 95%CI: 12.0-15.7), respectively. Associations were identified between low maternal schooling (PR = 1.25; 95%CI: 1.03-1.51) and low monthly family income (PR = 1.22; CI95%: 1.01-1.48) and the introduction of inappropriate complementary feeding. The study identified the introduction of inappropriate complementary feeding in the first year of life among children in municipalities with high socioeconomic vulnerability in the South of Brazil, associated with low maternal schooling and low monthly family income.

Highlights

Maternal breast milk alone is sufficient to meet the infant’s nutritional needs in the first six months of life, and starting at this age the introduction of complementary feeding is necessary to supply adequate nutrients for the child’s healthy growth and development 1
The study’s aim is to identify factors associated with the introduction of inappropriate complementary feeding in the first year of life among children living in municipalities with low socioeconomic status in the South of Brazil
Calculation of the sample size considered 21.5% prevalence of anemia in children less than five years of age in the South of Brazil 15, maximum error of 5%, 95% confidence interval (95%CI), infinite population, and sampling and design effect of 1.5

Summary

Introduction

Maternal breast milk alone is sufficient to meet the infant’s nutritional needs in the first six months of life, and starting at this age the introduction of complementary feeding is necessary to supply adequate nutrients for the child’s healthy growth and development 1. Studies show an increase in early inappropriate introduction of complementary feeding with the supply of inappropriate complementary foods like cookies, instant noodles, soft drinks, powdered fruit drinks, and salty snacks in the first months of life [8,9,10] The introduction of these ultra-processed, energy-dense, and hyperpalatable foods, associated with the interruption of maternal breastfeeding, jeopardizes the child’s growth and development, besides favoring infections, allergies, and nutritional disorders. Calculation of the sample size considered 21.5% prevalence of anemia in children less than five years of age in the South of Brazil 15, maximum error of 5%, 95% confidence interval (95%CI), infinite population, and sampling and design effect (deff) of 1.5. In Brazil, the technical regulations setting minimum requirements for advertising and commercial promotion of non-nutritive foods 34 do not apply to the labeling, which is still an important medium for the promotion of these products by the food industry

Methods

Results

Conclusion