Abstract
Early introduction of complementary foods can have a detrimental impact on children’s long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was ‘age at which particular core and discretionary food items were first introduced’. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54–7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99–5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17–11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.
Highlights
According to the World Health Organization (WHO), infants should be exclusively breastfed until the age of six months, followed by the introduction of nutritious foods at six months of age to complement on-going breastfeeding [1]
There were no differences in the age, education level and infant feeding method of those who completed the 52-weeks interview and those who withdrew from the study
This study describes the complementary feeding practices of socioeconomically disadvantaged and ethnically diverse population residing in South Western Sydney (SWS), and the family and infant characteristics influencing the early introduction of core and discretionary foods amongst infants
Summary
According to the World Health Organization (WHO), infants should be exclusively breastfed until the age of six months, followed by the introduction of nutritious foods at six months of age to complement on-going breastfeeding [1]. Hepatology and Nutrition (ESPGHAN) guidelines [2] state that complementary foods should be introduced “no earlier than 17 weeks and no later than 26 weeks”. The transition from exclusive breastfeeding or formula-feeding to complementary foods is essential for children’s growth and development as well as their long-term health status [6,7]. Introduction of complementary foods may lead to nutritional or energy imbalance due to replacement of milk in the diet, potentially increasing the risk of gastrointestinal diseases, and food allergies [8]. Feeding behaviour in the first year of life sets the stage for a child’s nutritional preferences and habits in later life [13]
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