Introduction Of Complementary Foods Research Articles

Effects of Nutrition Education Program on Lactating Mothers in Relation to Infant Feeding Practices

Maternal and child health status is profoundly affected by infant feeding practices. In Pakistan, these practices are sub optimal which may lead to adverse outcomes. The initiation of breastfeeding within the first hour of birth, as well as good counseling of lactating mothers regarding infant weaning and introduction of complementary foods to the infants in a hygienic and clean environment, can decrease the risk of malnutrition and infections, leading to a decrease in infant morbidity and mortality. Increasing the awareness of mothers regarding recommended feeding practices is a key to improving this situation, especially in the region of South Asia. The current study was conducted with the aim of assessing the impacts of contextually developed nutrition education sessions on the knowledge and attitudes of women regarding infant feeding. A quasi experiment was conducted for this purpose. A sample of 400 lactating mothers between 20-30 years of age visiting a private post-natal clinic located in Lahore, Pakistan was selected. Half of the sample (200) was included in the experimental group and exposed to 12 weeks of educational intervention based on various audio-visual aids. Pretest and posttest knowledge and attitude scores of the women of both control and experimental groups were recorded. The results showed that women belonging to both control and experimental groups had similar knowledge regarding infant feeding at baseline (pretest). However, experimental group showed significant improvement in knowledge scores after intervention, as compared to control. The results also revealed that simple educational intervention can lead to profound improvements in maternal knowledge and attitudes regarding infant feeding. Increasing awareness is the first step in the translation of knowledge into practice. Therefore, similar interventions may be helpful in improving infant breast and complementary feeding practices. Effective implementation of nutrition education interventions that can improve the breastfeeding rates and also bring about improvement in complementary feeding practices is important for a developing country like Pakistan. This, in turn, may lead to better health outcomes for infants by reducing direct and indirect impacts of undernutrition.

Factors associated with intention to breastfeed in Vietnamese mothers: A cross-sectional study

Introduction Breastfeeding has many benefits for mothers, children, and the environment over both the short and longr-term. Prenatal intention to breastfeed is a powerful predictor of short-term breastfeeding outcomes. Objective This study aims to analyze breastfeeding intentions, including the intention to feed infants with breastmilk only and to continue exclusive breastfeeding to 6 months among pregnant mothers in Hanoi, Vietnam. Methods The analysis included 1230 singleton mothers, between 24- and 36-weeks’ gestation, who attended antenatal clinics in two hospitals in Hanoi in 2020. Results The proportion of mothers with an “breastfeeding intention” (i.e., intention to feed an infant with breastmilk only) and “exclusive breastfeeding intention” to 6 months was 59.9% and 41.7%, respectively. Mothers who were 25 years or older (aOR = 1.35, 95%CI:1.00–1.81), had an undergraduate educational degree or higher (aOR = 1.38, 95%CI: 1.08–1.76), had observed another woman breastfeeding (aOR = 1.43, 95%CI: 1.03–2.00), were not living with parents-in-law (aOR = 1.34, CI: 1.05–1.70), and were multiparous (aOR = 1.60, 95%CI: 1.16–2.19) had higher odds of “exclusive breastfeeding intention” to 6 months. Among primiparous women, those who thought their husbands support breastfeeding were more likely to intend to feed an infant with breastmilk only. Among multiparous women, feeding the previous child with breastmilk exclusively before the introduction of complementary foods and not giving solid foods together with water until 6 months, were significant predictors for both breastfeeding intentions. Conclusion Mothers without exclusive breastfeeding experience should be provided with greater support to promote exclusive breastfeeding intention and outcomes.

Associations of infant feeding practices with abdominal and hepatic fat measures in childhood in the longitudinal Healthy Start Study

BackgroundInfant feeding patterns have been linked with obesity risk in childhood, but associations with precise measures of body fat distribution are unclear. ObjectiveWe examined associations of infant feeding practices with abdominal fat and hepatic fat trajectories in childhood. MethodsThis study included 356 children in the Healthy Start Study, a prospective prebirth cohort in Colorado. Infant feeding practices were assessed by postnatal interviews and categorized as any human milk <6 mo compared with ≥6 mo; complementary foods introduced ≤4 mo compared with >4 mo; soda introduced ≤18 mo compared with >18 mo. Abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) areas and hepatic fat (%) were assessed by magnetic resonance imaging in early and middle childhood (median 5 and 9 y old, respectively). We examined associations of infant feeding with adiposity trajectories across childhood using linear mixed models. ResultsIn the sample of children, 67% consumed human milk ≥6 mo, 75% were introduced to complementary foods at >4 mo, and 81% were introduced to soda at >18 mo. We did not find any associations between duration of any human milk consumption and childhood adiposity trajectories. Early introduction to complementary foods (≤4 mo) was associated with faster rates of change for SAT and VAT during childhood (Slope [95% CI]: 15.1 [10.7,19.4] cm2/y for SAT; 2.5 [1.9,2.9] cm2/y for VAT), compared with introduction at >4 mo (5.5 [3.0,8.0] cm2/y and 1.6 [1.3,1.9] cm2/y, respectively). Similarly, early introduction to soda (≤18 mo) was associated with faster rates of change for all 3 outcomes during childhood (Slope [95% CI]: 20.6 [15.0,26.1] cm2/y for SAT, 2.7 [2.0,3.3] cm2/y for VAT, 0.3 [0.1,0.5] %/year for hepatic fat) compared with delayed introduction (5.4 [2.8,8.0] cm2/y, 1.7 [1.3, 2.0] cm2/y, -0.1 [-0.2,0.0] %/y, respectively). ConclusionsThe timing of introduction and quality of complementary foods in infancy was associated with rates of abdominal and hepatic fat accrual during childhood. Experimental studies are needed to assess underlying mechanisms.

Infant Complementary Feeding Methods and Subsequent Occurrence of Food Neophobia-A Cross-Sectional Study of Polish Children Aged 2-7 Years.

The study used an anonymous survey questionnaire consisting of five parts as the research tool. The first part of the questionnaire was a metric and concerned the socio-demographic data of the parent/guardian and their child. A standardised questionnaire assessing food neophobia among children was used to assess food neophobia: the Food Neophobia Scale-Children (FNSC). In the study group, 171 children (29.23%) had a low risk of food neophobia according to the FNSC, 182 children (31.11%) had a medium risk of neophobia, and 232 children (39.66%) had a high risk of neophobia. A correlation was observed between the age and the risk of food neophobia (p = 0.0002). Statistically significant differences were found between children aged 2 and 4 (p = 0.003) and children aged 2 and 5 years (p = 0.049). We observed no correlation between gagging (p = 0.88557), choking (p = 0.17597), and needing medical intervention (p = 0.61427) and the risk of associated neophobia. In the study group of children, the highest risk of food neophobia was characterized by children aged 4, 5, and 7 years. The length of breastfeeding and exclusive breastfeeding did not affect the risk of food neophobia. In the month in which complementary feeding (CF) was introduced, the children were fed using the baby-led weaning method (BLW method), and introducing puree and puree with lump food into the children's diet also did not affect the risk of food neophobia. It was shown, however, that children whose mothers observed difficulties during CF and whose children had a vomiting reflex and spat food out of their mouths during CF were more likely to develop food neophobia at the preschool age.

Professional Feeding Guidance Improved Infants' Self-Feeding Proportion during Complementary Foods Introduction in Beijing, China: An Exploratory Study.

An exploratory study was undertaken to examine the prevalence of infants' feeding patterns in Beijing, China, as well as the factors linked to infants' self-feeding proportion during the introduction of complementary foods, and the impact of professional feeding guidance on this proportion. A total of 122 families with infants aged 6-11 months from Beijing were included in the study. A descriptive analysis was employed to assess the prevalence of infants' feeding patterns, while generalized linear model analysis was utilized to investigate the factors associated with these patterns. All families were provided with comprehensive and personalized professional guidance regarding the introduction of complementary foods for infants. However, 64 families were lost to follow-up, leaving 58 families who were re-evaluated and queried after one month. To exclude the influence of infants aging, both the 64 families prior to receiving feeding guidance, and the 58 families after receiving feeding guidance, were included in the analysis. The families with infants aged 6-8 months and 9-11 months were compared separately based on the presence or absence of feeding guidance. Statistical tests, including the Wilcoxon rank-sum test and χ2 test, were conducted to assess any significant differences. The study revealed that the proportion of infants engaging in self-feeding was found to be remarkably low (10% [0%, 40%]). Furthermore, a significant positive association was observed between the proportion of infants engaging in self-feeding and their age (p < 0.001). Notably, after receiving professional feeding guidance, the proportion of infants engaging in self-feeding significantly increased (from 1% [0%, 20%] to 30% [10%, 50%], p < 0.001 for infants aged 6-8 months; from 20% [10%, 50%] to 40% [30%, 50%], p < 0.001 for infants aged 9-11 months). These findings contribute valuable insights for improving postnatal care practices during the introduction of complementary foods for infants.

The Effect of Weaning Practices on the Nutritional and Health Status of Saudi Preschool Children.

Background Weaning is a complex procedure that gradually introduces complementary foods to the baby's diet. Solid food should be started between the ages of 6 and 12 months. Weaning is a challenging and crucial stage in an infant's development. Extreme caution should be used during weaning an infant because delaying it can cause issues like sluggish growth, difficulties feeding, malnutrition, and iron deficiency. Objective The current study aims to determine the impact of delayed or early weaning practices on the nutritional status of preschool children in Saudi Arabia. Data was gathered about the time of complementary food introduction, preferred foods in the initial stages, and a child's health compared to those practices. Methodology By convenient sampling, a cross-sectional study was conducted to gather data from 385 parents of Saudi children at preschool age. Questionnaires were shared online. Data were recorded and analyzed on IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Descriptive analysis and multivariate ANOVA (MANOVA) tests were performed. Results Only 6.23% of the infants were introduced to complimentary food at optimal age (6 to 12 months), whereas 85% were found to have delayed weaning. As per the BMI, 74.4% of preschool children were severely underweight, 53.6% of infants consumed pureed vegetables early during weaning, and 64% of infants were introduced to eggs and cheese within the first year of life. The timing, pattern, and food items of weaning had a significant (p<0.05) impact on general physical health, as 48.8% of children had pale skin, 46.9% felt tired, 36.5% had swollen joints, and 42% complained of itching and an upset stomach. Conclusion This study couldn't define the direction of significance. Further studies can be done on a larger scale where biochemical tests, and screening can be done on children to find if any significant health problem is prevailing, and the direction of association can be defined.

Barriers and coping responses towards infant and young child feeding practices in rural Ethiopia: a descriptive qualitative study

ObjectiveTo explore barriers and coping responses toward infant and young child practices (IYCFP) in rural Ethiopia.MethodsA descriptive qualitative study using semi-structured in-depth interviews and focus group discussions was conducted with...

Bioaccessibility data of potentially toxic elements in complementary foods for infants: A review

The introduction of complementary foods (CFs) is a critical step in an infant's transition to solid foods, providing essential nutrients beyond breast milk. However, CFs may contain potentially toxic elements (PTEs), such as arsenic and cadmium that pose health risks to infants. In this context, understanding the bioaccessibility of PTEs is vital as it determines the fraction of a contaminant released from the food matrix and available for absorption in the gastrointestinal tract. Efforts have been made to standardize the assessment methodology for bioaccessibility, ensuring consistent and reliable data. Moreover, regulatory agencies have established guidelines for PTEs levels in food. However, important gaps still exist, which motivates many research opportunities on this topic.

Determinant of under nutrition among under five children in Ambo town during covid 19 pandemic in 2020. A community-based cross-sectional study

BackgroundAbout 8 to 44% of all child mortality in Africa is associated with undernutrition. To alleviate this problem, it is necessary to determine the magnitude and determinants of undernutrition during Covid 19 pandemic. However, there is scarce evidence in an urban setting like Ambo town. Therefore, this study assessed the magnitude and factors associated with undernutrition among under-five children in Ambo town, west Ethiopia.Methods and patientsA community-based cross-sectional study was conducted in Ambo town from March 01–30, 2020. The child and mother/caregiver socio-demographic characteristics, child illness and health care utilization, and child feeding practice-related data were collected using the standardized tool adopted from similar studies conducted in Ethiopia. Anthropometric measurements of the child were made using a calibrated scale. A systematic sampling technique was employed to select 363 mothers/caregivers of the child as a source of data. Nutritional status indices were generated using ENASMART software. After testing for collinearity, variables with a p-value < 0.25 in binary logistic regression were interred to backward multiple logistic regressions at a level of significance of p < 0.05.ResultsA total of 363 participants were included in this study providing a 100% response rate and providing the following result. The mean (+ SD) age of children was 28.85 (+ 14.17) months and that of mothers/caregivers was 28.12 + 48 years. This study found 16.00%, 25.30%, and 19.00% of the study participants were underweight, wasted, and stunted respectively. Decisions making on major food purchases, who usually care for the child, the age at which the child starts complimentary food, late introduction of complementary food were positively associated with wasting. Diarrhea, birth weight, child age, age at which the child starts complimentary food, consumption of milk and milk product, and who usually care for the child were significantly associated with being underweight. Consumption of milk and milk products, household food security level, and birth weight were independent determinants of stunting.ConclusionThis study identified a high prevalence of undernutrition, especially wasting. Childbirth weight, age, diarrhea, feeding practice, household (HH) food security, Decision making on major food purchases, late introduction of complementary food were found to be the potential determinants of undernutrition. Thus there should be an effort to improve the nutritional status of children in the study area by focusing on these factors.

Biological Relevance of Goat Milk Oligosaccharides to Infant Health.

Milk is often regarded as the gold standard for the nourishment of all mammalian offspring. The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of the life of the infant, followed by a slow introduction of complementary foods to the breastfeeding routine for a period of approximately 2 years, whenever this is possible ( Global Strategy for Infant and Young Child Feeding; WHO, 2003). One of the most abundant components in all mammals' milk, which is associated with important health benefits, is the oligosaccharides. The milk oligosaccharides (MOS) of humans and other mammals differ in terms of their concentration and diversity. Among those, goat milk contains more oligosaccharides (gMOS) than other domesticated dairy animals, as well as a greater range of structures. This review summarizes the biological functions of MOS found in both human and goat milk to identify the possible biological relevance of gMOS in human health and development. Based on the existing literature, seven biological functions of gMOS were identified, namely, MOS action as prebiotics, immune modulators, and pathogen traps; their modulation of intestinal cells; protective effect against necrotizing enterocolitis; improved brain development; and positive effects on stressor exposure. Overall, goat milk is a viable alternate supply of functional MOS that could be employed in a newborn formula.

Complementary Feeding and Child Appetitive Traits in a Sample of Hispanic Mother-Child Dyads.

Complementary feeding practices may contribute to toddler eating practices that affect weight outcomes. Studies are needed to understand the relationship between complementary feeding practices and toddler dietary self-regulation. This study tests the hypothesis that earlier complementary food introduction predicts toddler food responsiveness and emotional overeating (ie, tendency to overeat in response to food cues and emotions, respectively), and considers whether introduction of certain foods better predict toddler dietary self-regulation. This study is a secondary analysis of data from a parent longitudinal birth cohort study on early growth/development among Hispanic mother-infant dyads. The analytic sample included 174 mother-child dyads recruited from maternity clinics affiliated with the University of Southern California in Los Angeles County. Recruitment and data collection were ongoing from July 2016 to April 2020. At 1-, 6-, 12-, and 24-months postpartum, mothers reported exclusive breastfeeding duration and age of complementary food introduction via questionnaire. Child food responsiveness and emotional overeating scores calculated from the Child Eating Behavior Questionnaire at 12 and 24 months of age. Separate linear mixed models with repeated measures were used to examine associations between age of complementary food introduction as a predictor of child food responsiveness or emotional overeating, controlling for infant sex, birth body mass index z score, duration of exclusive breastfeeding, and mother's body mass index. In separate models, delaying complementary food introduction by 1 month was associated with a 6% reduction in food responsiveness (P= 0.007) and a 5% reduction in emotional overeating scores (P= 0.013). Fifty-eight unique combinations of complementary foods introduced first were found, precluding analyses to examine whether specific combinations were related to eating behavior outcomes due to sample size limitations. Earlier complementary feeding was associated with higher food responsiveness and emotional overeating scores among Hispanic children. Future studies in larger samples are needed to characterize patterns of complementary food introduction and their influence on child self-regulation.

Development of taste perception and complementary foods: A review

Breast milk meets the needs of a 6-month-old child in macronutrients (proteins, fats, carbohydrates) almost entirely, while in minerals and trace elements only partially. Complementary feeding is the stage of development of the child's eating behavior when its diet expands due to the introduction of additional products. The model of human eating behavior is formed in infancy and early childhood when stable taste preferences and attitudes to eating (regimen, serving size, table culture) are established. The European and North American Nutrition Committees, in their resolution (2008), noted that the timing of the introduction of complementary foods for breastfed and bottle-fed infants should be the same: no earlier than week 17 and no later than week 26. The age to introduce complementary foods in Russia is 4-6 months and 5.5 months in breastfed infants. Due to the intensive growth and increased physical activity of the child, it is advisable to use milk porridges as one of the main types of complementary foods necessary for children at 4–5 months to provide an additional (relative to human milk or its substitutes) amount of protein, energy, minerals, and vitamins. In recent years, ready-to-use liquid cereals have become popular. Due to the carbohydrate component of cereals, which promotes longer satiety, they can be given to young children before bedtime.

Associations between Delayed Introduction of Complementary Foods and Childhood Health Consequences in Exclusively Breastfed Children.

The timing of complementary food (CF) introduction is closely related to childhood health, and it may vary depending on the region, culture, feeding type, or health condition. Despite numerous studies on the benefits of breastfeeding and the optimal timing of CF introduction, there have been limited investigations regarding delayed CF introduction in exclusively breastfed children. We compared an exposed group (CF introduction ≥7 months) with a reference group (CF introduction at 4 -< 7 months) regarding hospital admission, disease burden, and growth until age 10. Data from a nationwide population-based cohort study involving children born between 2008 and 2012 in the South Korea were analyzed. The final cohort comprised 206,248 children (165,925 in the exposed group and 40,323 in the reference group). Inverse probability of treatment weighting with propensity score matching was used to balance baseline health characteristics in the comparison groups. We estimated the incident risk ratios (IRR) for outcomes using modified Poisson regression and weighted odds ratios (weighted ORs) and their 95% confidence intervals (CIs) using multinomial logistic regression. The exposed group was associated with low height-for-age z-score (HAZ) (IRR (95% CI) for -1.64 < HAZ ≤ -1.03: 1.11 (1.08 to 1.14); HAZ ≤ -1.64: 1.21 (1.14 to 1.27)) and frequent (≥6 events) hospitalizations (weighted OR 1.18 (1.09 to 1.29). The rates of hospital admission, death, and specific medical conditions did not differ between groups. However, delaying the introduction of CF until seven months in exclusively breastfed infants was associated with frequent hospitalization events and lower heights.

Retraction and Republication: Timing of Introduction of Complementary Foods - United States, 2016-2018.

Retraction and Republication: Timing of Introduction of Complementary Foods - United States, 2016-2018.

Household food security, child dietary diversity and coping strategies among rural households. The case of Kole District in northern Uganda

Household food security, feeding practices, dietary diversity and coping strategies to household food insecurity are largely interconnected. Using a cross sectional study approach involving 162 mothers and care givers of children 0-36 months of age in Kole district of northern Uganda, this study examined the household food security status, child dietary diversity and household coping strategies. The study revealed that a slight majority of the households (55%) were food secure although with a low level of child dietary diversity experienced (68.1% for children 6-23 months age group and 55.3% for 24-36 months age group). We found that starch-based foods derived from cereals, roots and tubers were the most predominantly used food group in child feeding (82%), with limited consumption of other essential food groups, notably fruits, vegetables, meats and dairy products (18% combined). Additionally, only 57% of children 0 to 6 months old were receiving exclusive breastfeeding, and the introduction of complementary foods is often delayed and not well planned for those above 6 months of age. Results also showed that a wide range of coping strategies are employed however the major ones were, reliance on less preferred food (54.9%), limiting portions of meals (35.2%), reducing number of meals taken in a day (29%), and gathering wild fruits and harvesting immature crops (29.6%). It was observed that household food security is a strong determinant of child dietary diversity, may influence feeding practices and the range of coping strategies applicable to households when they experience food insecurity. Furthermore, nutritional education, household size and livelihood diversity play a significant role in determining household food security status, child dietary diversity and coping with food insecurity within rural households. In conclusion, addressing household food security, and coping strategies can play an important role in improving child feeding practices and dietary diversity in rural communities.

Timing of Introduction of Complementary Foods - United States, 2016-2018.

The American Academy of Pediatrics (AAP) recommends introducing complementary foods (i.e., any solid or liquid other than breast milk or infant formula) to infants at approximately age 6 months (1). Although a consensus on ideal timing is lacking, most experts agree that introduction of complementary foods before age 4 months is too early because of infant gastrointestinal and motor immaturity (1,2). In addition, early introduction prevents exclusively breastfed infants from reaching the recommended 6 months of exclusive breastfeeding (1) and might be associated with increased risk for overweight and obesity (3). Nationally representative data on complementary feeding are limited; state-level estimates have been previously unavailable. CDC analyzed 2016-2018 data from the National Survey of Children's Health (NSCH) (N = 23,743) to describe timing of complementary feeding introduction and prevalence of early introduction of complementary foods before age 4 months (early introduction) among children aged 1-5 years. Prevalence of early introduction was 15.6% nationally and varied geographically and across sociodemographic and infant feeding characteristics. These estimates suggest that approximately one in six infants are introduced to complementary foods before they are developmentally ready. Efforts by health care providers and others who might influence infant feeding practices could help decrease the number of infants who are introduced to complementary foods too early.

Developmental Feeding Stages and Their Impact on Child Feeding Behavior.

Previous research has shown that critical periods of feeding skills development exist and feeding problems can arise in children due to delays in attaining feeding developmental milestones. This study aims to delineate the transitional process of feeding development in healthy children and children with gastrointestinal diseases (GIDs) and to examine the relationship between feeding milestones and the appearance of later feeding problems. A cross-sectional case-control study among 711 healthy Greek children and 119 children with GID, aged 2-7 years. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale and "self-reported" questionnaires assessing child's feeding history. Differences in feeding behavior of preschoolers between the 2 groups were found concerning the time of introduction of complementary (pureed), lumpy, and table foods as well as finger feeding and regular cup-drinking. Age-specific milestones as proposed by guidelines were not reached. Late introduction of complementary and lumpy foods (>6 months and >9 months, respectively) as well as finger feeding (>9 months) were predictive of more problematic feeding behaviors later on. The trajectory of feeding development, including less studied feeding milestones, both in healthy children and children with GIDs, indicates that there are discrepancies between current feeding practices and infant feeding guidelines, and a tendency to delay the acquisition of all assessed feeding milestones.

Patterns and determinants of breastfeeding and complementary feeding practices over the first year of life in a rural Gambian population

Background: Although breastfeeding is common in The Gambia, high rates of undernutrition in children under five highlight the importance of understanding drivers of particular feeding patterns in this environment, especially early introduction of non-breast milk foods (NBMFs). The country’s marked seasonality, which is associated with annual food insecurity and heavy maternal workload, may influence breastfeeding patterns; however, longitudinal assessments of infant diet in relationship to such factors are limited. We aimed to characterize infant breastfeeding patterns and timing of introduction of local complementary foods in a rural Gambian population across the first twelve months of life. Potential environmental and sociodemographic predictors of exclusive breastfeeding (EBF) duration were explored in order to identify factors that may influence infant feeding decisions in this population. Methods: Data from dietary questionnaires (administered every ten days until 12 months of age) collected as a part of the Hormonal and Epigenetic Regulators of Growth study (2013-2018) were used to calculate EBF duration in a subsample of 194 mother-infant pairs. Socioeconomic questionnaires and Principal Component Analysis were used to calculate household sociodemographic position (SEP). Multiple linear regression analyses were used to investigate potential predictors of EBF duration, including seasonality, SEP, and maternal and infant factors. Results: Mean age at introduction of food or liquid other than maternal milk was five months (±1.5). At twelve months, 98.7% of infants continue to receive some maternal milk. Being born in May significantly predicted shorter EBF duration by -1.68 months (95% CIs: -2.52, -0.84mo; P&lt;.0001). SEP, maternal parity, and infant sex were non-significant predictors of EBF duration. Conclusions: Maternal milk is a vital component of infant diet across the first twelve months of life in this population. Earlier introduction of NBMFs coincides with the annual period where maternal agricultural workload intensifies in this region, though additional investigation is warranted.

Expression of Concern: Timing of Introduction of Complementary Foods - United States, 2016-2018.

Expression of Concern: Timing of Introduction of Complementary Foods - United States, 2016-2018.

Introduction of complementary feeding: analysis of practices and factors that influence parental decisions

The World Health Organization (WHO) recommends that mothers exclusively breastfeed their infant for the first six months to achieve optimal growth and development. In addition, children should receive nutritious complementary foods and continue to breastfeed until age two years or older. Several factors still greatly influence the introduction of complementary feeding (ICF). Thus, this research aimed to analyze whether parents perform the appropriate ICF for their children. This survey used a questionnaire prepared via Google Forms®, with 58 participants, 100% women with 28 years old on average. Exclusive breastfeeding (EBF) until the sixth month was reported by 51.7% of the interviewees. Based on feeding characteristics, 69% started introducing food at six months old. Regarding early ICF, infant formula was the most offered food (36.2%). Foods such as crackers, stuffed biscuits, sugar, fruit juice, and cow's milk were offered early to children younger than 24 months. The lack of information, the economic factor, time concerning work, and practicality were the factors that interfered with the introduction of food to children. The importance of professional nutritionists in raising awareness among parents is highlighted, transmitting confidence and aiming at an adequate introduction of complementary foods.