Early Introduction Of Complementary Foods Research Articles

Complementary feeding practices to children during their first year of life

This study aimed to investigate complementary feeding practices during children's first year of life in Botucatu, SP, Brazil. Practices were described according to the age range and the breastfeeding (BF) practice. Data were collected during a multi-vaccination campaign through the interview of 1,238 individuals who accompanied children younger than one year old being vaccinated. Differences associated with the BF situation were identified by the chi-square test and Fisher's exact test. The early introduction of complementary food was observed, which led to the low frequency of exclusive breastfeeding (36.9% <4 months). Children younger than 4 months old consumed tea (30.7%); children between 4 and 6 months old consumed fruits (54.1%), soups (39.9%) and home-made food (19.2%). Juice was offered only to 15.2% of children younger than 4 months old who were completed weaned, 60% of the children was offered water. Data show that the consistence of the food consumed was inappropriate: children between 6 and 8 months old were offered the family's regular food (48.8%) and children older than 8 months (71.6%) were offered soup. Therefore, interventions focused on complementary feeding are justified on the city.

Delayed cord clamping and haemoglobin levels in infancy: a randomised controlled trial in term babies

This study was carried out to assess whether delaying umbilical cord clamping is effective in improving the haematological status of term infants living in a malaria-endemic area, and whether this is associated with complications in infants and mothers. We randomly assigned women delivering term babies in Mpongwe Mission Hospital, Zambia, to delayed cord clamping (DCC, n = 46) or immediate cord clamping (controls, n = 45) and followed their infants on a bi-monthly basis until the age of 6 months. We compared the haemoglobin (Hb) change from cord values and the proportion of anaemic infants. Secondary outcomes related to infant and maternal safety. Throughout the observation period infant Hb levels in both groups declined, but more rapidly in controls than in the DCC group [difference in Hb change from baseline at 4 months 1.1 g/dl, 95% confidence interval (CI) 0.2; 2.1]. By 6 months, this difference had disappeared (0.0 g/dl, 95% CI -0.9; 0.8). The odds ratio for iron deficiency anaemia in the DCC group at 4 months was 0.3 (95% CI 0.1; 1.0), but no differences were found between the groups at 6 months. No adverse events were seen in infants and mothers. Our findings indicate that DCC could help improve the haematological status of term infants living in a malaria-endemic region at 4 months of age. However, the beneficial haematological effect disappeared by 6 months. This simple, free and safe delivery procedure might offer a strategy to reduce early infant anaemia risk, when other interventions are not yet feasible.

Maternal knowledge of nutrition, problem‐solving abilities and the introduction of complementary foods into infants’ diets

The purpose of the present study was to identify variables (maternal knowledge and problem‐solving ability) associated with the early introduction of complementary foods (i.e. foods other than breastmilk or formula) into infants’ diets. Ninety‐eight primarily African‐American mothers who presented to an urban, ambulatory care clinic in the Midwest completed questionnaires. Maternal knowledge regarding doctors’ recommendations for complementary feeding was associated with when mothers introduced solids (r = 0.25, p < .05), cow’s milk (r = 0.35, p < .05), juice (r = 0.42, p < .001) and water (r = 0.38, p < .001). Maternal nutrient knowledge was associated with when cow’s milk (r = 0.37, p < .05) and fruit drink/soda (r = 0.52, p < .01) were introduced. The quality of maternal problem‐solving was associated with when mothers introduced fruit drink/soda (r = 0.34, p < .05). Results underscore the role that healthcare professionals play in complementary feeding.

Introduction of complementary food to infants within the first six months postpartum in rural Vietnam

To document the introduction of complementary food and factors influencing the decision to feed infants with solid food within 6 mo postpartum in rural Vietnam. A longitudinal study of 463 women who gave birth during August-October 2002 was conducted. An early introduction of complementary food was found, which increased from 16.4% at week 1 to 56.5% at week 16 and nearly 100% at week 24. Home-cooked solid food was introduced by 4.8%, 40.9% and 74.3% of women at weeks 1, 16 and 24, respectively. Logistic regression analysis found that at week 24 postpartum, it was less likely for the infant to be fed with solid food if the mother was a farmer (OR 0.52, 95% CI: 0.18-0.95) and passed secondary school (OR 0.28, 95% CI: 0.10-0.54), whose husband was satisfied with the infant's sex (OR 0.30, 95% CI: 0.17-0.53), her mother-in-law preferred exclusive breastfeeding (OR 0.18, 95% CI: 0.04-0.75), or her friends practised exclusive breastfeeding (OR 0.41, 95% CI: 0.16-1.10). However, infants were likely to be fed with solid food when their parents had higher income and lived independently (OR 1.76, 95% CI: 1.01-3.06). Community mobilization for sharing the workload with women could help them to cope with employment and breastfeeding.

Protein energy malnutrition in complemented breast‐fed babies: implications of the timing of complementary feeding

The study investigated the association between complementation and protein energy malnutrition among 201 rural and urban women with infants of 0‐18 months of age in the Osun State of Nigeria. The infants mothers were interviewed about their child feeding practices and anthropometric measurements were made on the infants. The result indicated growth faltering in infants from one month old in rural areas and from four months old in the urban communities. Stunting was prevalent and underweight and wasting were also noticed in the study population as a consequence of early introduction of complementary foods. The main recommendations were that complementary foods should not be introduced before the infant is four‐six months of age and that the complementary foods used presently should be improved nutritionally through a long‐term nutritional public education.

Growth Pattern of Children under Two Years of Age in Alexandria

This study was conducted to assess children growth pattern and factors affecting it. The cross sectional data of 250 children were collected during growth monitoring sessions in Smouha Health Center, Alexandria. Weight and height percentiles for each child were obtained, awareness of mothers regarding the interpretation of growth charts was evaluated, and the attendance rate for growth monitoring was also calculated. Only 1.4% of children aged 0-6 months had a weight for age < 5th percentile. Growth faltering prevailed among 22.3% of infants below 6 months; the prevalence of overweight was increasing with age to reach 20% at the second year of age. Both low parental education and irregular attendance rate for growth monitoring were significantly associated with high frequency of growth faltering whereas early introduction of complementary food before six months was significantly associated with overweight. Early preventive interventions in the first year of life should be considered in order to prevent the faltering pattern of growth; nutrition education should be also directed to tackle the problem of overweight among young infants.

Lactational amenorrhea is associated with child age at the time of introduction of complementary food: a prospective cohort study in rural Senegal, West Africa

In Africa, lactational amenorrhea is the major reason for birth spacing. We studied whether the early introduction of complementary food to infants is associated with an increased risk of menstruation resumption in rural African women. Senegalese women (n = 855) were included at 2-3 mo postpartum and followed up at 4-5 and 6-7 mo in dispensaries. A subsample of 502 women were followed up at 9-10 mo and twice yearly at home thereafter. Risk factors for menstruation resumption were assessed with logistic regression, with control for maternal parity, occupation, education, postpartum body mass index, child sex and weight-for-age, and season. The risk of menstruation resumption was 4.2% (95% CI: 2.8%, 5.6%) at 6-7 mo and 6.5% (4.0%, 8.9%) at 9-10 mo. Compared with the introduction of complementary food after 6-7 mo, introduction at 2-3, 4-5, or 6-7 mo was associated with a greater odds of menstruation resumption at 6-7 mo [odds ratios (ORs): 5.08 (1.01, 25.5), 6.00 (1.29, 27.4), and 4.45 (0.96, 20.6; NS), respectively]. Introduction of food at 4-5 or 6-7 mo compared with that after 6-7 mo was associated with significantly greater odds of menstruation resumption at 6-7 mo (5.13; 1.16, 22.6) but not at 9-10 mo (3.07; 0.65, 14.4; NS) or year 2. Child age at introduction of complementary food was significantly associated with the odds of menstruation resumption at 6-7 mo postpartum.

The effect of work status on exclusive breastfeeding in Nairobi.

For many women today work is essential for the economic survival of their families while they also fulfil their role of providing optimum nutrition to their babies through breastfeeding. The objective of the study is to document the effect of returning to work on exclusive breastfeeding by mothers in Kenya. A cross-sectional study of 444 working mothers was undertaken in Nairobi, Kenya. About one half of the mothers were in formal paid employment and the rest were self-employed. The mean number of hours the mothers were away from home due to work was 46.2 hours per week. The prevalence of exclusive breastfeeding was 13.3% at three months. Early introduction of complementary foods was high, with 46.4% of the mothers introducing other foods before one month. Breast milk insufficiency and return to work were the main reasons cited for the cessation of exclusive breastfeeding. In a logistic regression analysis the mode of work (fixed working hours versus shift working hours) was associated with exclusive breastfeeding at one month (OR=0.45) and two months (OR=0.39). Working mothers were able to continue breastfeeding, although the exclusive breastfeeding rates were low. The early introduction of other foods is of public health importance as it exposes infants to increased risk of infection and poor nutrition, particularly diarrhoeal diseases and may lead to flattening of the growth curve. Shift work makes it impossible for some mothers to exclusively breastfeed their infants.

Effect of Timing of Introduction of Complementary Foods on Iron and Zinc Status of Formula Fed Infants at 12, 24, and 36 Months of Age

Objective The timing of introduction of complementary food to an infant’s diet is variable throughout the world. Our objective was to determine whether early introduction of complementary foods affects iron and zinc status of formula-fed infants at 12, 24, and 36 months of age.Design A randomized, prospective trial was conducted. Infants were randomly assigned to receive either a) early introduction (at 3 to 4 months of age) of commercially prepared or parent’s choice of complementary foods; or b) late introduction (at 6 months of age) of commercially prepared complementary foods or parent’s choice of complementary foods. In addition to complementary foods, infants were fed commercial infant formula as recommended by their pediatrician. Hemoglobin, mean corpuscular volume, and serum ferritin and zinc concentrations were determined at 12, 24, and 36 months of age. Three-day diet diaries were completed at 3, 6, 12, 18, 24, 30, and 36 months of age.Subjects/setting One hundred seventy-five infants younger than 3 months were recruited by mailings to parents in the Cincinnati area. Of these, 172 were enrolled, 90 in the early introduction group and 82 in the late-introduction group. One hundred thirty-three infants (n=67 in the early, n=66 in the late group) completed the study.Statistical analyses performed Student t test and regression analyses were used to determine whether there were group differences and whether there was a relationship between serum parameters and dietary intake.Results Infants fed complementary foods early had significantly greater iron intakes until 6 months of age; however, there were no differences in the iron status parameters (ferritin, hemoglobin, and mean corpuscular volume) at 12, 24, or 36 months of age. The early introduction group consumed slightly less zinc than the late introduction group at 5 months (4.4 vs 4.8mg/day, P<.01) and 6 months (4.4 vs 4.7mg/day, P<.01). At all other times there were no differences between the early and late group in zinc intakes. The serum zinc concentration was not associated with dietary zinc. Both groups had normal serum zinc concentrations at 12, 24, and 36 months and there were no differences between groups.Applications/conclusions The iron and zinc status of infants in this study was not influenced by the timing or type of complementary foods introduced. However, the infants were formula fed and the mean iron and zinc intakes that were equal or greater than the Recommended Dietary Allowances for the first 6 months of age. J Am Diet Assoc. 2001;101:443–447.

Prematurity, immune function and infant feeding practices.

Recently, there has been much interest in the literature in the role of early nutrition and the health of the individual in adulthood. A majority of infants in the UK are born full term, while preterm infants account for 4-6% of the total births. Milk feeding practices are divided into three groups: breast, combination (breast-fed with formula as 'top-up') and bottle (formula). In studies conducted by our group and other researchers immune function in full-term and preterm infants has been assessed by monitoring total and specific immunoglobulin E and specific immunoglobulin G levels. Dietary modification by the pregnant mother with a history of allergy in the family has been shown to have a positive effect with respect to allergy outcome and prevention of atopic disease in the infant. However, this dietary modification has to occur before week 22 of pregnancy and continue until the end of lactation to achieve a beneficial outcome to the infant. The stress of mothers restricting their diets may be disadvantageous to the fetus, and therefore any gain due to the dietary restriction may be lost. Researchers have shown that the early introduction of complementary foods and the greater diversity of these foods appeared to result in an increase in the incidence of atopic disease in the infant. In conclusion, in order to reduce the risk in their babies, mothers with a family history of atopic disease should breast-feed for more than 15 weeks and introduce solid foods after 4 months, limiting the variety until at least 6 months.

Perceptions of mother-infant separations and attitudes toward non-maternal care: Social class differences

This study examined non-maternal involvement in feeding during the first 2 years of life and its association with breastfeeding duration, early introduction of complementary foods, and dietary intakes of selected foods and beverages. Data were from the Infant Care, Feeding and Risk of Obesity Study, a cohort of 217 low-income, African–American mother–infant dyads, followed from 3 to 18 months postpartum. Non-maternal caregivers (NMCs) were defined as persons involved in feeding an infant/toddler 50% or more of the total daily feedings. Use of any NMC and the type of NMC was tabulated for each study visit (3, 6, 9, 12, and 18 months). At each time point, more than half of all households reported a NMC. Fathers, grandmothers, and licensed childcare providers were the most common types of NMCs. In longitudinal models adjusted for confounding variables, NMC use was associated with a decreased likelihood of continued breastfeeding, and an increased likelihood of infants and toddlers consuming juice or whole fruit. Given the high prevalence of non-maternal involvement in feeding, interventions targeting multiple family members are warranted as they are likely to be more effective than those targeting the mother alone.