Timing Of Solid Food Introduction Research Articles

Exploring breastfeeding patterns and barriers in a Kerala tertiary care hospital: a cross-sectional study

Background: Exclusive breastfeeding is vital for maternal and child health, yet challenges persist. This study in a Kerala tertiary care hospital aimed to assess prevalence, identify barriers, and explore cultural influences. Aim was to determine the prevalence of exclusive breastfeeding, uncover the barriers mothers face, and explore cultural factors affecting infant feeding choices. Methods: Utilizing Google forms, 274 postpartum women were surveyed. Participants provided data on awareness, practices, challenges, and factors influencing their infant feeding choices. Results: While 94.9% were aware of the ideal breastfeeding duration, only 74.1% practised exclusive breastfeeding until six months. Inadequate breast milk, sore nipples, and family pressure emerged as challenges. The timing of solid food introduction significantly impacted exclusive breastfeeding. Conclusions: Our study offers insights into exclusive breastfeeding practices. Culturally sensitive interventions, comprehensive support systems, and healthcare provider engagement are crucial. This study echoes recent research, emphasizing the multifaceted nature of exclusive breastfeeding practices, calling for diverse and context-specific strategies to empower mothers and ensure infants receive the best nutritional start.

HLA Genotype and Probiotics Modify the Association Between Timing of Solid Food Introduction and Islet Autoimmunity in the TEDDY Study.

To study the interaction among HLA genotype, early probiotic exposure, and timing of complementary foods in relation to risk of islet autoimmunity (IA). The Environmental Determinants of Diabetes in the Young (TEDDY) study prospectively follows 8,676 children with increased genetic risk of type 1 diabetes. We used a Cox proportional hazards regression model adjusting for potential confounders to study early feeding and the risk of IA in a sample of 7,770 children. Any solid food introduced early (<6 months) was associated with increased risk of IA if the child had the HLA DR3/4 genotype and no probiotic exposure during the 1st year of life. Rice introduced at 4-5.9 months compared with later in the U.S. was associated with an increased risk of IA. Timing of solid food introduction, including rice, may be associated with IA in children with the HLA DR3/4 genotype not exposed to probiotics. The microbiome composition under these exposure combinations requires further study.

Patterns in Mothers’ Recollection of Health Care Providers’ Young Child Feeding Recommendations

ObjectiveCharacterize feeding guidance mothers recall receiving from their child's health care provider (HCP). DesignCross-sectional study of mothers participating in the 2017–2019 National Survey of Family Growth. ParticipantsUS mothers reporting (n = 1,302) information about their youngest child (aged 6 months to 5 years). Variables MeasuredWeighted percentage of mothers who recalled their child's HCP discussing 6 different feeding topics by demographic characteristics. AnalysisLogistic regression assessing the relationship between recall of feeding guidance and demographics. ResultsIn this sample, 36.9% of mothers (95% confidence interval, 32.3–41.4) recalled HCPs recommending solid food before 6 months old (34.6% at 4–5 months, and 2.3% before 4 months). Mothers who were older or had a higher education level were more likely than their counterparts to recall their HCP discussing several of the feeding topics examined. Conclusion and ImplicationsMothers reported high recollection of early childhood nutrition guidance from their HCP; however, certain topics (eg, appropriate timing of solid food introduction) could be prioritized, and some subpopulations may need additional focus to improve receipt of messages. A better understanding of variability in recall of feeding guidance could provide information for interventions to address barriers to receiving and retaining guidance.

Early Introduction of Plant Polysaccharides Drives the Establishment of Rabbit Gut Bacterial Ecosystems and the Acquisition of Microbial Functions.

ABSTRACTIn mammals, the introduction of solid food is pivotal for the establishment of the gut microbiota. However, the effects of the first food consumed on long-term microbiota trajectory and host response are still largely unknown. This study aimed to investigate the influences of (i) the timing of first solid food ingestion and (ii) the consumption of plant polysaccharides on bacterial community dynamics and host physiology using a rabbit model. To modulate the first exposure to solid nutrients, solid food was provided to suckling rabbits from two different time points (3 or 15 days of age). In parallel, food type was modulated with the provision of diets differing in carbohydrate content throughout life: the food either was formulated with a high proportion of rapidly fermentable fibers (RFF) or was starch-enriched. We found that access to solid food as of 3 days of age accelerated the gut microbiota maturation. Our data revealed differential effects according to the digestive segment: precocious solid food ingestion influenced to a greater extent the development of bacterial communities of the appendix vermiformis, whereas life course polysaccharides ingestion had marked effects on the cecal microbiota. Greater ingestion of RFF was assumed to promote pectin degradation as revealed by metabolomics analysis. However, transcriptomic and phenotypic host responses remained moderately affected by experimental treatments, suggesting little outcomes of the observed microbiome modulations on healthy subjects. In conclusion, our work highlighted the timing of solid food introduction and plant polysaccharides ingestion as two different tools to modulate microbiota implantation and functionality.IMPORTANCE Our study was designed to gain a better understanding of how different feeding patterns affect the dynamics of gut microbiomes and microbe–host interactions. This research showed that the timing of solid food introduction is a key component of the gut microbiota shaping in early developmental stages, though with lower impact on settled gut microbiota profiles in older individuals. This study also provided in-depth analysis of dietary polysaccharide effects on intestinal microbiota. The type of plant polysaccharides reaching the gut through the lifetime was described as an important modulator of the cecal microbiome and its activity. These findings will contribute to better define the interventions that can be employed for modulating the ecological succession of young mammal gut microbiota.

Understanding immunological origins of atopic dermatitis through multi-omic analysis.

The pathophysiology of atopic dermatitis (AD) is multifactorial, impacted by individual medical, demographic, environmental, and immunologic factors. This study used multi-omic analyses to assess how host and microbial factors could contribute to infant AD development. This longitudinal cohort study included 129 term infants, identified as AD (n=37) or non-AD (n=92) using the Infant Feeding Practices-II survey and review of medical records. Standardized surveys were used to assess medical and demographic traits (gestational age, sex, race, maternal AD, and atopy family history), and environmental exposures (delivery method, maternal tobacco use, pets, breastfeeding duration, and timing of solid food introduction). Saliva was collected at 6months for multi-omic assessment of cytokines, microRNAs, mRNAs, and the microbiome. The contribution of each factor to AD status was assessed with logistic regression. Medical, demographic, and environmental factors did not differ between AD and non-AD infants. Five "omic" factors (IL-8/IL-6, miR-375-3p, miR-21-5p, bacterial diversity, and Proteobacteria) differed between groups (p < .05). The severity of AD was positively associated with levels of miR-375-3p (R=.17, p=.049) and Proteobacteria (R=.22, p=.011), and negatively associated with levels of miR-21-5p (R=.20, p=.022). Multi-omic features accounted for 17% of variance between groups, significantly improving an AD risk model employing medical, demographic, and environmental factors (X2 =32.47, p=.006). Interactions between the microbiome and host signaling may predispose certain infants to AD by promoting a pro-inflammatory environment.

Timing of Solid Food Introduction and Risk of Childhood Obesity

Research Article| April 01 2022 Timing of Solid Food Introduction and Risk of Childhood Obesity AAP Grand Rounds (2022) 47 (4): 40. https://doi.org/10.1542/gr.47-4-40 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Timing of Solid Food Introduction and Risk of Childhood Obesity. AAP Grand Rounds April 2022; 47 (4): 40. https://doi.org/10.1542/gr.47-4-40 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: cereals, childhood obesity, obesity, solid food Source: D’Hollander CJ, Keown-Stoneman CDG, Birken CS, et al. Timing of introduction to solid food, growth, and nutrition risk in later childhood. J Pediatr. 2022;240:102-109.e3; doi: https://doi.org/10.1016/j.jpeds.2021.08.076Google Scholar Investigators from multiple institutions in Canada conducted a cohort study to compare subsequent growth and eating behaviors in children begun on infant cereal at 4 or 6 months of age. Study participants were healthy children, 0-10 years old, seen at 10 primary care sites and enrolled between 2008 and 2019. Information collected on study participants included demographics, birth weight, gestational age, type of infant feeding (breast/bottle/both), cow’s milk intake, sugar-sweetened beverage intake, and maternal BMI. Parents were asked at what month their child began infant cereal; only those who were begun on infant cereal between 4 and 6 months were included in the primary analyses. Anthropometric measurements were obtained on study children to obtain BMI which were converted to z-scores; those with zBMI >2 were categorized as obese. Parents of children 18 months to 5 years old completed a validated questionnaire (NutriSTEP) assessing their child’s nutritional intake and eating behaviors. The overall scores and sub-scores on each of the 2 components were obtained, with higher scores indicative of more nutritional risk. The primary study outcome was zBMI at 1, 5, and 10 years of age. Secondary outcomes included obese status and nutritional risk. Regression analyses were used to compare these outcomes among children started on infant cereal at 4 or 6 months. Potential confounders were included in the models. A total of 8,943 children were enrolled in the study. The mean age at initial study visit was 2.1 years, and average length of follow-up was 4.4 years. Among the participants, 1,558 began infant cereal at 4 months, 1,796 at 5 months, and 3,713 at 6 months of age. Rates of breastfeeding were higher in those who started cereal at 6 months than at 4 months (65.8% and 46.8%, respectively); otherwise, baseline characteristics were similar in the 2 groups. Compared to those started at 6 months, introduction of cereal at 4 months was associated with significantly higher zBMI at 1 and 10 years of age (0.06; 95% CI, 0.01, 0.12 and 0.17; 95% CI, 0.06, 0.28, respectively), with no significant difference at 5 years. Children who began infant cereal at 4 months were significantly more likely to be obese at 10 years of age than those started at 6 months (OR, 1.82; 95% CI, 1.18, 2.80). There were no significant differences between groups in overall NutriSTEP scores or dietary intake sub-scores, but eating behavior sub-scores were significantly higher in those who started cereal at 4 months compared to those started at 6 months, suggesting greater nutritional risk. The authors conclude that initiation of infant cereal at 4 vs 6 months of age was associated with greater zBMI and increased risk of obesity. Dr Doolittle has disclosed no financial relationship relevant to this commentary. This commentary does not contain a... You do not currently have access to this content.

Timing of infant formula introduction in relation to BMI and overweight at ages 1 and 3 years: the Born in Guangzhou Cohort Study (BIGCS).

Mounting evidence suggests that the first few months of life are critical for the development of obesity. The relationships between the timing of solid food introduction and the risk of childhood obesity have been examined previously; however, evidence for the association of timing of infant formula introduction remains scarce. This study aimed to examine whether the timing of infant formula introduction is associated with growth z-scores and overweight at ages 1 and 3 years. This study included 5733 full-term (≥ 37 gestational weeks) and normal birth weight (≥ 2500 and < 4000 g) children in the Born in Guangzhou Cohort Study, a prospective cohort study with data collected at 6 weeks, 6, 12 and 36 months. Compared with infant formula introduction at 0-3 months, introduction at 4-6 months was associated with the lower BMI, weight-for-age and weight-for-length z-scores at 1 and 3 years old. Also, introduction at 4-6 months was associated with the lower odds of at-risk of overweight at age 1 (adjusted OR 0·72, 95 % CI 0·55, 0·94) and 3 years (adjusted OR 0·50, 95 % CI 0·30, 0·85). Introduction at 4-6 months also decreased the odds of overweight at age 1 year (adjusted OR 0·42, 95 % CI 0·21, 0·84) but not at age 3 years. Based on our findings, compared with introduction within the first 3 months, introduction at 4-6 months has a reduction on later high BMI risk and at-risk of overweight. However, these results need to be replicated in other well-designed studies before more firm recommendations can be made.

The Australian Feeding Infants and Toddlers Study (OzFITS) 2021: Study Design, Methods and Sample Description.

(1) Background: Caregiver feeding practices during the first two years of a child’s life influence nutrition, growth, and development, as well as long term taste preferences and dietary patterns. Suboptimal feeding practices lead to poorer health outcomes, such as obesity, that persist into adulthood. Although the importance of early life nutrition is well-established, there are no Australia-wide surveys of dietary intakes of children under two years of age. The 2021 Australian Feeding Infants and Toddlers Study (OzFITS) aims to fill this gap. This paper describes the methods and study sample of OzFITS 2021. (2) Methods: OzFITS 2021 is a cross-sectional study of children aged 0 to 23.9 months of age and their caregiver across Australia. Data were collected between April 2020 and April 2021. A telephone-based survey was completed with a caregiver to obtain information on child and caregiver characteristics and feeding practices. For exclusively breastfed infants, the number of breastfeeds in a 24 h period was reported. Dietary intakes for mixed fed children were estimated using a one-day food record, with 30% of caregivers completing a second food record on a non-consecutive day. (3) Results: We enrolled 1140 caregiver and child dyads. Of those eligible to complete a food record, 853 (87%) completed the food record. Compared to the Australian population, caregivers were more likely to be university-educated (>75%), married or in a de facto relationship (94%), and have a household income >$100,000/y (60%). (4) Conclusions: OzFITS 2021 is the first national study to examine food and nutrient intake in Australian children aged under 2 years. The study will provide information on breastfeeding rates and duration, use of breast milk substitutes, and timing of solid food introduction. Dietary intake data will allow the comparison of core food groups and discretionary food intake to Australian guidelines and estimate the prevalence of inadequate intake of key nutrients, like iron. Healthcare practitioners and policymakers can use the study findings as a source of evidence to inform the next iteration of infant feeding guidelines.

Association Between the Age of Solid Food Introduction and Eczema: A Systematic Review and a Meta-analysis

To review all available literature to determine if the timing of solid food introduction influences the risk of atopic eczema. Cow’s milk was purposely excluded in this review because it is not given as a solid food.Children enrolled in 11 cohort studies, 2 case controls, 1 cross-sectional study, and 2 randomized controlled trials were included.PubMed and Embase databases were searched using the key words solid food, complementary and allergenic food introduction, and eczema, with the final literature search performed on February 18, 2017. Two authors independently assessed all applicable English-language human studies and performed data extraction. Cohort studies, case-controlled studies, cross-sectional studies, and randomized controlled trials containing original data were included in this review.A total of 1414 articles were initially identified; after removal of duplicates, 1092 articles underwent title and abstract screening, with 987 articles being excluded. The remaining 105 articles underwent full text review, and 89 articles were excluded. A total of 17 articles met the inclusion criteria: 11 were cohort studies (1 cohort study generated 2 publications), 2 were case controls, 1 was a cross-sectional study, and 2 were randomized controlled trials. In the 2 randomized controlled trials, researchers examined early egg introduction; in 1 of these studies, researchers showed that early egg introduction (between 4 and 6 months) may reduce the risk of atopic eczema, whereas researchers in the other trial failed to demonstrate this response. Because of heterogeneity between the studies, a limited meta-analysis was performed; this did not show an association between the age of solid food introduction and risk of eczema.No strong evidence was found that early solid food introduction was associated with less risk of atopic eczema.Every day, parents ask health care providers, when should my infant start solid foods? How early is early? Can this help prevent eczema? The takeaway from this study is that early solid food introduction has little bearing on an infant’s risk of eczema development. On the basis of recommendations from many national and international health organizations, solid food introduction should occur around 6 months of age and not before 4 months of age.

Caregiver and Expecting Caregiver Support for Early Peanut Introduction Guidelines

To assess current opinions and preferences of new and expecting caregivers regarding early allergenic solid food introduction and how such introduction may be accomplished by surveying a sample of expecting and recently delivered caregivers.The population included US residents 18 to 55 years of age that identified as expecting caregivers or caregivers of newborns 12 months or younger.One thousand expecting caregivers and 1000 caregivers of infants <12 months of age were surveyed during a 3-week period in April 2017 (3 months after the release of the National Institute of Allergy and Infectious Diseases guidelines on early peanut introduction and 26 months after publication of the LEAP Study). The survey contained 32 questions on knowledge, attitude, and preference regarding timing of solid food introduction, concern and knowledge for the potential development of food allergy, attitudes regarding office-based recommendations for the introduction of potentially allergenic solids, and in-office procedures for assessment of food allergies.Two thousand of 2196 respondents completed the survey. A family history of food allergy was significantly associated with a better awareness of the guidelines (odds ratio [OR]: 1.2; 95% confidence interval [CI]: 1.02–1.49; P = .03, nonsignificant after adjustment for multiple comparisons), concern for their child developing a food allergy (OR: 2.5; 95% CI: 1.8–3.5; P < .001), and belief in the timing of introduction in developing food allergy (OR: 1.2; 95% CI: 1.03–1.46; P = .02, nonsignificant after adjustment for multiple comparisons). Only 31% of respondents reported willingness to introduce peanut before or around 6 months of age, with nearly 40% willing to introduce only after 11 months of age. An exception was egg, in which 60% reported willingness to introduce before 8 months of age. Fifty-one percent were unwilling to allow skin testing before 11 months of age, and 56.8% were unwilling to allow an oral food challenge before 11 months of age. Overall, 58% of the combined sample indicated that they would support medicalization of early introduction of potentially allergenic solids foods with in-office risk assessment, 28.1% would not support, and 13.6% reported they would do what their physician recommended. The preference for early introduction and willingness to allow in-office assessment was greater among expecting caregivers than those recently delivered.Recently delivered and expecting caregivers surveyed in this study expressed considerable hesitancy regarding readiness to introduce peanut and other potentially allergenic solid foods early and hesitancy regarding in-office assessments to help mitigate potential risk of such introduction.There have been many efforts to disseminate LEAP Study results and subsequent updated National Institute of Allergy and Infectious Diseases guidelines. Implementation of the new guidelines is equally important and requires that health care providers have discussions with parents and identify barriers to change. This study sheds light on the hesitancy that expecting and recently delivered caregivers may have regarding these guidelines.

Current practice in the introduction of solid foods for preterm infants.

The present study compared the age of first solid foods in a cohort of preterm infants with term infants and identified factors influencing timing of solid food introduction. Structured interviews on infant feeding practices, growth and medical status at term equivalence and at 3, 6, 9 and 12months corrected postnatal age. The age of solid food introduction was compared between term and preterm infants, and the influence of maternal, infant and milk feeding factors was assessed. This prospective longitudinal study recruited primary carers of preterm and term infants from a regional metropolitan referral hospital in eastern Australia. One hundred and fifty infants (preterm, n85; term, n65). When corrected for prematurity, preterm infants received solid foods before the recommended age for the introduction of solid foods for term infants. Median introduction of solid foods for preterm infants was 14 weeks corrected age (range 12-17 weeks). This was significantly less than 19 weeks (range 17-21 weeks) for term infants (P < 0·001). Lower maternal education and male gender were associated with earlier introduction of solid foods among preterm infants. Preterm infants are introduced to solid foods earlier than recommended for term infants, taking account of their corrected age. Further research is needed to assess any risk or benefit associated with this pattern and thus to develop clear evidence-based feeding guidelines for preterm infants.

Prevention of Food Allergy: The Significance of Early Introduction.

Over the last two decades, the prevalence of food allergies has registered a significant increase in Westernized societies, potentially due to changes in environmental exposure and lifestyle. The pathogenesis of food allergies is complex and includes genetic, epigenetic and environmental factors. New evidence has highlighted the role of the intestinal microbiome in the maintenance of the immune tolerance to foods and the potential pathogenic role of early percutaneous exposure to allergens. The recent increase in food allergy rates has led to a reconsideration of prevention strategies for atopic diseases, mainly targeting the timing of the introduction of solid foods into infants’ diet. Early recommendation for high atopy risk infants to delay the introduction of potential food allergens, such as cow’s milk, egg, and peanut, until after the first year of life, has been rescinded, as emerging evidence has shown that these approaches are not effective in preventing food allergies. More recently, high-quality clinical trials have suggested an opposite approach, which promotes early introduction of potential food allergens into infants’ diet as a means to prevent food allergies. This evidence has led to the production of new guidelines recommending early introduction of peanut as a preventive strategy for peanut allergy. However, clinical trials investigating whether this preventive dietary approach could also apply to other types of food allergens have reported ambiguous results. This review focuses on the latest high-quality evidence from randomized controlled clinical trials examining the timing of solid food introduction as a strategy to prevent food allergies and also discusses the possible implications of early complementary feeding on both the benefits and the total duration of breastfeeding.

Early Life Nutrient Intake Is Associated with Weight-for-Length Z-Scores at 3 and 12 Months (P11-127-19)

ObjectivesRapid weight gain over the first 12 months of life is a risk factor for childhood obesity. While macronutrient concentrations in human milk (HM) or infant formula (IF) have been associated with rapid weight gain or weight-for-length Z-scores later in infancy, few studies evaluate milk intake. Therefore, the objective was to assess how nutrient intake at 6 weeks of age, across multiple feeding modes, influences growth over the first year of life. MethodsData were collected from 222 healthy mother-infant pairs enrolled in the STRONG Kids 2 Cohort. Twenty-four hour test weighing was conducted to measure milk intake volume and a human milk sample was collected at 6 weeks postpartum. Milk samples were analyzed for total protein (Bradford assay), fat (total lipid extraction), and carbohydrate (Orcinol assay). Mode of feeding at 6 weeks, servings per day of HM and/or IF, and formula type were reported by mothers. For exclusively breastfeeding infants, HM macronutrient concentrations and total intake were used to calculate nutrient intake. For those receiving IF, the numbers of feedings from HM and/or from IF and formula nutrition information were also used to calculate nutrient intake. Infant length and weight collected at study visits were used to calculate weight-for-length Z-scores (WFL-Z). Mixed linear models were used to measure associations between macronutrient intake, total calories, total milk intake and WFL-Z at 3 months and 12 months of age. Models were controlled for 6-week feeding mode, breastfeeding duration, and timing of solid food introduction. ResultsAt 3 months, WFL-Z was associated with total milk (P = 0.03) and caloric intake (P = 0.03) as well as intake of fat (P = 0.02), carbohydrate (P = 0.05), and protein (P = 0.03). WFL-Z at 12 months was associated with protein (P = 0.02) and fat (P = 0.04) intakes at 6 weeks but no longer associated with other measures of nutrient intake. ConclusionsOur results support previous findings suggesting that high protein intake in infancy contributes to obesity risk. While milk intake was only quantified once, data show that nutrient intake at 6 weeks-of-age influences future growth. More research is needed to understand other lifestyle and nutritional factors between 3 and 12 months that contribute to growth trajectories and weight during infancy. Funding SourcesNational Dairy Council, NIH RO1DK107561, The Gerber Foundation, The Doris Kelley Christopher Foundation.

Maternal triacylglycerol signature and risk of food allergy in offspring

The prevalence of IgE-mediated food allergy (FA) is increasing worldwide, but the underlying mechanisms are poorly understood. We sought to examine the role of maternal lipidomic profiles in risk of FA development in offspring and to investigate the potential modification effects by timing of first solid-food introduction. This report included 1068 mother-child dyads from the Boston Birth Cohort. Maternal lipid metabolites in plasma were assessed by using liquid chromatography tandem mass spectrometry. Food sensitization (FS) was defined as a specific IgE level of 0.35 kU/L or greater to any of the 8 common food allergens determined by using ImmunoCAP. FA was defined based on FS, clinical symptoms, and food avoidance. Logistic regression was applied to analyze associations between maternal metabolites and risk of FS and FA in offspring and to explore potential effect modifications. Of the 1068 children, 411 had FS, and 132 had FA. Among the 209 metabolites, maternal triacylglycerols (TAGs) of shorter carbon chains and fewer double bonds were associated with greater risk of FA, whereas TAGs of longer carbon chains and more double bonds were significantly associated with lower risk of FA in offspring. These associations were stronger in children with delayed solid-food introduction (≥7months of age) than those with earlier solid-food introduction (P=.010 for interaction between the maternal TAG score and timing of solid-food introduction). No significant association was found for FS. This is the first study to demonstrate a link between maternal TAGs and risk of FA in offspring and potential risk modification by timing of solid-food introduction.

Infant temperament, maternal feeding behaviours and the timing of solid food introduction.

Despite guidance from the World Health Organization and the U.K. Department of Health, many mothers introduce solid food before their infant is 6 months old. The current study aimed to investigate relationships between maternal feeding behaviours (preintroduction and postintroduction to solids), infant temperament, and the timing of introduction to solid food. Eighty‐one women were recruited on low‐risk maternity units and were contacted at 1 week, 3, and 6 months postpartum. Mothers of infants (45 males, 36 females, mean birth weight 3.52 kg [SD 0.39]) completed the behaviours component of the Infant Feeding Style Questionnaire via telephone interview at 3 months. At 6 months, they were observed feeding their infant solid food at home and reported infant temperament using the Infant Behaviour Questionnaire‐Revised (short form). Partial correlations (covariates: birth weight, maternal age, breastfeeding duration, and postnatal depression) revealed negative associations between age of introduction to solid food and temperament (smiling and laughter) and laissez‐faire milk feeding behaviours; and positive associations between age of introduction to solid food and restrictive milk feeding behaviours and verbal involvement during an observed mealtime. Hierarchical multiple regression analysis revealed that an infant's birth weight and the degree to which their mothers perceive them to smile and laugh are key predictors of when they will be introduced to solid food, over and above other variables of interest (e.g., maternal milk feeding behaviours, breastfeeding duration, and postnatal depression).

Association between the age of solid food introduction and eczema: A systematic review and a meta-analysis.

Eczema is a common childhood ailment responsible for a considerable disease burden. Both timing of introduction to solid food and allergenic food are believed to be related to childhood eczema. Despite the growing body of evidence, the relationship between timing of any solid food introduction (allergenic and/or non-allergenic) and development of eczema has not previously been systematically reviewed. PubMed and EMBASE databases were searched using food and eczema terms. Two authors selected papers according to the inclusion criteria and extracted information on study characteristics and measures of association. Meta-analyses were performed after grouping studies according to the age and type of exposure. A total of 17 papers met the inclusion criteria, reporting results from 16 study populations. Of these, 11 were cohort studies, 2 case-controls, 1 cross-sectional study and 2 randomized controlled trials. Limited meta-analyses were performed due to heterogeneity between studies. Timing of solid food introduction was not associated with eczema. One randomized controlled trial provided weak evidence of an association between early allergenic (around 4 months) food introduction and reduced risk of eczema. The available evidence is currently insufficient to determine whether the timing of introduction of any solid food influences the risk of eczema.

Early life nutrition, glycemic and anthropometric profiles of children exposed to gestational diabetes mellitus in utero

• This study showed that prolonged infant feeding with breast milk, at least >8 months, is associated with lower A1C levels in children exposed to GDM . • Neither exclusive breastfeeding duration nor the timing of solid food introduction was associated with glycemic or anthropometric profile of children. • These results suggest that the impact of in utero exposure to GDM can be partly attenuated by prolonged breastfeeding duration during early life.

Pediatric Ileocolic Intussusception Caused by Introducing Solid Food Before 6 Months Old: A Case Report

A 7-months-old girl presented with bloody diarrhea and vomiting. She had been fed with red rice since she was 5 months old. She was restless, defecated red currant jelly stool and sausage-shaped mass was palpable on the inferior of umbilical region. The ultrasound showed a 3.16 × 2.58 cm mass with a target-like appearance which is consistent with intussusception. She underwent exploratory laparotomy, invagination release (milking) and appendectomy. Pathologic examination of the lymph node on the mesenteric side of caecum revealed lymphoid tissue hyperplasia. The introduction to solid food before 6 months in this patient was suspected as the predisposing factor of the intussusception. More effective counseling about the timing of solid food introduction by pediatrician or primary health care provider may prevent other similar cases like this from happening.

Nutritional aspects of commercially prepared infant foods in developed countries: a narrative review.

Nutritional intake during infancy is a critical aspect of child development and health that is of significant public health concern. Although there is extensive research on breast-feeding and timing of solid food introduction, there is less evidence on types of solid foods fed to infants, specifically commercially prepared infant foods. The consumption of commercially prepared infant foods is very prevalent in many developed countries, exceeding the consumption of homemade foods in some situations. Although these food products may have practical advantages, there are concerns about their nutritional composition, sweet taste, bioavailability of micronutrients, diversity of ingredients and long-term health effects. The extent that the manufacturing, fortification and promotion of these products are regulated by legislation varies between countries and regions. The aim of the present narrative review is to investigate, appraise and summarise these aspects. Overall there are very few studies directly comparing homemade and commercial infant foods and a lack of longitudinal studies to draw firm conclusions on whether commercial infant foods are mostly beneficial or unfavourable to infant health.

Risk factors for childhood obesity: Do the birth weight, type of delivery, and mother's overweight have an implication on current weight status?

The aim of this study was to identify risk factors, including the type of delivery, breastfeeding and its duration, birth weight, the timing of solid food introduction, the mother's education level at birth, and smoking status during pregnancy, that are associated with obesity in children living in Istanbul. This study involving 4990 healthy children aged 2-14 years, at an outpatient clinic in a tertiary care hospital from June 2012 to July 2014. The overall rates of overweight and obesity in children were 13.1% and 7.8%, respectively. Results demonstrated that 44.5% of children were delivered by caesarean section. In all age groups, 7.8% of children delivered by caesarean section were obese compared with 7.9% of children born vaginally. No significant association between caesarean section delivery and obesity in childhood was found in our study [odds ratio (OR)=0.98, 95% confidence interval (CI)=0.64-2.87, P=0.454]. There was also no association between duration of breastfeeding and the introduction of solid foods before 4 months or after 6 months of age and childhood obesity (OR=0.95, 95% CI=0.69-1.3, P=0.771; OR=0.99, 95% CI=0.64-1.53, P=0.261). Regression analyses revealed that children with birth weights greater than 3801 g or those with maternal body mass index (BMI) equal to or greater than 30 had an increased risk of being obese or overweight (OR=1.78, 95% CI=1.19-2.65; OR=3.95, 95% CI=1.94-5.81). This study demonstrated that increased birth weight and maternal BMI are significant risk factors for obesity in children living in Istanbul, Turkey. No relation between caesarean section delivery and childhood obesity was found in this study.