Abstract
Background
Although there has been inconsistency in recommendations regarding the optimal time
for introducing complementary foods, most experts agree that introduction should not
occur before 4 months. Despite recommendations, studies suggest that 20% to 40% of
US infants are introduced to foods at younger than 4 months. Previous studies focused
on the introduction of solid foods and are not nationally representative.
Objective
Our aims were to provide a nationally representative estimate of the timing of introduction
of complementary foods and to describe predictors of early (<4 months) introduction.
Design
We conducted a cross-sectional analysis of 2009-2014 National Health and Nutrition
Examination Survey data.
Participants
The study included 1,482 children aged 6 to 36 months.
Main outcome measures
Timing of first introduction to complementary foods (anything other than breast milk
or formula) was analyzed.
Statistical analyses performed
Prevalence estimates of first introduction to complementary foods are presented by
month. Logistic regression was used to assess characteristics associated with early
(<4 months) introduction.
Results
In this sample, 16.3% of US infants were introduced to complementary foods at <4 months,
38.3% between 4 and <6 months, 32.5% between 6 and <7 months, and 12.9% at ≥7 months
of age. In unadjusted analyses, early introduction varied by breastfeeding status;
race/Hispanic origin; Special Supplemental Nutrition Program for Women, Infants, and
Children participation; and maternal age. In adjusted analyses, only breastfeeding
status remained significant; infants who never breastfed or stopped at <4 months were
more likely (odds ratio 2.27; 95% CI 1.62 to 3.18) to be introduced to complementary
foods early than infants who breastfed ≥4 months.
Conclusions
Despite using a broader definition of complementary foods, this analysis found a lower
prevalence of early introduction in this nationally representative sample than previous
studies that included only solids. However, many young children were still introduced
to complementary foods earlier than recommended. Strategies to support caregivers
to adhere to infant feeding guidelines may be needed.
Keywords
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Biography
C. M. Barrera is an ORISE Fellow, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Biography
H. C. Hamner is a health scientist, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Biography
C. G. Perrine is team lead, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Biography
K. S. Scanlon is director, Special Nutrition Research and Analysis Division, Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Washington, DC; at the time of the study, she was chief, Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA.
Article info
Publication history
Published online: January 04, 2018
Accepted:
October 18,
2017
Received:
June 19,
2017
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT There is no funding to disclose.
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
