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Dietary and Complementary Feeding Practices of US Infants, 6 to 12 Months: A Narrative Review of the Federal Nutrition Monitoring Data

Published:October 21, 2021DOI:https://doi.org/10.1016/j.jand.2021.10.017

      Abstract

      Complementary foods and beverages (CFBs) are key components of an infant’s diet in the second 6 months of life. This article summarizes nutrition and feeding practices examined by the 2020 Dietary Guidelines Advisory Committees during the CFB life stage. Breastfeeding initiation is high (84%), but exclusive breastfeeding at 6 months (26%) is below the Healthy People 2030 goal (42%). Most infants (51%) are introduced to CFBs sometime before 6 months. The primary mode of feeding (ie, human milk fed [HMF]; infant formula or mixed formula and human milk fed [FMF]) at the initiation of CFBs is associated with the timing of introduction and types of CFBs reported. FMF infants (42%) are more likely to be introduced to CFBs before 4 months compared with HMF infants (19%). Different dietary patterns, such as higher prevalence of consumption and mean amounts, were observed, including fruit, grains, dairy, proteins, and solid fats. Compared with HMF infants of the same age, FMF infants consume more total energy (845 vs 631 kcal) and protein (22 vs 12 g) from all sources, and more energy (345 vs 204 kcal) and protein (11 vs 6 g) from CFBs alone. HMF infants have a higher prevalence of risk of inadequate intakes of iron (77% vs 7%), zinc (54% vs <3%), and protein (27% vs <3%). FMF infants are more likely to have an early introduction (<12 months) to fruit juice (45% vs 20%) and cow’s milk (36% vs 24%). Registered dietitian nutritionists and nutritional professionals should consider tailoring their advice to caregivers on dietary and complementary feeding practices, taking into account the primary mode of milk feeding during this life stage to support infants’ nutrient adequacy. National studies that address the limitations of this analysis, including small sample sizes and imputed breast milk volume, could refine findings from this analysis.

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      Biography

      R. L. Bailey is a professor, Department of Nutrition Science, Purdue University, West Lafayette, IN.

      Biography

      J. S. Stang is an associate professor, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota–Twin Cities.

      Biography

      T. A. Davis is a professor, US Department of Agriculture, Agricultural Research Service Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.

      Biography

      T. S. Naimi is a physician, Section of General Internal Medicine, Boston University Medical Center, Boston, MA.

      Biography

      B. O. Schneeman is a professor emerita, Department of Nutrition, University of California, Davis.

      Biography

      K. G. Dewey is a distinguished professor emerita, Department of Nutrition, University of California, Davis.

      Biography

      S. M. Donovan is a professor, Department of Food Science and Human Nutrition, and an endowed chair in nutrition and health, University of Illinois, Urbana-Champaign.

      Biography

      R. Novotny is a professor, Department Human Nutrition Food and Animal Science, University of Hawai’i at Mānoa, Honolulu.

      Biography

      R. E. Kleinman is a professor of pediatrics, Harvard Medical School; and chief, Department of Pediatrics, Massachusetts General Hospital, Boston, MA.

      Biography

      E. M. Taveras is a professor of Nutrition, Department of Pediatrics, Harvard Medical School; and chief, Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, MA.

      Biography

      L. Bazzano is a professor in nutrition research and director, Tulane Center for Lifespan Epidemiology Research, New Orleans, LA.

      Biography

      L. G. Snetselaar is a professor, Department of Epidemiology and endowed chair in preventive nutrition education, University of Iowa, Iowa City.

      Biography

      J. de Jesus is a nutrition advisor, Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD.

      Biography

      K. O. Casavale is a senior nutrition advisor, Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, US Department of Health and Human Services, College Park, MD.

      Biography

      E. E. Stoody is a lead nutritionist, Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA.

      Biography

      J. D. Goldman, mathematical statistician, Food Surveys Research Group, Agricultural Research Service, US Department of Agriculture, Beltsville, MD.

      Biography

      A. J. Moshfegh is a supervisory nutritionist, Food Surveys Research Group, Agricultural Research Service, US Department of Agriculture, Beltsville, MD.

      Biography

      D. G. Rhodes is a nutritionist, Food Surveys Research Group, Agricultural Research Service, US Department of Agriculture, Beltsville, MD.

      Biography

      K. A. Herrick is a program director, Risk Factor Assessment Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.

      Biography

      K. Koegel is a nutritionist, Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA.

      Biography

      C. G. Perrine is an epidemiologist, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA.

      Biography

      T. Pannucci is a lead nutritionist, Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA.