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Urkia-Susin I, Guenetxea-Gorostiza J, Rada-Fernandez de Jauregui D, Mazquiaran-Bergera L, Martinez O, Maiz E. Development and validation of the baby eating behaviour coding system (BEBECS) to assess eating behaviour during complementary feeding. Appetite 2024; 196:107257. [PMID: 38364972 DOI: 10.1016/j.appet.2024.107257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
Eating behaviour in children is a matter of study for which diverse tools have been designed. Coding systems for videotaped meals allow the extraction of detailed in vivo information; however, there is no tool available for infants following a Baby-Led Weaning (BLW) method. This study aimed to create and validate a new tool to assess eating behaviour in infants during weaning, applicable regardless of the complementary feeding method. The Baby Eating Behaviour Coding System (BEBECS) was developed comprising time variables, behaviours, feeder-led actions, and other meal-related variables. Sixty videos of infants aged 6-18 months following spoon-feeding (SF) or BLW methods were coded by two trained coders. These scores were analysed together with intake and maternal ratings of liking and calmness. Additionally, combined analysis and internal comparison assessed the possible differences in BEBECS variables between SF and BLW. Inter-rater and test-retest reliability had good to excellent agreement: Cohen's Kappa >0.75, Lin's CCC >0.70, and Intraclass Correlation Coefficient >0.75, for almost all variables. Infants' liking and intake of the offered food correlated positively with meal duration and total count of mouth approaches but negatively with having leftovers and time between mouth approaches. Infants' calmness and tiredness were negatively correlated. More food than initially offered was available during the meal in BLW but not in SF. There was a tendency towards more autonomous behaviour in BLW infants regarding changes observed in the time the food was in the mouth at each stage (6, 12, and 18 months). In conclusion, BEBECS has the potential to be a valid tool for application in the research of infant eating behaviour during weaning by trained coders.
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Affiliation(s)
- Iratxe Urkia-Susin
- Department of Pharmacy and Food Science (G3S Research Group), Faculty of Pharmacy, University of the Basque Country UPV/EHU, Unibertsitateko Ibilbidea 7, 01006, Vitoria-Gasteiz, Araba, Spain; Bioaraba Health Research Institute, Nutrition and Food Safety Group Araba University Hospital, Vitoria-Gasteiz, Spain.
| | - Jone Guenetxea-Gorostiza
- Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Unibertsitateko Ibilbidea 7, 01006, Vitoria-Gasteiz, Araba, Spain; Biogipuzkoa Health Research Institute, Mental Health Group, Donostia, Spain
| | - Diego Rada-Fernandez de Jauregui
- Bioaraba Health Research Institute, Nutrition and Food Safety Group Araba University Hospital, Vitoria-Gasteiz, Spain; Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Unibertsitateko Ibilbidea 7, 01006, Vitoria-Gasteiz, Araba, Spain
| | - Leire Mazquiaran-Bergera
- Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Unibertsitateko Ibilbidea 7, 01006, Vitoria-Gasteiz, Araba, Spain; Biogipuzkoa Health Research Institute, Mental Health Group, Donostia, Spain
| | - Olaia Martinez
- Department of Pharmacy and Food Science (G3S Research Group), Faculty of Pharmacy, University of the Basque Country UPV/EHU, Unibertsitateko Ibilbidea 7, 01006, Vitoria-Gasteiz, Araba, Spain; Bioaraba Health Research Institute, Nutrition and Food Safety Group Araba University Hospital, Vitoria-Gasteiz, Spain
| | - Edurne Maiz
- Biogipuzkoa Health Research Institute, Mental Health Group, Donostia, Spain; Department of Clinical and Health Psychology and Research Methodology, Faculty of Psychology, University of the Basque Country UPV/EHU, Tolosa Hiribidea 70, 20018, Donostia, Gipuzkoa, Spain
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Cox AM, Taylor RW, Haszard JJ, Beck KL, von Hurst PR, Conlon CA, Te Morenga LA, Daniels L, McArthur J, Paul R, McLean NH, Jones EA, Katiforis I, Brown KJ, Gash M, Rowan M, Fleming EA, Jupiterwala R, Bruckner BR, Heath ALM. Baby food pouches and Baby-Led Weaning: Associations with energy intake, eating behaviour and infant weight status. Appetite 2024; 192:107121. [PMID: 37972656 DOI: 10.1016/j.appet.2023.107121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
Although concern is frequently expressed regarding the potential impact of baby food pouch use and Baby-Led Weaning (BLW) on infant health, research is scarce. Data on pouch use, BLW, energy intake, eating behaviour and body mass index (BMI) were obtained for 625 infants aged 7-10 months in the First Foods New Zealand study. Frequent pouch use was defined as ≥5 times/week during the past month. Traditional spoon-feeding (TSF), "partial" BLW and "full" BLW referred to the relative proportions of spoon-feeding versus infant self-feeding, assessed at 6 months (retrospectively) and current age. Daily energy intake was determined using two 24-h dietary recalls, and caregivers reported on a variety of eating behaviours. Researchers measured infant length and weight, and BMI z-scores were calculated (World Health Organization Child Growth Standards). In total, 28% of infants consumed food from pouches frequently. Frequent pouch use was not significantly related to BMI z-score (mean difference, 0.09; 95% CI -0.09, 0.27) or energy intake (92 kJ/day; -19, 202), but was associated with greater food responsiveness (standardised mean difference, 0.3; 95% CI 0.1, 0.4), food fussiness (0.3; 0.1, 0.4) and selective/restrictive eating (0.3; 0.2, 0.5). Compared to TSF, full BLW was associated with greater daily energy intake (BLW at 6 months: mean difference 150 kJ/day; 95% CI 4, 297; BLW at current age: 180 kJ/day; 62, 299) and with a range of eating behaviours, including greater satiety responsiveness, but not BMI z-score (6 months: 0.06 (-0.18, 0.30); current age: 0.06 (-0.13, 0.26)). In conclusion, neither feeding approach was associated with weight in infants, despite BLW being associated with greater energy intake compared with TSF. However, infants who consumed pouches frequently displayed higher food fussiness and more selective eating.
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Affiliation(s)
- Alice M Cox
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | | | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Lisa A Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Jenny McArthur
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Rebecca Paul
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Neve H McLean
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Emily A Jones
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Kimberley J Brown
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Madeline Gash
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Madeleine Rowan
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | | | - Rosario Jupiterwala
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Bailey R Bruckner
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
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Pearce J, Rundle R. Baby-led weaning: A thematic analysis of comments made by parents using online parenting forums. J Hum Nutr Diet 2022; 36:772-786. [PMID: 35996924 DOI: 10.1111/jhn.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Baby-led weaning (BLW) centres on making the baby an active partner, rather than a passive recipient of complementary feeding. Key features of BLW include self-feeding foods in their natural form, eating with the rest of the family and consuming family foods. This differs from traditional weaning (TW) where parents initially spoon feed purees, alongside finger foods, before graduating to more textured food. Previous research, however, has suggested parents may not fully adhere to one weaning style. This study aimed to explore how the meaning and interpretation of BLW may contribute to the weaning style used. METHODS Messages and responses posted on three UK parenting forums, and relating to complementary feeding, were analysed using an interpretive thematic approach. RESULTS The characterisation of BLW by parents was varied but they described BLW having an ethos which included trusting the baby, role modelling, developing confidence with food and sharing the social aspects of mealtimes. BLW also offered an alternative to those actively seeking something different or a default for those whose baby refused purees or spoon feeding. BLW felt like a natural progression, with low parental effort for some, and a source of anxiety, stress, choking risk and mess for others. Many parents struggled to find a process (what to eat and when) within BLW, that they could follow. Finger foods were used synonymously with BLW but many mixed/blurred aspects of both TW and BLW. CONCLUSIONS The interpretation of BLW varies considerably between parents and a broader definition of BLW may be required, along with guidance on the process and purpose of BLW. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jo Pearce
- Food & Nutrition Subject Group, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB
| | - Rachel Rundle
- Food & Nutrition Subject Group, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB
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van Dijk M, Leonardi G, Pérez DL, Rączaszek-Leonardi J. Co-regulation of movements during infant feeding. Infant Behav Dev 2022; 69:101755. [PMID: 35998427 DOI: 10.1016/j.infbeh.2022.101755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/08/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022]
Abstract
The process by which infants move from liquid feeding to caregiver-assisted spoon feeding of semi-solid food is quite a dramatic transition. In previous studies, we observed that in the weeks after the introduction to solid food, mother-infant dyads showed increased co-regulation and synchronization of their respective feeding behaviors (e.g. offering food, accepting/refusing, timing). Learning this new way of feeding and eating requires that infants coordinate their position and movements with the complementary position and movements of the caregiver. The present study augments the category-based analysis of this co-regulation by the analysis of coupling in the dyads based on automatically extracted movement data. Previously collected video data from 10 mother-infant dyads were re-analyzed for the purpose of this study. Movement trajectories of mother's hand and infant's face were obtained by applying an automatic movement detection algorithm (TLD, Kalal et al., 2012; for applications to mother-infant interactions see López Pérez et al., 2017). Coordination was assessed by the method of Diagonal Cross Recurrence Profiles (DCRP), which expresses the degree of synchronization at different time lags. Profiles for each dyad from two different occasions --with one visit in the first week of solid feeding and one approximately 4-5 weeks later-- were compared. The results showed that, on average, most synchronization occurred in the first visit at lag 0. In the second visit there was an average delay in synchronization of about 1 s, with leading behavior starting from the infant. This suggests that the coordination was initially closely synchronized and became somewhat looser over time. Possibly, infants have begun to anticipate and guide the feeding movements enacted by the mother. However, our findings underline the idiosyncratic and complex nature of co-regulation of movements during the introduction of solid food. Whereas some dyads showed signs of increased organization, others seemed to disorganize, re-organize, or showed no organization at all. Many (interacting) factors --both individual and contextual-- may be responsible for the observed differences between dyads. Further research is needed to understand why specific synchronization pathways emerge and whether and how these might relate both to later feeding and eating and to the emergent patterns of participation.
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Affiliation(s)
- Marijn van Dijk
- Heymans Institute for Psychological Research, University of Groningen, Groningen, the Netherlands.
| | - Giuseppe Leonardi
- Institute of Psychology, University of Economics and Human Sciences, Warsaw, Poland
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Costantini C, Joyce A, Britez Y. Breastfeeding Experiences During the COVID-19 Lockdown in the United Kingdom: An Exploratory Study Into Maternal Opinions and Emotional States. J Hum Lact 2021; 37:649-662. [PMID: 34496657 PMCID: PMC8641027 DOI: 10.1177/08903344211026565] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/30/2021] [Accepted: 05/27/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The COVID-19 pandemic has hugely impacted upon people's psychological and physical wellbeing; however, the effects of the COVID-19 lockdown on mothers of young children, with particular regard to breastfeeding, are unknown. RESEARCH AIMS To explore: (1) Sources of advice and support available to breastfeeding mothers during and prior to the COVID-19 lockdown; (2) Mothers' opinions on statements and recommendations made by the World Health Organization on the importance of breastfeeding and breastfeeding during the COVID-19 pandemic; (3) Maternal emotional states (i.e., anxiety and depression symptoms) experienced by breastfeeding mothers during the COVID-19 lockdown; and (4) influence of breastfeeding duration and number of children on breastfeeding opinions and emotional states. METHODS Mothers of children aged 0-36 months (N = 4018) took part in an online survey. The survey included demographic questions, as well as the Generalised Anxiety Disorder Questionnaire and the Patient Health Questionnaire. Mothers were further probed on opinions regarding breastfeeding practices during the COVID-19 pandemic. RESULTS Participants strongly agreed with the importance of breastfeeding, even if a mother showed symptoms of COVID-19. Differences in opinions on breastfeeding practices (e.g., the use of donor human milk and relactation), were found between participants in relation to breastfeeding duration and number of children. Participants with more than one child showed higher negative emotional states, namely anxiety symptoms. Except for Internet usage, participants indicated a decline in all sources of advice and support for breastfeeding during the COVID-19 lockdown. CONCLUSIONS Health bodies and professionals should consider maternal viewpoints and opinions regarding breastfeeding during the COVID-19 pandemic. Interventions are urgently needed in order to support breastfeeding mothers and prevent the development of mental health issues.
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Affiliation(s)
| | - Anna Joyce
- School of Psychotherapy and Psychology, Regent’s University London, UK
| | - Yolanda Britez
- School of Psychotherapy and Psychology, Regent’s University London, UK
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Urkia-Susin I, Rada-Fernandez de Jauregui D, Orruño E, Maiz E, Martinez O. A quasi-experimental intervention protocol to characterize the factors that influence the acceptance of new foods by infants: mothers' diet and weaning method. Dastatuz project. BMC Public Health 2021; 21:918. [PMID: 33985471 PMCID: PMC8120711 DOI: 10.1186/s12889-021-10967-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Children usually refuse to eat and taste fruits and vegetables; and turning unhealthy eating habits around is an important social challenge in industrialized countries. The Dastatuz project aims to study children food neophobia and to enhance fruit and vegetable acceptance. METHODS A quasi-experimental, multicentre, controlled and prospective intervention study is proposed, in which early factors influencing new food acceptance will be studied. Mothers in the third trimester of pregnancy (n = 144) and their infants will be the study population. Experimental groups will be established based on mothers´ fruit and vegetable intake (standard or high intake) and weaning method (baby lead weaning vs spoon feeding). The project will assess the possible impact of maternal diet and complementary feeding on infants eating behaviour until 18 months of age. Outcome measures will comprise maternal diet and psychological features during pregnancy and breast-feeding (validated questionnaires). Compositional and physicochemical analysis of milk during breastfeeding will also be carried out. During weaning, until 18 months of age, children's diet will be assessed with 24 h recalls and acceptance of new fruits and vegetables will be studied using video recording. DISCUSSION If the intervention is effective, this research work would have a high potential to be transferred to future public health programs or nutrition guidelines, as a feasible solution to achieve a higher intake of fruits and vegetables among children. TRIAL REGISTRATION This study is registered at ClinicalTrials.gov. Identifier: NCT04262102 . Registration date: February 10, 2020 - Retrospectively registered.
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Affiliation(s)
- Iratxe Urkia-Susin
- Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
- Department of Clinical and Health Psychology and Research Methodology, Faculty of Psychology, University of the Basque Country EHU/UPV, Donostia-San Sebastián, Gipuzkoa, Basque Country, Spain
- Biodonostia Health Research Institute, Mental Health group, Donostia-San Sebastián, Basque Country, Spain
| | - Diego Rada-Fernandez de Jauregui
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
- Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
| | - Estibaliz Orruño
- Bioaraba Health Research Institute, Araba University Hospital, Vitoria-Gasteiz, Araba, Basque Country, Spain
| | - Edurne Maiz
- Department of Clinical and Health Psychology and Research Methodology, Faculty of Psychology, University of the Basque Country EHU/UPV, Donostia-San Sebastián, Gipuzkoa, Basque Country, Spain.
- Biodonostia Health Research Institute, Mental Health group, Donostia-San Sebastián, Basque Country, Spain.
| | - Olaia Martinez
- Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
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Bąbik K, Patro-Gołąb B, Zalewski BM, Wojtyniak K, Ostaszewski P, Horvath A. Infant feeding practices and later parent-reported feeding difficulties: a systematic review. Nutr Rev 2021; 79:1236-1258. [PMID: 33486523 DOI: 10.1093/nutrit/nuaa135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Early feeding practices may influence the acceptance of new foods and contribute to the development of feeding difficulties later in childhood. OBJECTIVE The aim of this systematic review was to evaluate the association of breastfeeding duration, timing of complementary feeding introduction, and feeding techniques with feeding difficulties or their subtypes, namely picky or fussy eating, food refusal, and food neophobia, in children older than 1 year of age. DATA SOURCES Guidance from the Cochrane Collaboration and the Centre for Reviews and Dissemination was followed. MEDLINE, Embase, and PsycINFO databases were searched up to December 2019. Additionally, references from included articles were screened. STUDY SELECTION Interventional and observational studies were eligible. Of the 3653 records obtained after the search strategy was applied, 21 observational studies (cohort, case-control, cross-sectional), many with important methodological limitations, and 1 randomized controlled trial were included. DATA EXTRACTION Three authors extracted data independently. RESULTS Results were synthesized narratively. Twelve observational studies assessed the association of breastfeeding duration with parent-reported feeding difficulties. Longer duration of breastfeeding tended to be associated with fewer childhood feeding problems in the majority of studies, but the differences were often small and not significant. Eight observational studies that examined the timing of complementary feeding introduction in relation to parent-reported feeding difficulties showed inconsistent results. Baby-led weaning, as compared with spoon-feeding, was significantly associated with less fussiness at age 12 to 36 months in 1 of 5 studies. CONCLUSIONS This review showed no strong evidence to support the hypothesis that early feeding practices contribute significantly to specific parent-reported feeding difficulties in children older than 1 year of age. Additional methodologically rigorous studies are needed to confirm these findings. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42018115792.
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Affiliation(s)
- Katarzyna Bąbik
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | | | | | - Katarzyna Wojtyniak
- Department of Pediatrics, Pediatric Teaching Clinical Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Ostaszewski
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Andrea Horvath
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
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Standard v. baby-led complementary feeding: a comparison of food and nutrient intakes in 6–12-month-old infants in the UK. Public Health Nutr 2019; 22:2813-2822. [DOI: 10.1017/s136898001900082x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:To compare food and nutrient intakes of infants aged 6–12 months following a baby-led complementary feeding (BLCF) approach and a standard weaning (SW) approach.Design:Participants completed an online questionnaire consisting of sociodemographic questions, a 28 d FFQ and a 24 h dietary recall.Setting:UK.Participants:Infants (n 134) aged 6–12 months (n 88, BLCF; n 46, SW).Results:There was no difference between weaning methods for the food groups ‘fruits’, ‘vegetables’, ‘all fish’, ‘meat and fish’, ‘sugary’ or ‘starchy’ foods. The SW group was offered ‘fortified infant cereals’ (P < 0·001), ‘salty snacks’ at 6–8 months (P = 0·03), ‘dairy and dairy-based desserts’ at 9–12 months (P = 0·04) and ‘pre-prepared baby foods’ at all ages (P < 0·001) more often than the BLCF group. The SW group was offered ‘oily fish’ at all ages (P < 0·001) and 6–8 months (P = 0·01) and ‘processed meats’ at all ages (P < 0·001), 6–8 months (P = 0·003) and 9–12 months (P < 0·001) less often than the BLCF group. The BLCF group had significantly greater intakes of Na (P = 0·028) and fat from food (P = 0·035), and significantly lower intakes of Fe from milk (P = 0·012) and free sugar in the 6–8 months subgroup (P = 0·03) v. the SW group. Fe intake was below the Reference Nutrient Intake (RNI) for both groups and Na was above the RNI in the BLCF group.Conclusion:Compared with the SW group, the BLCF group was offered foods higher in Na and lower in Fe; however, the foods offered contained less free sugar.
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