A comparison of preprepared commercial infant feeding meals with home-cooked recipes

Beliefs, Evaluations, and use of commercial infant Food: A survey among German parents

Complementary feeding is a critical milestone for parents, who must decide the extent to which they feed their infants with homemade foods (HMFs) or commercial infant foods (CIFs). The current study focused on how parents perceive and evaluate CIFs and what drives them to use these products. Understanding the wide variety of factors that influence parents' decisions to use CIFs as a food source is crucial to helping them make more balanced food choices for their infants. Data from an online survey with 858 German parents revealed their negative perceptions of CIFs, particularly in terms of nutritional quality and texture, and concerns that CIFs contain higher levels of pesticides and heavy metals compared to HMFs, despite acknowledging the expertise of the infant nutrition industry. These perceptions were likely to be driven by the 'natural-is-better' belief and parents' desire for control over the ingredients in their infants' meals, contributing to their skepticism towards CIFs. Additionally, our study found that while many parents know traditional nutrition guidelines, they are less familiar with recent updates. Parents' benefit beliefs about CIFs and parents' trust in the food industry strongly influenced the use of CIFs, while infant age and parent gender had a less strong, yet significant influence on CIFs consumption. Overall, the present study offers new quantitative insights into the factors that motivate parents to use CIFs. Furthermore, it underscores the need for health authorities to improve their communication strategies towards parents concerning new dietary guidelines.

What shapes parental feeding decisions over the first 18 months of parenting: Insights into drivers towards commercial and home-prepared foods among different socioeconomic groups in the UK

Infants born into families experiencing socioeconomic disadvantage follow a high-risk trajectory for obesity and poor health in later life. Differences in early childhood food experiences may be contributing to these inequalities. This study aimed to explore the factors that influence parental decisions on when, how and what food to introduce over the first 18 months of their child's life and identify differences according to families' social position. Particular attention was given to social and environmental determinants within and outside the home. This research utilised a longitudinal qualitative methodology, with interviews and photo-elicitation exercises completed by participants when their children were 4-6; 10-12 and 16-18 months of age. Participants were parents (61 mothers; 1 father), distributed across low, medium and high socioeconomic position (SEP). During analysis, observable differences in factors directing parents to home-prepared or commercial foods were identified. Factors that undermined the provision of home-prepared meals included lack of time after returning to work, insufficient support from partners, uncertainty around infant and young child feeding (defined as the introduction and provision of solids) and an implicit trust in the messaging on branded products. These factors directed parents towards commercial foods and were most persistent among families experiencing socioeconomic disadvantage due to barriers accessing formal childcare, less flexible working conditions and fathers being less involved in infant feeding. To facilitate an enabling environment for healthy infant and young child feeding practices and address dietary inequalities, immediate steps that policy makers and healthcare providers can take include: i) changing the eligibility criteria for shared parental leave, ii) aligning claims on commercial infant food labels with international best practices, and iii) improving access to formal childcare.

Diet Diversity During Infancy and the Prevalence of Sensitization and Allergy in Children up to 3 Years of Age in the Kujawsko-Pomorskie Voivodeship, Poland

The study examines the influence of a diversified diet, changes in the consistency of introduced foods, and the method of meal preparation during infancy on the development of sensitization and/or allergy in toddlers. Introducing more product groups into the diet reduced the risk of allergy at 6 months of age (adjusted odds ratio [aOR] = 0.17; 95% confidence interval [CI] 0.04-0.71; P = 0.015) and at 12 months (aOR = 0.14; 95% CI 0.03-0.57; P = 0.006). Children with allergy and/or sensitization had been introduced to fewer product groups at 6 months (P = 0.003; P < 0.001; P = 0.008) and at 12 months (P = 0.001, P < 0.001; P = 0.001) compared with those without allergy and/or sensitization. Children with allergy and/or sensitization were fed ready-made, ie, purchased, products significantly more often than self-prepared foods compared with children without allergy and/or sensitization (P = 0.001; P = 0.006). Allergic and/or sensitized children tended to be switched to solids later (11 vs 10 months, P = 0.041; P = 0.037) (12 vs 10 months, P = 0.013) than children without sensitization and/or allergy. The earlier introduction of a varied diet reduced the risk of allergy and/or sensitization. Delaying the introduction of solid foods and using ready-made products instead of self-prepared ones increases the risk of allergy in toddlers.

Assessment of quality and safety aspects of homemade and commercial baby foods

Dietary Guidelines in some countries recommend avoiding commercially processed baby food, while others encourage the consultation of ingredients and nutritional information. Therefore, the objective of this study was to systematically analyze different baby foods obtained from commercial market and "homemade" produced, in order to verify whether comercial products have low nutritional and unsafety attributes. The samples were analyzed for chemical composition, physicochemical aspects, texture, microbiological and mycotoxin contamination, and pesticide residues. Results showed that, in general, commercial samples have a higher energy density and better ratio of macronutrients. The sodium, pH, and texture of both products were in accordance with the recommendations. None of the baby foods evaluated were contaminated with yeast and molds, total coliforms, or Escherichia coli; however, Salmonella sp. was confirmed in one homemade sample. Pesticide residues were detected in all analyzed baby food samples; however, at lower levels than the limit of quantification. Ochratoxin A was detected in one homemade baby food sample (5.76 µg /kg). Considering the samples evaluated, commercial baby food samples appeared to be safer in relation to microbiological, pesticide residue standards, and mycotoxin contamination. Therefore, it could be concluded that the quality of commercial and homemade baby foods still needs to be improved, as well as more studies related to a critical analyses of both types of processes used.

Micronutrient Profile and Carbohydrate Microstructure of Commercially Prepared and Home Prepared Infant Fruit and Vegetable Purees

Large variability exists in ingredient selection and preparation of home prepared infant purees and there is a lack of data on nutritional quality in comparison to commercially prepared purees. This work had two aims. Study 1 compared the nutritional value of commercially prepared and home prepared infant purees. Food profiles from national food composition databases were used as a proxy for home prepared puree and served as the benchmark for the commercially prepared infant purees. Study 2 focused on a subset of produce that underwent molecular weight analysis to determine differences in carbohydrate profiles. Eighty-eight percent of the measurable micronutrients fell within or above the home prepared norm range with micronutrients falling below the range explained by differences in soil and growing conditions. Physicochemical characterization showed similar carbohydrate profiles with >90% of the carbohydrate fraction in the water extract constituted by low molecular weight sugars for purees produced with home preparation and commercial preparation. The estimated glycemic load (eGL) showed comparable potential impact on blood sugar levels with all purees having a low eGL (<10 glucose equivalent). In conclusion, these data suggest that both preparations provide similar micronutrient density and carbohydrate profiles.

Complementary Feeding in Italy: From Tradition to Innovation

Complementary feeding (CF) is a pivotal phase of the individual’s growth, during which children develops their future dietary habits. To date, only few studies investigated and compared weaning modalities between different geographical areas. The aim of this article is to describe the current Italian practice for CF in healthy term infants among different areas (North, Center, South) of Italy. Two different multiple-choice questionnaires were produced and sent to 665 Italian primary care pediatricians (PCP) and 2023 families with children under 1 year of age. As emerged from our investigation, in Italy CF is usually started between the 5th and 6th month of life. The preferred approach (chosen by 77% of families) involves the use of home-cooked liquid or semi-liquid ailments, or industrial baby foods. A new CF modality is emerging, consisting of traditional complementary foods with adult food tastings (10% of families). Approximately 91% of pediatricians give written dietary suggestions, and 83% of families follow their advice. We found significantly divergent weaning habits among different areas of Italy. PCP have a key role in guiding parents during the introduction of new foods in their infant’s diet and should take this as an opportunity to educate the whole family to healthy dietary habits.

Recipe Components and Parents' Infant and Young Child Feeding Concerns: A Mixed-Methods Study of Recipe Posts Shared in Thai Facebook Groups for Parents

Social media is increasingly becoming a significant source of information for parents, including about feeding young children. However, little attention has been given to the characteristics of recipes for infants and young children and how they interact with parental perceptions regarding food decisions shared by users on social media. Building on findings related to shared recipe components and parental food choices, between December 2019 and July 2020, this study retrospectively collected 80 shared recipes each from five Thai Facebook groups. This extraction created 379 shared recipes with 1751 peers’ commentaries on the shared recipes’ posts. The shared recipes were classified and components quantified across child age groups, then the textual contents around the reasons behind the food choices were described qualitatively. The results showed that there were differences in meal types, food ingredients, and seasoning used across child age groups. Further analysis found that food allergy awareness was one driving concern behind parental perceptions on food choices in children’s diets. These concerns resulted in delays in the introduction of animal-source foods. Moreover, peers’ commentaries on shared recipes offered a venue for exchanging experiences with food products. Because of the potential influence on parental beliefs and perceptions, further studies are required to understand the impact of existing online communities on actual feeding practices.

Are Homemade and Commercial Infant Foods Different? A Nutritional Profile and Food Variety Analysis in Spain

Complementary feeding (CF) is an important determinant of early and later life nutrition with great implications for the health status and the development of an adequate growth. Parents can choose between homemade foods (HMFs) and/or commercial infant foods (CIFs). There is no consistent evidence as to whether HMFs provide a better nutritional profile and variety over CIFs. The aim of this study was to compare the nutritional profiles and food variety of HMFs versus CIFs in the Spanish market targeted for infants (6-11 months) and young children (12-18 months). Thirty mothers with their children aged 6 to 18 months were included in this cross-sectional study, following a 3-day weighed food diary of which HMFs were collected and chemically analyzed. HMFs meals for infant provided significantly lower energy, higher protein and higher fiber, for young children provided significantly higher protein and fiber than CIFs meals. HMFs fruit purees for infant shown significantly higher fiber and for young children provided higher energy than CIFs. HMFs meals contained a significantly greater number of different vegetables than CIFs meals (3.7 vs. 3.3), with carrot as the most frequently used in both. However, in CIFs fruit purees shown higher different fruits than HMFs, in both the banana was the fruit most frequently used. There was a predominance of meat and lack of oily fish and legumes in both HMFs and CIFs meals. HMFs and CIFs were equally characterized by a soft texture and yellow-orange colours. Importantly, our findings emphasize the need for clear guidelines for the preparation of HMFs as well as the promotion of food variety (taste and textures) in both HMFs and CIFs to suit infants' and young children's nutritional and developmental needs.

Effect of a Parent-Focused eHealth Intervention on Children's Fruit, Vegetable, and Discretionary Food Intake (Food4toddlers): Randomized Controlled Trial

Background

In Western countries, children’s diets are often low in fruits and vegetables and high in discretionary foods. Diet in early life tends to track through childhood and youth and even into adulthood. Interventions should, therefore, be delivered in periods when habitual traits are established, as in toddlerhood when children adapt to their family’s diet.

Objective

In this study, we assessed the effect of the Food4toddlers eHealth intervention, which aimed to enhance toddlers’ diets by shaping their food and eating environment.

Methods

The Food4toddlers randomized controlled trial was conducted in Norway in 2017-2018. Parent-child dyads were recruited through social media. In total, 298 parents completed an online questionnaire at baseline (mean child age 10.9 months, SD 1.2). Postintervention questionnaires were completed immediately after the intervention (ie, follow-up 1; mean child age 17.8 months, SD 1.3) and 6 months after the intervention (ie, follow-up 2; mean child age 24.2 months, SD 1.9). The intervention was guided by social cognitive theory, which targets the linked relationship between the person, the behavior, and the environment. The intervention group (148/298, 49.7%) got access to the Food4toddlers website for 6 months from baseline. The website included information on diet and on how to create a healthy food and eating environment as well as activities, recipes, and collaboration opportunities. To assess intervention effects on child diet from baseline to follow-up 1 and from baseline to follow-up 2, we used generalized estimating equations and a time × group interaction term. Between-group differences in changes over time for frequency and variety of fruits and vegetables and frequency of discretionary foods were assessed.

Results

At follow-up 1, a significant time × group interaction was observed for the frequency of vegetable intake (P=.02). The difference between groups in the change from baseline to follow-up 1 was 0.46 vegetable items per day (95% CI 0.06-0.86) in favor of the intervention group. No other significant between-group differences in dietary changes from baseline to follow-up 1 or follow-up 2 were observed. However, there is a clear time trend showing that the intake of discretionary foods increases by time from less than 1 item per week at baseline to more than 4 items per week at 2 years of age (P<.001), regardless of group.

Conclusions

A positive intervention effect was observed for the frequency of vegetable intake at follow-up 1 but not at follow-up 2. No other between-group effects on diet were observed. eHealth interventions of longer duration, including reminders after the main content of the intervention has been delivered, may be needed to obtain long-terms effects, along with tailoring in a digital or a personal form.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN) 92980420; https://doi.org/10.1186/ISRCTN92980420

Commercial complementary food use amongst European infants and children: results from the EU Childhood Obesity Project

PURPOSE

The objective of this secondary analysis is to describe the types of commercial complementary foods (CCF) consumed by infants and young children enrolled in the European Childhood Obesity Project (CHOP), to describe the contribution of CCF to dietary energy intakes and to determine factors associated with CCF use over the first 2 years of life.

METHODS

The CHOP trial is a multicenter intervention trial in Germany, Belgium, Italy, Poland and Spain that tested the effect of varying levels of protein in infant formula on the risk for childhood obesity. Infants were recruited from October 2002 to June 2004. Dietary data on CCF use for this secondary analysis were taken from weighted, 3-day dietary records from 1088 infants at 9 time points over the first 2 years of life.

RESULTS

Reported energy intakes from CCF during infancy (4-9 months) was significantly higher (p ≤ 0.002) amongst formula-fed children compared to breastfed children. Sweetened CCF intakes were significantly higher (p ≤ 0.009) amongst formula-fed infants. Female infants were fed significantly less CCF and infant age was strongly associated with daily CCF intakes, peaking at 9 months of age. Infants from families with middle- and high-level of education were fed significantly less quantities of CCF compared to infants with parents with lower education. Sweetened CCF were very common in Spain, Italy and Poland, with over 95% of infants and children fed CCF at 9 and 12 months of age consuming at least one sweetened CCF. At 24 months of age, 68% of the CHOP cohort were still fed CCF.

CONCLUSIONS

CCF comprised a substantial part of the diets of this cohort of European infants and young children. The proportion of infants being fed sweetened CCF is concerning. More studies on the quality of commercial complementary foods in Europe are warranted, including market surveys on the saturation of the Western European market with sweetened CCF products.

Caloric compensation in infants: developmental changes around the age of 1 year and associations with anthropometric measurements up to 2 years

BACKGROUND

Previous results based on dietary recall suggest that the ability to adjust eaten quantities to food energy density (ED) may deteriorate around the age of 1 y. However, this hypothesis has not been investigated experimentally.

OBJECTIVES

The first aim of the study was to describe changes in the short-term caloric compensation ability of infants around the age of 1 y. We expected a decrease in this ability with age. The second aim was to identify individual factors [e.g., breastfeeding duration, body mass index (BMI) z-score, and change in BMI z-score] related to interindividual variations in caloric compensation ability.

METHODS

We adapted the preload paradigm to calculate a COMPX score. The measure was performed in the laboratory at 11 and 15 mo. The parent offered a food preload that was either low or high in ED (LED = 33 kcal/100 g or HED = 97.9 kcal/100 g, respectively), followed by an ad libitum meal after 25 min. The infants were measured and weighed. Information about the infants' milk-feeding history was collected.

RESULTS

We obtained COMPX scores at 11 and 15 mo for 31 infants (12 females). As hypothesized, the caloric compensation ability significantly decreased with age (COMPX11 = 52% ± 133%; COMPX15 = -14% ± 151%; P = 0.03). The more the COMPX score decreased, the more the BMI z-score between 11 and 15 mo increased (P = 0.03) and the higher the BMI z-score was at 2 y (P = 0.03). No associations were found between COMPX scores and breastfeeding duration (all P > 0.60).

CONCLUSIONS

Caloric compensation ability decreases between 11 and 15 mo. This decrease is associated with a larger increase in weight status from 11 to 15 mo and a higher weight status at 2 y. This study calls for further research to better understand the early determinants of caloric compensation ability. This trial was registered at www.clinicaltrials.gov as NCT03409042 (https://clinicaltrials.gov/ct2/show/NCT03409042).

An update on complementary feeding

Complementary feeding is an important developmental milestone in children and occurs at a formative time for the development of healthy eating habits that can continue into later childhood and beyond. The timing of weaning has been a controversial subject and recommendations in the UK differ from those in Europe. In the UK and New Zealand, baby-led weaning is becoming increasingly popular. The importance of responsive feeding is highlighted to make parents aware of a baby's cues indicating hunger or fullness. There have also been advances in the science of immunology that deem the early introduction of allergens to be a preventive strategy for food allergies. This article discusses the nutritional requirements for infants and reviews the foods that should be introduced and avoided. Guidelines are changing all the time, so nurses must keep up to date with current research to be able to offer advice to parents of infants.

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.