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Alemu SF, Zerga AA, Yimer RD, Tadesse SE. Time to complementary feeding initiation and its predictors among children aged 9-23 months in Meket District, Northeast Ethiopia: a Cox Weibull regression. J Nutr Sci 2023; 12:e98. [PMID: 37744639 PMCID: PMC10511819 DOI: 10.1017/jns.2023.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 09/26/2023] Open
Abstract
.Globally and nationally, only 64⋅5 and 49⋅2 % of infants received solid or semi-solid foods, respectively. The available evidence indicates that the time to initiate complementary feeding practices is still poor and varies by region. The aim of the present study was to assess the time to initiation of complementary feeding and its predictors among children aged 9-23 months in Meket District, Amhara Region, Ethiopia. A community-based retrospective cohort study was conducted from June to July 2022 among 459 systematically selected mothers/caregivers with their children from 9 to 23 months of age. The result of descriptive statistics was reported by table, frequency, Kaplan-Meier curve and percent. The proportional hazard model assumption was checked, and a Weibull regression model was used to see the predictors of timely initiation of complementary feeding. An adjusted hazard ratio with a 95 % confidence interval and a P-value of 0⋅05 were used to declare the significant predictors. The median time of complementary feeding initiation was 6 months. Attending primary education (adjusted hazard ration (AHR) 1⋅8; 95 % CI 1⋅16, 2⋅78), occupation of the mother (AHR 1⋅43; 95 % CI 1⋅04, 1⋅95), home delivery (AHR 1⋅61; 95 % CI 1⋅09, 2⋅37) and birth preparedness (AHR 1⋅37; 95 % CI 1⋅03, 1⋅81) were the predictors of time to complementary feeding initiation. The median time to complementary feeding initiation was consistent with the WHO recommendation. Maternal education, maternal employment, place of delivery and birth preparedness were the predictors of time to initiation of complementary feeding. Therefore, working with the education sector, increasing the delivery rate in health facilities, strengthening counselling on birth preparation, increasing maternity leave until 6 months of age and initiating corner feeding should be part of the complementary feeding practices promotion agenda.
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Affiliation(s)
| | - Aregash Abebayehu Zerga
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Reta Dewau Yimer
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Kim JH, Lee E, Ha EK, Lee GC, Shin J, Baek HS, Choi SH, Shin YH, Han MY. Infant Feeding Pattern Clusters Are Associated with Childhood Health Outcomes. Nutrients 2023; 15:3065. [PMID: 37447391 DOI: 10.3390/nu15133065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Feeding behavior habits have a pattern with a certain tendency during infancy. We aimed to identify the associations between feeding patterns in infancy and the subsequent 10-year childhood disease burden. (2) Methods: Data from 236,372 infants were obtained from the national health insurance and screening program records in South Korea. Parent-administered questionnaires during infancy provided details on the feeding type and types/frequency of complementary food for analyzing feeding patterns. The outcomes were all-cause hospitalization and the development of 15 representative childhood diseases until the age of 10 years. Anthropometric measurements obtained at 6 years of age were analyzed. To estimate outcome risks while considering multiple risk factors, we employed a Cox proportional hazard and modified Poisson regression. (3) Results: Three clusters were identified: high prevalence of breastfeeding with regular exposure to a variety of solid foods (n = 116,372, cluster 1), similar prevalence of breastfeeding and formula feeding with less exposure to solid foods (n = 108,189, cluster 2), and similar prevalence of breastfeeding and formula feeding with the least exposure to solid foods in infancy (n = 11,811, cluster 3). Compared with cluster 1, children in clusters 2 and 3 had increased risks of all-cause hospitalization (hazard ratio (HR), (95% confidence interval (CI)), 1.04 (1.03-1.06) and 1.08 (1.05-1.11), respectively). Children in clusters 2 and 3 had an increased risk of upper respiratory infection, pneumonia, and gastroenteritis, as well as neurobehavioral diseases. Overweight/obesity at the age of 6 years was associated with clusters 2 and 3. (4) Conclusions: Feeding patterns in infancy were associated with an increased risk of childhood disease burden.
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Affiliation(s)
- Ju Hee Kim
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea
| | - Gi Chun Lee
- Department of Computer Science and Engineering, Konkuk University, Seoul 05029, Republic of Korea
| | - Jeewon Shin
- Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, 59, Yatap-ro, Seongnam 13496, Republic of Korea
| | - Hey-Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul 05355, Republic of Korea
| | - Sun-Hee Choi
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Man Yong Han
- Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, 59, Yatap-ro, Seongnam 13496, Republic of Korea
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Nantel A, Gingras V. Are Complementary Feeding Practices Aligned with Current Recommendations? A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:794. [PMID: 37238342 PMCID: PMC10217166 DOI: 10.3390/children10050794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023]
Abstract
The complementary feeding introduction period (introduction of solid foods alongside breastmilk or formula) is defining in children's health; however, it appears that many parents do not follow complementary feeding guidelines. Our aim was to describe current parental feeding practices during complementary feeding in relation to current recommendations and explore determinants of adherence to guidelines. We included any relevant studies published within the last decade in French or English and summarized findings by recommendation category. The timing of complementary food introduction varied widely across and within continents (earlier in North America and often delayed in Asia). The introduction of allergenic foods tended to be delayed globally. Although some parents now begin complementary feeding with solid foods (i.e., baby-led weaning), delayed introduction of lumpy textures was still prevalent in the United States and in Europe. The consumption of iron-rich foods was predominantly low in Africa. Added sugars were globally introduced early, especially in America. Evidence for the prevalence of responsive feeding practices among parents is unclear due to the small number of studies. Determinants of complementary feeding practices included parental characteristics, such as age, education, socio-economic status, and race/ethnicity. Interventions aiming to increase adherence to complementary feeding guidelines must account for parental characteristics.
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Affiliation(s)
- Audrey Nantel
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada;
- Research Center of the Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
| | - Véronique Gingras
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada;
- Research Center of the Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
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Sirkka O, Abrahamse-Berkeveld M, van der Beek EM. Complementary Feeding Practices among Young Children in China, India, and Indonesia: A Narrative Review. Curr Dev Nutr 2022; 6:nzac092. [PMID: 35769448 PMCID: PMC9233619 DOI: 10.1093/cdn/nzac092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/24/2022] [Accepted: 04/27/2022] [Indexed: 11/21/2022] Open
Abstract
Under- and overnutrition are co-existing health issues in several countries across Asia. Poor complementary feeding (CF) is a significant determinant of malnutrition in children and a major cause of morbidity and mortality. The purpose of this narrative review is to summarize the most recent evidence regarding the CF practices in 3 countries with a high prevalence of stunting and overweight, and currently undergoing rapid economic and nutritional transition: China, India, and Indonesia. We focused particularly on the adequacy of CF, based on the WHO feeding indicators (2021) regarding timing, frequency, diversity, as well as the consumption of specific food groups. According to the findings, the majority of infants in the 3 countries are introduced to CF at an inappropriate time: either too early (particularly in urban/rural areas of China and Indonesia) or too late (India) compared with the WHO recommendation. Furthermore, in all countries, diets are characterized by a low variety and frequency of CF and consist mainly of staple foods with poor nutritional quality, such as rice, cereals, or noodles. Nutrient-dense and protein-rich foods, such as foods of animal origin, are either inadequately consumed (rural areas of China and India) or introduced too late (urban areas of China and Indonesia) in the diets of children. In all countries, the consumption of fruit and vegetables, especially during the early CF period, is poor. In contrast, a significant proportion of both urban and rural children, particularly in Indonesia and India, are consuming energy-dense/nutrient-poor snacks and sugary drinks during the CF period. The described practices may pose a significant risk for the development of energy and/or nutrient gaps, magnifying the double and triple burden of malnutrition present in these countries. Further research is warranted to understand the significance of the observed practices for stunting and/or overweight/obesity risk.
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Affiliation(s)
- Outi Sirkka
- Danone Nutricia Research, Utrecht, The Netherlands
| | | | - Eline M van der Beek
- Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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FERREIRA RDMM, SANTOS DCD, VILELA LBF, OLIVEIRA TLD, EGEA MB. Early introduction of complementary foods in infants under six months: a case study from Rio Verde, Brazil. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.55522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Parkar SG, Rosendale DI, Stoklosinski HM, Jobsis CMH, Hedderley DI, Gopal P. Complementary Food Ingredients Alter Infant Gut Microbiome Composition and Metabolism In Vitro. Microorganisms 2021; 9:microorganisms9102089. [PMID: 34683410 PMCID: PMC8540059 DOI: 10.3390/microorganisms9102089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 12/12/2022] Open
Abstract
We examined the prebiotic potential of 32 food ingredients on the developing infant microbiome using an in vitro gastroileal digestion and colonic fermentation model. There were significant changes in the concentrations of short-chain fatty-acid metabolites, confirming the potential of the tested ingredients to stimulate bacterial metabolism. The 16S rRNA gene sequencing for a subset of the ingredients revealed significant increases in the relative abundances of the lactate- and acetate-producing Bifidobacteriaceae, Enterococcaceae, and Lactobacillaceae, and lactate- and acetate-utilizing Prevotellaceae, Lachnospiraceae, and Veillonellaceae. Selective changes in specific bacterial groups were observed. Infant whole-milk powder and an oat flour enhanced Bifidobacteriaceae and lactic acid bacteria. A New Zealand-origin spinach powder enhanced Prevotellaceae and Lachnospiraceae, while fruit and vegetable powders increased a mixed consortium of beneficial gut microbiota. All food ingredients demonstrated a consistent decrease in Clostridium perfringens, with this organism being increased in the carbohydrate-free water control. While further studies are required, this study demonstrates that the selected food ingredients can modulate the infant gut microbiome composition and metabolism in vitro. This approach provides an opportunity to design nutrient-rich complementary foods that fulfil infants’ growth needs and support the maturation of the infant gut microbiome.
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Niu H, Zhou X, Zhang X, Liu T, Wu Y, Lyu L, Liang C, Chen S, Gong P, Zhang J, Han X, Jiang S, Zhang L. Breast milk contains probiotics with anti-infantile diarrhoea effects that may protect infants as they change to solid foods. Environ Microbiol 2021; 23:1750-1764. [PMID: 33684236 DOI: 10.1111/1462-2920.15390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/04/2021] [Indexed: 12/20/2022]
Abstract
Infants often experience complementary food-induced diarrhoea (CFID), which occurs when infants switch from breast milk to solid foods. The relative abundances of Prevotella and Rothia were higher in stools of infants with CFID, while the relative abundances of Enterococcus and Escherichia were higher in healthy infants. The abundance of Lactobacillus spp. normally found in breast milk fed to infants with CFID was significantly reduced, and Enterococcus spp. were less abundant when diarrhoea occurred. Furthermore, Lactobacillus and Enterococcus were present as shared bacteria in both mother and infant, and they were considered potential anti-CFID probiotics as their relative abundances in breast milk were negatively correlated to infant CFID. Kyoto encyclopedia of genes and genomes (KEGG) functional analysis showed that the function of amino acid metabolism differed between infants with CFID and healthy infants. Therefore, CFID might be related to the decomposition of proteins in food supplements. The screening revealed seven hydrolytic casein and five hydrolytic casein and rice protein isolates from 320 suspected Lactobacillus and Enterococcus isolates. The animal experiments demonstrated that a mixture of five isolates effectively hydrolysed the casein and rice protein and prevented diarrhoea in young rats. Thus, the occurrence of CFID was found to be closely related to the intestinal and breast milk microbiota, and bacteria that could assist in the digestion of cereal proteins were involved in CFID.
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Affiliation(s)
- Haiyue Niu
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, 150001, China
| | | | | | - Tongjie Liu
- College of Food Science and Engineering, Ocean University of China, Qingdao, 266003, China
| | - Yifan Wu
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, 150001, China
| | - Linzheng Lyu
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, 150001, China
| | - Cong Liang
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, 150001, China
| | - Shiwei Chen
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, 150001, China
| | - Pimin Gong
- College of Food Science and Engineering, Ocean University of China, Qingdao, 266003, China
| | - Jiliang Zhang
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, 150001, China
| | - Xue Han
- School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang, 150001, China
| | - Shilong Jiang
- Heilongjiang Feihe Dairy Co. Ltd., Beijing, 100015, China
| | - Lanwei Zhang
- College of Food Science and Engineering, Ocean University of China, Qingdao, 266003, China
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Binns C, Lee MK, Yun Low W, Baker P, Bulgiba A, Dahlui M, Thuy Duong DT, Guldan G, Hairi N, Hokama T, Kagawa M, Karunathilake I, Abdul Majid H, Maycock B, Nanishi K, Qiu L, Raheem RA, Scott J, Tang L. Guidelines for Complementary Feeding of Infants in the Asia Pacific Region: APACPH Public Health Nutrition Group. Asia Pac J Public Health 2020; 32:179-187. [PMID: 32475150 DOI: 10.1177/1010539520931328] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Good nutrition in the first "1000 days," including breastfeeding and appropriate complementary foods, prepares for a healthy childhood and adult life, also contributes to the prevention of the double burden of malnutrition. Exclusive breastfeeding provides all required nutrients until an infant is around 6 months of age when complementary foods are needed. A literature review was undertaken of complementary foods in the Asia Pacific region. The foods being used at present are often of low nutrient density may provide insufficient amounts of some critical nutrients, and generally the variety is limited. Guidelines for complementary feeding are provided to assist in education and in public health planning.
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Affiliation(s)
- Colin Binns
- Curtin University, Perth, Western Australia, Australia
| | - Mi Kyung Lee
- Murdoch University, Perth, Western Australia, Australia
| | - Wah Yun Low
- University of Malaya, Kuala Lumpur, Malaysia
| | - Philip Baker
- Queensland University of Technology, Brisbane, Queensland, Australia
| | | | | | | | - Georgia Guldan
- University of Papua New Guinea, Port Moresby, Papua New Guinea
| | - Noran Hairi
- University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | | | - Bruce Maycock
- Asia Pacific Academic Consortium of Public Health, Kuala Lumpur, Malaysia
| | | | - Liqian Qiu
- Women's Hospital, Zhejiang University Hangzhou, China
| | | | - Jane Scott
- Curtin University, Perth, Western Australia, Australia
| | - Li Tang
- Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Manohar N, Hayen A, Bhole S, Arora A. Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants-Results from HSHK Birth Cohort Study. Nutrients 2020; 12:E258. [PMID: 31963864 PMCID: PMC7019241 DOI: 10.3390/nu12010258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/21/2022] Open
Abstract
Early introduction of complementary foods can have a detrimental impact on children's long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was 'age at which particular core and discretionary food items were first introduced'. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54-7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99-5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17-11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.
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Affiliation(s)
- Narendar Manohar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia;
| | - Andrew Hayen
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia;
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW 2010, Australia;
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia
- Oral Health Alliance, Oral Health Centre, University of Queensland, Brisbane, QLD 4072, Australia
- Metro North Oral Health Services, Stafford, QLD 4053, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia;
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW 2010, Australia;
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney Faculty of Medicine and Health, Westmead, NSW 2050, Australia
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