The timing of introducing complementary feeding affects nutritional status and children’s health. The aim of this study was to determine sociodemographic and birth-related factors associated with the age of introducing complementary foods. This cross-sectional study investigated parents (n = 5815) of children aged 12–36 months from Poland (n = 4065) and Austria (n = 1750) using a single online questionnaire. During the study, detailed data about sociodemographic characteristics, variables related to pregnancy, and early feeding practices were collected. Univariate and multivariate logistic regression models were used to investigate factors associated with the introduction of complementary feeding before 4 completed months, between 4 and 6 months, and after 6 completed months separately for both countries. Complementary foods were introduced before 4 months in 3.0% of infants (2.4% in Poland and 4.3% in Austria), between 4 and 6 months in 65.0% (60.5% in Poland and 75.3% in Austria), and after 6 completed months in 32.1% of infants (37.1% in Poland and 20.4% in Austria). The factors related to earlier introduction of complementary feeding were lower maternal age (in Austria 25–29 years: aOR 2.21 (95% CI 1.06–4.65)) and education level (in Poland and Austria primary and vocational: aOR 14.49 (95% CI 3.73–56.35), aOR 2.13 (95% CI 1.10–4.11), respectively), preterm birth (in Poland and Austria: aOR 10.21 (95% CI 5.73–18.20); aOR 4.45 (95% CI 2.42–8.18), respectively), never breastfeeding (Poland: aOR 2.73 (95% CI 1.29 – 5.76)) and receiving an infant formula after hospital discharge (in both countries: aOR 3.73 (95% CI 2.06–6.75); aOR 3.65 (95% CI 1.87–7.12), respectively). These factors should be taken into account by health professionals in identifying mothers who are least likely to follow nutritional recommendations.

Children aged <2 years should not be given meals with the addition of salt and sugar due to health risks and to promote healthier dietary habits. The aims of this study were: to assess the prevalence of the use of added salt (AS), sugar (ASu) and both salt and sugar (AS&Su) in the diets of Polish and Austrian toddlers aged 12–24 and 25–36 months; to explore the sociodemographic and early nutritional factors associated with the use of AS and ASu; to investigate the difference in dietary habits and maternal concerns about toddlers’ eating regarding the use of AS and ASu in toddlers’ diet. This cross-sectional anonymous study was conducted in 5893 mothers of children aged 12–36 months, recruited through social media in 2017–2019. The questionnaire consisted of questions about sociodemographics, early feeding practices and current children’s nutrition (e.g., use of AS and ASu, food frequency questionnaire). Multivariate logistic regression and cluster analyses were applied. Austrian mothers more often used AS than mothers from Poland (at 2 years old: 74.8% vs. 52.8%; at 3 years old 87.4% vs. 74.4%, p ≤ 0.001), however Polish mothers were more prone to use ASu (at 2 years old: 34.7% vs. 27.7%; at 3 years old: 59.0% vs. 45.8%, p ≤ 0.001). In younger toddlers (12–24 months), the odds of using of AS, ASu, and AS&Su increased with toddlers’ age, when the mother was a multipara, was not currently breastfeeding, or had exclusively breastfed for 4–5 months. This risk decreased when older toddlers (25–36 months) were introduced to solids by baby-led weaning (BLW). Toddlers from both countries who consumed meals with AS or ASu more often a followed Western-like dietary pattern. Our study emphasizes the need for parental nutritional education when beginning to introduce solid foods.

There is growing evidence that bone health may be programmed in the first years of life. Factors during the prenatal period, especially maternal nutrition, may have an influence on offspring’s skeletal development and thus the risk of osteoporosis in further life, which is an increasing societal, health and economic burden. However, it is still inconclusive which early life factors are the most important and to what extent they may affect bone health. We searched through three databases (PubMed, Google Scholar, Cochrane Library) and after eligibility criteria were met, the results of 49 articles were analyzed. This narrative review is an overall summary of up-to-date studies on maternal diet, nutritional status, and birth-related factors that may affect offspring bone development, particularly bone mineral density (BMD). Maternal vitamin D status and diet in pregnancy, anthropometry and birth weight seem to influence BMD, however other factors such as subsequent growth may mediate these associations. Due to the ambiguity of the results in the analyzed studies, future, well-designed studies are needed to address the limitations of the present study.

Early nutrition plays a crucial role not only in providing essential nutrients for proper child development, but may also be an important step in creating desirable eating behaviors, which can be transmitted into adulthood. The aim of this study was to assess possible links between early feeding factors, such as breastfeeding, complementary feeding (timing and method) as well as types of complementary foods and mealtime environment during the first three months of complementary feeding and eating behaviors in children aged 1–3 years old. This cross-sectional, online survey involved 467 mothers of toddlers aged 1–3 years old from the whole of Poland. The questionnaire consisted of questions about early feeding and the Children’s Eating Behavior Questionnaire (CEBQ). The adjusted linear regression model revealed that longer duration of any breastfeeding was negatively related to enjoyment of food (EF), desire to drink (DD) and positively related to satiety responsiveness (SR) and slowness in eating (SE) subscales. Moreover, offering homemade complementary foods more often than commercial may be related to higher SR. Eating meals during distraction seems to be negatively associated with EF, and positively with DD and SE subscales. Our study highlights possible links between early feeding factors and toddlers’ eating behaviors, so further investigation, also including dietary factors, is needed.

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AbstractOver the last years, there has been increasing interest in Baby-Led Weaning (BLW), an approach in which infants feed themselves with finger foods. Previous studies have shown that BLW may be associated with lower food fussiness and risk of obesity, but in the other hand with growth flattering. However, the results are limited and still inconclusive. The aim of this study was to investigate the associations between complementary feeding method and body mass index (BMI) z-score in children aged 19–36 months from Poland and Austria. This anonymously, the cross-sectional internet-based study was conducted in 2018 and 2019 among 6645 mothers of children aged 12–36 months, recruited through social media. The analysis included data from 5856 mothers (35.5% from Austria) with complete data. Complementary feeding method was categorized as traditional spoon feeding (TSF), partial BLW (children was both spoon-fed and fed themselves), as well as BLW. BMI z-score was calculated based on declared body mass and height using the WHO cut-off points. BLW method was used in 16.4% of children, whereas the TSF in 30.5% of the total study group. Normal BMI z-score was observed in 73.8% of the total study group, thinness in 9.6% and overweight and obesity in 4.3%. The BLW increased the risk of thinness only in children aged 31–36 months (aOR: 1.48; 95%CI: 1.04–2.11) but did not influence the risk of overweight and obesity. In this present large cross-sectional study conducted in two European countries, we did not find an association between BLW and overweight and obesity risk. However, in the older group, BLW increased the risk of thinness. Previous studies observing a risk of thinness were also cross-sectional, although conducted among smaller study groups. In contrary to this, In contrary to this, the RCT trials using modified BLW version Baby-Led Introduction to SolidS (BLISS) did not observe any case of growth flattering. In another cross-sectional study investigating dietary intake of infants aged 6–8 months, who were complementary fed using BLW or TSF method, authors did not observe a difference in energy intake between the two groups. Further studies investigating the role of complementary feeding method and subsequent BMI, especially in long-term are necessary.