Factors affecting the introduction of complementary foods in the preterm infant

Abstract

Objectives: The aim of the study was to identify current infant feeding practices among carers of preterm infants. Design: Structured interviews on milk and complementary feeding practices were conducted with mothers of preterm infants at intervals until infants were 12 months corrected age. Setting: Recruitment took place in three local Surrey hospitals over a 2 y period. Subjects: Two-hundred and fifty-three preterm infants (139 male, 114 female) including 33 sets of twins and three sets of triplets were recruited. Results: Forty-nine percent of the preterm infant group received first solid foods (the commencement of 'weaning') before the current Department of Health (DoH) guideline. The mean AE s.e.m. weaning age from birth was 17.1 AE 0.23 weeks. Ninety-five percent of the infants were weaned before the DoH guideline when the data was examined from term (mean 11.5 AE s.e.m. 0.21 weeks). Twenty-one percent were weaned before the DoH guideline for preterm infants which is that 'the infant weighs at least 5 kg' (mean 5.61 AE s.e.m. 0.01 kg). Human milk-fed infants were significantly lighter at weaning than combined milk-fed infants (5.32 AE 0.12 vs 5.72 AE 0.01 kg; P < 0.05) even though they were weaned at a similar age. Infant formula-fed infants (mean weaning age from term 10.2 AE 0.47 weeks) were weaned significantly earlier than both human milk-fed (11.9 AE 0.49 weeks; P < 0.05) and combined milk-fed (11.9 AE 0.25 weeks; P < 0.005) infants. Conclusions: The introduction of complementary foods varied widely between carers of preterm infants and compliance with DoH guidelines was poor. Further studies on preterm infants are necessary to see if weaning practices affect long-term growth and morbidity and to provide a basis for the development of appropriate recommendations. Sponsorship: This work was funded by the MAFF Food Intolerance Programme. European Journal of Clinical Nutrition (2002 Keywords: preterm infants; introduction of complementary foods; milk feeding Introduction About 5% of babies born in the UK are preterm and the number surviving is increasing as technology advances, as is apparent from the results of a survey in the north of England (Tin et al, 1997). The classification 'preterm' includes all infants born before 37 weeks gestation and does not take into account birth weight. This results in a very heterogeneous population.Guidelines on the introduction of complementary foods for infants are stated in the Department of Health (DoH, 1994) report, Weaning and the weaning diet. However, as little information exists on complementary feeding of preterm infants, guidelines for the introduction of foods other than human milk or infant formula in this group are less detailed and giving advice may present difficulties.The introduction of solid foods to complement human milk or infant formula or both (ie the weaning process), is recognised as one of the most crucial dietary events in an infant's life (Lanigan et al, 2001). If the process is begun too early this may cause development of allergic disease...

Introducing Solid Foods to Preterm Infants in Developed Countries

“…Table 1 summarizes the relevant published studies from the UK [23,24] and Italy [25] since 1994. Two of the cohorts [24,25] involved infants born preterm and one investigated infants born with low birth weight (including some infants born at term) [23].…”

“…Table 1 summarizes the relevant published studies from the UK [23,24] and Italy [25] since 1994. Two of the cohorts [24,25] involved infants born preterm and one investigated infants born with low birth weight (including some infants born at term) [23]. Despite the 1994 UK Department of Health [22] guideline recommending that solid foods commence when the infant born preterm reaches 5 kg, 18% of infants born preterm in the Italian study and 21–50% of the UK infants were introduced to solid foods prior to reaching this target weight.…”

Caracterização do desenvolvimento da alimentação de crianças nascidas pré-termo entre três e 12 meses

“…The lack of information about the eating habits in the early preterm lifes 12 , since they are part of a group with risk to early weaning and malnutrition, brings the need for further research in this area, so it could be established a profile of these infant, and it could be drawn more specific guides for their responsible.…”

“…Suggests that the weight would be a more appropriate measure to wean preterm infants, however, this could delay the introduction of complementary foods for months and subsequently could cause feeding problems. Finally, the study highlighted the need to develop practical guidelines to appropriate complementary feeding for premature babies for responsible and health professionals 12 …”

Do mothers understand healthy eating principles for low-birth-weight infants?

“…In a similar study of preterm infants, 21% were weaned before achieving a body weight of 5 kg 14 . In addition, food diversity was commonly practised by mothers in our sample, with 39% combining foods as first weaning foods.…”