Introduction of Solid Food to Young Infants

Abstract

Timing of the first introduction of solid food during infancy may have potential effects on life-long health. To understand the characteristics that are associated with the timing of infants’ initial exposure to solid foods. The 2000 National Survey of Early Childhood Health (NSECH) was a nationally representative telephone survey of 2,068 parents of children aged 4–35 months, which profiled content and quality of health care for young children. African-American and Latino families were over-sampled. Analyses in this report include bivariate tests and logistic regressions. 62% of parents reported introducing solids to their child between 4–6 months of age. African-American mothers (OR = 0.5 [0.3, 0.9]), English-speaking Latino mothers (OR = 0.4 [0.2, 0.7]), White mothers with more than high school education (OR = 0.5 [0.2, 1.0]), and mothers who breastfed for 4 months or longer (OR = 0.4 [0.3, 0.7]) were less likely to introduce solids early. Most parents (92%) of children 4–9 months of age reported that their pediatric provider had discussed introduction of solids with them since the child’s birth, and provider discussion of feeding was not associated with the timing of introduction of solids. Although most parents recall discussing the introduction of solid foods with their child’s physician, several subgroups of mothers introduce solid foods earlier than the AAP recommendation of 4–6 months. More effective discussion of solid food introduction linked to counseling and support of breastfeeding by the primary health care provider may reduce early introduction of solids.

Prevalence and Reasons for Introducing Infants Early to Solid Foods: Variations by Milk Feeding Type

“…This reduction of recall bias may also explain why we observed a higher rate of early solid food introduction than other studies in US populations (40.4% vs 19% to 29%). 5,12 There are a few limitations to our study. One limitation is that the IFPS II sample is not nationally representative; participants are predominantly white, have a moderate income, and are English literate.…”

“…5,12 The AAP recommendation in place at the time of IFPS II data collection was that solid foods were to be introduced no earlier than 4 months of age. Notably, with the 2012 revision of this recommendation by the AAP, the recommended age for introduction of solid foods was increased from 4 to 6 months, which would result in 92.9% of our analytic sample being classified as "early introducers."…”

“…4 In addition, researchers have suggested that early introduction of solids may increase the risk of some chronic diseases, such as diabetes, obesity, eczema, and celiac disease. [5][6][7][8] The early introduction of solids also ends exclusive breastfeeding and has been associated with reduced duration of any breastfeeding. 9 Given the important health benefits of breast milk for infants (reduced risk of respiratory and ear infections, diarrhea, diabetes, obesity, and sudden infant death syndrome), any interference with breastfeeding is of concern.…”

“…10,11 Despite the AAP recommendation, in national studies we have seen that many parents are not adhering to infant feeding guidelines on solid food introduction. 5,9,12 To address this issue, several studies have been launched to identify the predictors of early solid food introduction. Predictors that have been identified include low maternal education, low maternal age, smoking status, formula feeding, and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).…”

“…Predictors that have been identified include low maternal education, low maternal age, smoking status, formula feeding, and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). 5,[13][14][15] Although there have been studies on infant feeding, little is known about reasons for early introduction. We found no study that has examined systematically whether reasons for early introduction to solids vary by milk feeding type (ie, breast milk only, formula only, or mixed).…”