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Fussy Infants Receive Complementary Food Earlier Than Non-Fussy Ones

by Mita Majumdar on  May 25, 2011 at 12:38 PM Health Watch   - G J E 4
Low-income, black, first-time mothers are more likely to introduce complementary foods before 4 months to fussy infants, reveals a study published in the journal Pediatrics.

Complementary feeding refers to the transition from exclusive breastfeeding to family foods covering the period from 6 months to 18-24 months of age. According to the WHO, 'It is the time when malnutrition starts in many infants, contributing significantly to the high prevalence of malnutrition in children under five years of age world-wide'. The WHO further recommends that 'infants start receiving complementary foods at 6 months of age in addition to breast milk, initially 2-3 times a day between 6-8 months, increasing to 3-4 times daily between 9-11 months and 12-24 months with additional nutritious snacks offered 1-2 times per day, as desired'.

It is a well-established fact that fussy infant temperament is linked to rapid growth during infancy and greater adiposity in childhood. Parents often use food to quiet fussy infants. Earlier studies have revealed that mothers and caregivers use infant fussing as a cue for beginning complementary feeding (CF). However, few studies have examined the associations between maternal perception of infant temperament and CF.

Heather Wasser, from the University of North Carolina and colleagues took up the present study with an objective to

1. Assess the feeding patterns of 0 to 4 month-old infants by low-income, black, first-time mothers; and

2. Examine associations between maternal perception of infant temperament and early introduction of CF.

First-time black mothers aged 18 to 35 years were recruited and assessed during in-home visits at infant ages 3, 6, 9, 12, and 18 months. Data was collected from the 3-month visit (n = 217), at which 42 infants were between 2.7 and 2.9 months old, 162 were between 3.0 and 3.9 months old, and 1 was 4.0 months old. Assessment was done for relationships between early feeding of solids or juice and 6 dimensions of perceived infant temperament.

The study results suggested a high prevalence of early complementary feeding among low-income black women who were first-time mothers. Following are the main points:

• 77 percent of the infants were fed solid foods at 3 months, 25 percent were fed juice, and 6 percent were exclusively   breastfed.

• Two dimensions, distress to limitations (DTL) and confidence interval (CI), were associated with early feeding of solid foods.

• Low intensity pleasure (swaying or rocking) was associated with early feeding of juice.

• Among formula-fed infants, those fed either solids or juice had an average daily energy intake of 100 cal greater than infants given only formula.

• Maternal characteristics such as breastfeeding, obesity, and depressive symptoms were significantly associated with early CF.

• Obese mothers and mothers with depressive symptoms were less likely to feed juice before 4 months.

The investigators concluded: 'Several domains of perceived infant temperament are related to early CF and caloric intakes may be higher among infants who receive CF versus those who do not receive CF before 4 months. This demonstrates that maternal perception of infant behavior is an important factor to include in future research. Developing counseling methods to help mothers respond to infant behavior in ways that are supportive of optimal feeding seem warranted. The finding of a protective effect of breastfeeding against early introduction of solid foods in the context of predominant use of formula highlights the need for breastfeeding interventions targeted to this population'.

Source:
http://pediatrics.aappublications.org/content/early/2011/01/10/peds.2010-0166.full.pdf

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