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Introduction of complementary foods with respect to French guidelines: description and associated socio-economic factors in a nationwide birth cohort (Epifane survey).

ABSTRACT: We described the introduction of complementary food (ICF) during the first year of life and identify associations observed with maternal and infant characteristics. We studied 3368 children included in the Epifane cohort, France, 2012. Maternal and infant characteristics and age at introduction of 28 complementary foods were collected at birth and at 1, 4, 8 and 12 months. Kaplan-Meier plots were used to represent probabilities of ICF. A score was used as tertiles in multinomial logistic regression to identify maternal and infant factors associated with ICF agreement with French recommendations. Median age of ICF was 152 days. While 12.6% of infants received complementary food before the age of 4 months, 95% of them were introduced after 7 months. Recommendations were generally followed, except for eggs and added fats, introduced in only 23.2% and 53.1% of 1-year-old infants, respectively. Factors significantly associated with the first ICF score tertile (low agreement with recommendations) vs. third tertile were as follows: maternal age 18-24 years (OR = 2.24 [1.49-3.35]) or 25-29 years (OR = 1.57 [1.21-2.04]), education less than or equal to high school graduation (OR = 1.94[1.51-2.48]), birthplace in France (OR = 2.13 [1.41-3.21]), three or more children (OR = 1.70 [1.15-2.51]), no follow-up antenatal classes (OR = 1.58 [1.22-2.04]), unemployment before and after pregnancy (OR = 1.64 [1.04-2.59]), unemployment before pregnancy and return to work within 12 months (OR = 2.06 [1.05-4.02]), no breastfeeding (OR = 2.08 [1.55-2.79]) or lasting <28 days (OR = 1.68 [1.22-2.31]) or 1-4 months (OR = 1.45 [1.08-1.96]). Recommendations concerning complementary food were generally followed. However, guidelines should be clarified and adapted to families who have difficulties in adopting them.

SUBMITTER: Boudet-Berquier J

PROVIDER: S-EPMC6865956 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe influences of breastfeeding and infant diet in the prevention of allergy-related diseases are uncertain and many of the studies conducted on the topic are limited by methodological challenges. Our aim was to assess whether the duration of breastfeeding and age at complementary food introduction affected the prevalence of asthma, wheeze, allergic rhinoconjunctivitis (ARC) and eczema at two and six years of age.MethodsWe used information gathered between 2000 and 2014 through questionnaires in the Prevention of Allergy among Children in Trondheim (PACT) study, a prospective cohort study in Trondheim, Norway. The current study includes 6802 children who submitted questionnaires detailing breastfeeding duration and or age at introduction to complementary foods, as well as at least one of the child health questionnaires completed at two and six years of age. Adjusted odds ratios (aORs) were calculated for each combination of exposure and outcomes and sensitivity analyses were performed to assess the possible influence of recall bias and reverse causality.ResultsThe mean duration of breastfeeding was 11 months (SD 5.6) in this study population and 5695 of 6796 (84%) infants had been breastfed for at least 6 months. We did not find any conclusive preventative effect of longer breastfeeding on parental reported doctor-diagnosed asthma, aOR 0.79 (95% CI 0.51, 1.21). However, at 6 years of age we observed a reduction in the less strictly defined outcome wheeze, aOR 0.71 (95% CI 0.53, 0.95). Longer breastfeeding was associated with a reduced risk of ARC at 2 years, aOR 0.65 (95% CI 0.49, 0.86), with a continued protective trend at 6 years, aOR 0.77 (95% CI 0.58, 1.04).ConclusionsLonger breastfeeding resulted in a reduced risk of wheeze and a trend towards a protective effect on ARC up until school age. No conclusive associations were seen between the duration of breastfeeding or age at introduction to complementary foods and prevention of asthma, wheeze, ARC and eczema.Trial registrationThe trial is registered in Current Controlled Trials as ISRCTN28090297 .

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Introduction of complementary foods with respect to French guidelines: description and associated socio-economic factors in a nationwide birth cohort (Epifane survey).

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