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Age of introduction of first complementary feeding for infants: a systematic review.

ABSTRACT: Despite a World Health Organization recommendation for exclusive breastfeeding of all full-term infants to 6 months of age, it is not clear what the health implications may be. Breast milk alone may not meet the nutrition needs for all growing infants, leaving them at risk for deficiencies. The objective of this study was to investigate the relationship between moderate (4 months) versus late (6 months) introduction of complementary foods to the full-term breastfed infant on iron status and growth.An electronic search of peer-reviewed and gray-literature was conducted for randomized control trials (RCTs) and observational studies related to the timing of introduction of complementary foods. Iron status and growth data from the relevant RCTs were analyzed using RevMan 5.2.11.Three RCTs and one observational study met the inclusion criteria. Meta-analysis showed significantly higher hemoglobin levels in infants fed solids at 4 months versus those fed solids at 6 months in developing countries [mean difference [MD]: 5.0 g/L; 95% CI: 1.5, 8.5 g/L; P = 0.005]. Meta-analysis also showed higher serum ferritin levels in the 4-month group in both developed and developing countries [MD: 26.0 ?g/L; 95% CI: -0.1, 52.1 ?g/L, P = 0.050], [MD: 18.9 ?g/L; 95% CI: 0.7, 37.1 ?g/L, P = 0.040]. Short follow-up periods and small sample sizes of the included studies were the major limitations.RCT evidence suggests the rate of iron deficiency anemia in breastfed infants could be positively altered by introduction of solids at 4 months.

SUBMITTER: Qasem W

PROVIDER: S-EPMC4557230 | biostudies-other | 2015 Sep

REPOSITORIES: biostudies-other

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Age of introduction of first complementary feeding for infants: a systematic review.

Qasem Wafaa W Fenton Tanis T Friel James J

BMC pediatrics 20150902

<h4>Background</h4>Despite a World Health Organization recommendation for exclusive breastfeeding of all full-term infants to 6 months of age, it is not clear what the health implications may be. Breast milk alone may not meet the nutrition needs for all growing infants, leaving them at risk for deficiencies. The objective of this study was to investigate the relationship between moderate (4 months) versus late (6 months) introduction of complementary foods to the full-term breastfed infant on i ...[more]

PMID: 26328549

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Project description:BackgroundSub-optimal nutrition among children remains a problem across South Asia (SA). Appropriate complementary feeding practices (CFP) can greatly reduce this risk. The primary objective of this systematic review (SR) of CF studies was to assess timing, dietary diversity, meal frequency and influencing factors in children under two in Bangladesh.MethodsSearches included English-language research published between January 2000 and June 2016 within MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, BanglaJOL, Cochrane Library, CINAHL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research concerning the adequacy of complementary feeding practices in South Asian children aged 0-2 years and/or their families. We excluded interventional papers and those focusing exclusively on breast-feeding. In total 45,712 titles and abstracts were screened against inclusion criteria, 860 of which received independent full text review by two reviewers. 36 papers relevant to Bangladesh were identified. The 'EPPI-Centre Weight of Evidence Framework' was used to objectively assess each study's value in answering the review question. As per WHO Infant and Young Children Feeding Guidelines (IYCF), introduction of CF was assessed as the proportion of infants aged 6-8 months who received solid, semi-solid or soft foods. Search terms were: "children", "feeding" and "Asians" with their derivatives. Two researchers undertook study selection, data extraction and quality appraisal.ResultsThree cohort, 30 cross-sectional and 3 mixed methods studies were included. Despite adopting the WHO IYCF Guidelines, sub-optimal CF practices were found in many studies. Timely initiation of CF practices ranged from 24 to 83%. Achieved minimum dietary diversity ranged from 25% to 44% and minimum meal frequency from 33% to 81%. Influencing factors included maternal education, poor knowledge of CF practices and socioeconomic variables.ConclusionsThis is the first systematic review to evaluate CF practices in Bangladesh. Despite adoption of the WHO IYCF guidelines, inadequate CFP remain in communities across Bangladesh.Trial registrationPROSPERO Registration No: CRD42014014025.

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Age of introduction of first complementary feeding for infants: a systematic review.

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Age of introduction of first complementary feeding for infants: a systematic review.

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