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Background: As a nutritious food‐providing protein, essential fatty acids, vitamin D, iodine and choline eggs have historically been central to an infant weaning diet. However, food poisoning scares and allergy concerns have contributed to low consumption among infants aged 6–12 months. Methods: This paper presents a secondary data analysis of infant egg exposure and intake using three weaning data sets: a 7‐day food frequency questionnaire (n = 297), a 24‐h recall (n = 180) and a 3‐day weighed food diary (n = 71). Egg introduction, frequency of consumption and intake in grams were analysed for infants aged 6–8, 9–10 and 11–12 months). Comparisons were made by whether infants were following a baby‐led approach to weaning (where infants self‐feed family foods) or a traditional approach where pureed foods are given alongside finger foods. Data were collected in the United Kingdom between 2015 and 2018. Results: Our data showed that despite introduction being recommended from the start of weaning at 6 months of age by the Department of Health, just 54% of infants aged 6–8 months had ever been offered eggs. Average egg intake was one to two times per week, increasing with age. However, in terms of frequency and grams consumed, our data suggest a small increase in consumption compared with previous research, although limitations of our smaller sample size should be noted. Finally, a baby‐led approach was associated with increased exposure and consumption; baby‐led infants consumed eggs twice as frequently as spoon‐fed infants. Conclusions: The findings have important implications for public health messaging and for supporting families in introducing solid foods. Key points: Despite introduction being recommended from the start of weaning at age 6 months, just 54% of infants aged 6–8 months had ever been offered eggs.Only 40% of infants aged 6–8 months and about two‐thirds of those aged 9–12 months had consumed eggs in the last week. Those who had consumed eggs most commonly did so once or twice a week.Infants following a baby‐led weaning approach who self‐feed family foods were introduced to eggs at an earlier stage of weaning and consumed eggs twice as frequently as spoon‐fed infants. [ABSTRACT FROM AUTHOR]

Background: The period from 6 to 24 months in an infant's life presents a critical window for understanding feeding practices and for designing culturally appropriate interventions. However, little is known about the complementary feeding practices of Black mothers and how this period can be used to optimise the long‐term health of their children. The present study aimed to identify factors that influence the complementary feeding practices of low‐income Black mothers with children aged 6–24 months. Methods: Participants were recruited through Research Match, Facebook advertising, flyers, and snowballing techniques. Low‐income, Black mothers, with a 6–24‐month‐old infant, and who lived in Franklin County, Ohio, USA, were eligible for the study. A cross‐sectional design using in‐depth interviews was used. Reflexive thematic analysis was utilised to analyse and interpret the feeding practices of Black mothers. Results: Mothers (n = 8) were aged between 18 and 30 years old and most completed college or had some college education (n = 6). Half (n = 4) were married, employed, and rated their diet quality and their children's as very good. Three themes emerged: (a) complementary feeding at ≥ 6 months of age; (b) involvement of health care providers and service organisations in feeding decisions; and (c) use of responsive feeding cues. Conclusions: All mothers breastfed exclusively and most (n = 6) initiated complementary feeding at 6 months. Paediatricians, other health providers and service organisations were instrumental in helping Black mothers adopt complementary feeding practices. Mothers also engaged in responsive feeding practices. These findings point to the critical nature of access and education in helping Black mothers in the study achieve feeding recommendations for their infants. Key points/Highlights: Little is known about the complementary feeding practices of Black mothers and how the 6–24‐month period in their infants' lives can be used to optimise the long‐term health of their children.The present study identified factors associated with the complementary feeding practices of low‐income parents with children 6–24 months of age and will inform the development of culturally appropriate interventions.Black mothers in the study followed the established guidelines for complementary feeding practices.Physicians, other health care providers and social service organisations were critical in helping low‐income Black mothers with their infant feeding decisions and practices.Interdisciplinary work offers unique perspectives and paradigms that help to improve understanding of the factors that impact complementary feeding decisions in low‐income Black families. [ABSTRACT FROM AUTHOR]

Background: The prenatal, perinatal, postnatal and nutritional (A3PN) support study was a 4‐year initiative aimed to reduce maternal mortality in Haiti. A cross‐sectional study was developed to collect the baseline data for evaluation purposes of the A3PN. This study aimed to determine the factors contributing to dietary diversity (DD) in Haitian children aged 6–23 months. Methods: A cross‐sectional study during two seasons (the lean season and the harvest season) was carried out in Haiti to assess the DD of children and their mothers using non‐quantitative 24‐h recalls. Indicators of DD were minimum dietary diversity for children (MDD‐C) and minimum dietary diversity for women (MDD‐W). Mid‐upper arm circumference was measured in women and children, and food security was assessed using the Household Hunger Scale. Focus groups were also conducted to gain a better understanding of the quantitative findings. Results: Only 7.3% of the children included in this study met the MDD‐C. Factors associated with MDD‐C were the season (odds ratio [OR]: 0.141 [0.039–0.513]), land ownership or rental (OR: 4.603 [1.233–17.188]), maternal education (OR: 0.092 [0.011–0.749]), the mother's responsibility for the main or secondary source of income for the household (OR: 2.883 [1.030–8.069]) and her DD (OR: 5.690 [1.916–16.892]). Focus groups revealed the existence of various food restrictions. Conclusions: The results indicated that the low prevalence of MDD‐C in three regions of study in Haiti is indicative of a serious public health concern that might be further aggravated by local food taboos. They also suggest that to fight against hunger, it is necessary to focus on women's well‐being. Key points: The low prevalence of minimum dietary diversity for children in three regions of study in Haiti is indicative of a serious public health concern that might be further aggravated by local food taboos. To fight against hunger, it is necessary to improve women's lives by increasing access to land ownership, to fair wages and working conditions, to diverse and stable food sources irrespective of season and climate change and to timely and reliable information about the importance of food diversity and continued breastfeeding. [ABSTRACT FROM AUTHOR]

Background: The optimal time of starting complementary foods (CFs) in infants remains a subject of debate. This population‐based longitudinal cohort study evaluated the association between early CF introduction and body mass index (BMI) in children aged 5–7 years. Methods: The present study included 917,707 children born in Korea during 2008–2009. Initial timing of CF introduction was obtained by questionnaires administered between 4 and 6 months and 9 and 12 months of age. The cohort consisted of 154,565 eligible individuals who properly completed the screening programme, including structured questionnaires, anthropometric measurements and physical examinations. To balance baseline characteristics, children were subjected to propensity score matching based on 95 covariates, including indicators of baseline health such as perinatal condition, birth weight, economic status, clinical disease and drug exposure. Exposure was defined as introduction to CF at age < 4 months, and outcomes were overweight (BMI z‐score > 85th percentile) and obesity (BMI z‐score > 95th percentile) at ages 5–7 years. Results: Of the 154,565 eligible children in the observed cohort, 10,499 (6.8%) were introduced to CF at age < 4 months and 144,066 (93.2%) at age ≥ 4 months. Propensity score matching yielded 9680 children introduced to CF at age < 4 months and 35,396 at age ≥ 4 months. The risk for being overweight or obese at age 5–7 years was slightly higher among those who started CF at age < 4 months than at age ≥4 months (adjusted relative risk = 1.06; 95% confidence interval = 1.02–1.09). A similar but stronger association was observed for being obese at age 5–7 years (adjusted relative risk = 1.12; 95% confidence interval = 1.05–1.19). Conclusions: Early CF introduction before age 4 months was associated with increased BMI at age 5–7 years. Key points: The optimal time of starting complementary foods (CFs) in infants remains a subject of debate.Early CF introduction before age 4 months was associated with increased body mass index (BMI) at age 5–7 years, which suggest that introducing CFs after 4 months as adherence to current guidelines is desirable regarding children's body mass.Physicians, parents, and caregivers of infants should be aware that early CF introduction is associated with increased childhood BMI. [ABSTRACT FROM AUTHOR]

An editorial is presented on how complementary feeding is a key developmental milestone that exerts powerful changes in terms of functional changes to the gastrointestinal tract, the immune system and metabolic processes. Topics include crease the risk of waterborne infection and exposure to contaminants commit families; and World Health Organization promotes breast milk and considers that commercial follow‐on or growing‐up milks are unnecessary.

Background: The first 2 years of life represent a critical phase for growth and development, with the quality of the diet at this stage having repercussions throughout adulthood. The present study aimed to develop an Index for Measuring the Quality of Complementary Feeding (IMQCF) for infants, as well as to evaluate diet quality and its effects on the nutritional status of preterm infants. Methods: This cross‐sectional study was conducted at a Brazilian University Hospital. The data were extracted by care protocol of outpatient preterm infants at 2 years of corrected age (CA). Dietary data were collected from 24‐h recalls. The diet quality was assessed by the IMQCF composed of nine items based on a Brazilian Food Guide for children aged <2 years. Response options were scored 0–100, with scores closer to 100 representing a better quality diet. Association with growth indicators (Z‐scores for weight‐ and length‐for‐age (WAZ and LAZ) were evaluated via tests of mean difference and multiple linear regression. Results: The median complementary feeding (CF) score was 72.2 (61.1–77.8) A shorter breastfeeding duration or infant formula use and the early introduction of wheat‐based foods, ultra‐processed foods and cow's milk in the preterm's diet were the main factors interfering in the adequacy of diet. There was an association between the quality of the diet score and WAZ (0.44; 95% confidence interval = 0.03–0.85; P = 0.03). Conclusions: The introduction of poor quality food in the first 2 years of life interfered with the CF quality of preterm infants and can affect nutritional status at 2 years of CA, possibly in the long term. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of published data regarding maternal socio‐demographic characteristics and associated complementary feeding practices of moderately malnourished infants and young children (IYC) in sub‐Saharan Africa. In the present study, this association was investigated in Arua, Uganda. Methods: A cross‐sectional baseline survey was conducted among 204 conveniently sampled mothers of IYC aged 6–18 months with moderate acute malnutrition earmarked for dietary supplementation in four randomly selected sub‐counties to determine their socio‐demographic characteristics using a validated questionnaire. A 24‐h recall was used to evaluate complementary feeding practices in terms of minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). Associations were determined using multivariate logistic regression analysis. Results: The majority (70.1%) of mothers had a primary school education, with 15% having no formal education. Foods especially purchased or prepared for IYC were provided by 42.6% of the mothers. The MDD and MMF of IYC were 13.2% and 41.2%, respectively. MMF and MDD for MAD were met by 6.9% of IYC. Maternal level of education and MMF was significantly associated (P = 0.003), whereas the provision of foods especially purchased or prepared for IYC was significantly associated with MMF (P = 0.003). Maternal care was significantly associated with MAD (P = 0.004). Conclusions: Optimal complementary feeding practices were not met by the majority of mothers. Maternal level of education and care of IYC were strong predictors of MMF. Nutrition education and care should be promoted among mothers of IYC with moderate acute malnutrition to improve MDD, MMF and MAD. [ABSTRACT FROM AUTHOR]

Background The current literature regarding the transition from milks to solid foods across the first 2 years of life is limited despite the important influence of early dietary intake on children's growth and development. The present study describes dietary intake from birth to 2 years across four developmental relevant time-points within an Australian birth cohort. Methods Dietary data from 466 infants was collected at four time-points in the first 2 years of life via parent-reported questionnaire, including a 45-item food and beverage frequency questionnaire. Subsample analyses of children who were aged 1-3, 6-8, 12-14 and 18-20 months at the time of data collection were conducted. Results Infant formula remained consistently consumed by over 75% of children from the 6-8- to 18-20 months old age groups. Mean (SD) age of introduction to solid foods was 5.2 (1.3) months. Almost 20% and 10% of children were introduced before 16 and after 32 weeks, respectively. The highest consumption of core foods, recommended for a healthy diet, daily was seen in the 12-14 months old age group with lower proportions in the 18-20 months old age group coinciding with an increased proportion of children eating discretionary choice foods, not recommended for a healthy diet. Discretionary choice foods/beverages presented in children's diets as early as in the 6-8 months old age group. By 18-20 months, at least 20% of children were consuming savoury biscuits, sweet biscuits, muesli bars and luncheon meats at least twice a week. Conclusions The present study identified a number of findings outside the recommendations of the Australian Dietary and Infant Feeding Guidelines. Further work is warranted to explore these outcomes. [ABSTRACT FROM AUTHOR]

Background The mainstay of dietary management of food allergies remains the elimination diet. However, the removal of major food groups may predispose children to an inadequate nutrient intake. We therefore set out to establish growth status in food allergic children receiving dietetic input in the UK. Methods Dietitians were approached via the Food Allergy and Intolerance Specialist Group from the British Dietetic Association and asked to submit anthropometrical data for children with food allergies. Data collected related to the systems involved and number of foods excluded. Malnutrition was defined according to World Health Organization standards. Results Data from 13 different centres yielded 97 patients (51 male and 46 female) of which 66 excluded ≤2 foods and 31 excluded ≥3 foods. Data indicated that 8.5% had a weight for age ≤ −2 Z-score and, conversely, 8.5% were ≥2 Z-score. For height for age, 11.1% were ≤ −2 Z-score and, for weight for height, 3.7% were ≤ −2 Z-score and 7.5% ≥2 Z-score. Type of allergy, system involved and specific food elimination did not impact on the level of malnutrition. However, the elimination of ≥3 foods significantly impacted on weight for age ( P = 0.044). Conclusions The present study demonstrates that children with food allergies are more underweight than the general UK population, which appears to be linked to the number of foods excluded. However, the impact of the disease process itself should not be disregarded. Additionally, obesity can also occur in this population despite dietary elimination. [ABSTRACT FROM AUTHOR]

Background Breastfed infants may grow more slowly in the second half of infancy than formula-fed infants, differences in weaning practice may contribute. Methods Dietary intakes of 4-month-old infants have been investigated cross-sectionally. Diet was assessed using a structured 1-day un-weighed dietary record in 852 white singletons (72% of those invited) from a random sub-sample of infants taking part in Avon Longitudinal Study of Parents and Children. Nutrient intakes of formula-fed infants were compared by sex and with UK reference values. Estimated mean energy and nutrient intakes, mean bodyweight and daily quantities of food consumed were compared by weaning practice. Results In formula-fed infants mean energy intakes and intakes of most nutrients were adequate. There were significant differences in intakes of most nutrients by weaning practice; however, mean energy intake and body weight of breastfed infants was similar to formula-fed infants. Infants given formula milk were less likely to consume vegetables and fruit, and more likely to consume commercial infant drinks, compared with infants who were breastfed. In breastfed infants breast milk intake was lower if solids were given (905 g versus 818 g; P = 0.01); however, nutrient intake was not compromised. In formula-fed infants milk intake was not different in those having solids compared to those having milk only (810 g versus 795 g; P = 0.649). Conclusions Differences in weaning practice and patterns of food consumption were seen between breast- and formula-fed infants, these may contribute to later growth differences. [ABSTRACT FROM AUTHOR]

Background It is recommended that infants from the age of 6 months should be introduced to drinking from a cup and the use of a bottle should be actively discouraged after the age of 1 year. The number of young children using a feeder bottle after the age of 1 year is not known but it is recognized by health professionals as a ‘growing’ concern. Aims To obtain local information about the number of children using a bottle past the age of 1 year, what fluids were being offered and to assess parental awareness about when a cup can be introduced. Methods The study data was collected by questionnaire from 407 parents between June 1998 and January 1999. Socially disadvantaged groups were targetted for the sample group as well as care being taken to include a representative ethnic population. Results Ninety-nine per cent of the study infants were below the age of 2 years, with the age range being 12-28 months. Thirty per cent were using only a cup/beaker, 8% of infants still used a bottle only, and 62% used both a bottle and a cup. Drinks/food other than milk and water had been offered from the bottle by 47% of respondents. More than 60% of the parents thought that the age at which the use of a bottle should be discontinued was older than that recommended. Only 18% thought a cup/beaker could be introduced as early as 6 months. Conclusion The results show that there is a need to actively encourage the use of a cup at an earlier age and to discourage the inappropriate and extended use of a feeder bottle. Barriers to change need to be addressed. [ABSTRACT FROM AUTHOR]

SummaryIntroduction: In previous reports, the diets of second- compared with first-generation adults have shown greater signs of acculturation. This study aimed to assess whether this was also true amongst 3-year-old UK-born children of first- (1G) (n=117) and second-generation (2G) (n=109) Pakistani mothers in Bradford. Materials and methods: A random sample of mothers was selected (n=320), with generation groups matched for month of birth, sex of child and district of residence. Home-based interviews were undertaken by multilingual female interviewers. Mother's social characteristics and infant feeding practices were examined and a 24-h dietary recall for the child was collected. Child's position in the family was not considered in this analysis. Results: Interviews were completed for 226 mothers (117, 1G and 109, 2G). The groups varied according to educational background, linguistic ability and employment status, but analysis of dietary recall indicated more similarities between the groups than differences. For example, traditional foods were limited to midday or evening meals, snacks usually consisted of crisps and biscuits, and sweetened milk or tea was consumed at breakfast. Some differences did exist: water was more likely to be consumed by children of 1G mothers at the midday and evening meals; fish and chips were a more frequent food item among those of 2G mothers. Conclusion: Evidence of dietary transition between groups was minimal using this methodology. This may be due to the cohesive nature of the Pakistani community resulting in it evolving in unison, or because all young children may be subject to similar dietary and cultural expectations and pressures. [ABSTRACT FROM AUTHOR]