Complementary Feeding Practices in a Cohort of Italian Late Preterm Infants

Abstract

Limited data are available on complementary feeding in preterm infants, who show increased nutritional needs and are at risk of altered postnatal growth. The aim of this study was to investigate the timing and content of complementary feeding in a cohort of late preterm infants. We conducted a prospective, observational study, including mothers who had given birth to infants admitted to level I or II of care with a gestational age between 34 and 36 weeks. Mothers were contacted at 3, 6 and 12 months after delivery by phone calls and were asked about their infant’s mode of feeding and the timing and schedule of the introduction of different solid foods types. A total of 49 mothers and 57 infants completed the study. The mean postnatal age of the introduction of complementary foods was 5.7 ± 0.7 months. Low energy and/or low protein-dense foods were first introduced in most infants. Fruit as the first type of complementary food in the infant’s diet was associated with a 1.6-month advance in initiating complementary feeding. The present findings provide further insight into complementary feeding practices in late preterm infants and underline the need for specific recommendations addressing this vulnerable population.

Factors Influencing the Age of Complementary Feeding—A Cross-Sectional Study from Two European Countries

“…We also found that every week of pregnancy duration was associated with a decrease of 33% of odds of early introduction to solids. On the other hand, a study of late preterm infants from Italy showed that in most cases, infants were introduced to complementary foods within 4 and 6 months of postnatal age [38]. Currently, there is no specific recommendation about introducing complementary feeding in prematurely born infants; nonetheless, it should be considered due to increased nutritional requirements, and the possibility of delayed motoric development, feeding difficulties or respiratory compromise depending on gestational age or comorbid diseases [37].…”

Complementary Feeding in Preterm Infants: A Systematic Review

“…After examining the full texts of the 40 retrieved papers, 14 were excluded, as 9 did not actually deal with CF and 5 reported data only about term infants, leading to 26 suitable studies [ 5 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Five additional papers were identified from the reference lists of included studies [ 33 , 34 , 35 , 36 , 37 ]; 31 studies were then included in the systematic review [ 5 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ,…”

“…Among these, there were six narrative reviews [5,14,15,22,27,32], one systematic review [13], two meta-analyses [11,33], one commentary [17], two recommendations [36,37] and one study protocol [31]. Among the remaining 18 trials, there were 14 observational studies [6,9,10,12,[18][19][20][21]24,[28][29][30]34,35], two randomized controlled trials (RCTs) [16,25] and two papers pooling data from different RCTs [23,26].…”

“…Giannì, 2018 [29] Observational trial Evaluation of practices related to CF in a cohort of Italian late preterm infants. Late preterm infants were weaned at almost six months of age and received low energy and/or low protein-dense foods as first solid foods.…”

“…[6]. Data from an observational study performed in Italy suggest that late preterm (GA 34-36 weeks) infants are also introduced to solid foods earlier than recommended, at a mean postnatal age of 5.7 months and a mean CA of 4.6 months [29]. In this cohort, specific feeding practices were associated with huge variation in the timing of CF: specifically, the introduction of fruit as the first type of solid food was associated to a 1.4 months earlier CF initiation.…”