The Early Introduction of Complementary (Solid) Foods: A Prospective Cohort Study of Infants in Chengdu, China

Abstract

The objective of this study was to document the types of foods introduced to infants before six months of age and identify factors associated with their early introduction. A prospective cohort study of infant feeding for the first six months after birth was undertaken in the city of Chengdu, PR China. The participants were 845 mothers who delivered their infants in hospitals in Chengdu. Mothers were interviewed within 15 days of giving birth and were followed up with for six months. The outcome measures were the introduction of complementary foods to infants within four and six months postpartum. Complementary foods are defined as any food, whether manufactured or locally prepared, used as a complement to breast milk or infant formula. In this study the emphasis was on solids and not liquid foods. More than 94% of the infants were given complementary foods (semi-solid or solid foods) before the age of six months and 10% by four months. The most commonly introduced food was infant cereal, which was given to three quarters of the infants by six months. Multivariate analysis showed that maternal education level was a significant factor affecting the introduction of complementary foods before four months, adjusted odds ratio 2.983 (1.232–7.219), with the more educated mothers introducing complementary foods earlier. More antenatal and postnatal health promotion efforts are required to highlight the benefits of introducing solid foods later than is the current practice in Chengdu, at or close to six months of age. Further education is also required for training health professionals including pediatricians, midwives, and community health staff.

The risk of inappropriate timing of complementary foods introduction is increased among first-time mothers and poor households

“…Maternal education was among the factors which did not have a significant relationship with inappropriate timing of introducing complementary foods. Our finding was the opposite of an earlier study conducted among Chinese population in which maternal education was the only significant factor associated with the introduction of complementary food (40). However, high educational attainment does not always represent the desirable knowledge of infant and young child feeding (41).…”

Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants—Results from HSHK Birth Cohort Study

“…The transition from exclusive breastfeeding or formula-feeding to complementary foods is essential for children's growth and development as well as their long-term health status [6,7]. Early introduction of complementary foods may lead to nutritional or energy imbalance due to replacement of milk in the diet, potentially increasing the risk of gastrointestinal diseases, and food allergies [8]. It can also lead to chronic diseases such as obesity [9] and early childhood caries (ECC) [10] that are highly prevalent amongst young Australian children [11,12].…”

Guidelines for Complementary Feeding of Infants in the Asia Pacific Region: APACPH Public Health Nutrition Group

“…In East Asia and the Pacific region, there are a number of small studies, but partly because of the variety of cultural practices, it is difficult to give a universal description of the complementary feeding practices in the region. 25-29…”