Early introduction to solid foods for infants under 4 months old is highly prevalent in the United States, even though recommendations call for solid food introduction between 4 and 6 months of age, according to an article published onlineMarch 25 in Pediatrics. The early introduction may leave affected infants vulnerable to higher risk for chronic diseases, such as diabetes and obesity, researchers note.
Heather B. Clayton, PhD, MPH, from the Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues analyzed the responses of 1334 mothers who participated in the Infant Feeding Practices Study II between 2005 and 2007. The study group included women who returned completed questionnaires during the months after birth and indicated when they introduced solid foods to their infants and why.
Overall, 40.4% of mothers introduced solid foods before their infants were 4 months old (P < .05), and some did so earlier than 4 weeks of age. Mothers were more likely to do so if they were younger, were unmarried, had less education, earned less, and participated in the Women, Infants, and Children program.
When the researchers accounted for the type of milk feeding of infants, they found that 52.7% of mothers who formula-fed started solid feeding before 4 months, compared with 50.2% of mothers who reported mixed feeding and 24.3% of mothers who breast-fed.
Most mothers (88.9%) gave their reason as "My baby was old enough to begin eating solid food," and many others (71.4%) said, "My baby seemed hungry a lot of the time." Using logistic regression analysis adjusting for age, marital status, education, and other variables, the researchers found that mothers who breast-fed were less likely to cite the reason as "I wanted to feed my baby something in addition to breast milk or formula" compared with women who formula-fed (adjusted odds ratio [aOR], 0.62; 95% confidence interval [CI], 0.39 - 0.99). Mothers who formula-fed were almost twice as likely as mothers who breast-fed to give the reason "A doctor or other health care professional said my baby should begin eating solid food" (aOR 1.79; 95% CI, 1.15 - 2.80).
At the time of the surveys, the American Academy of Pediatrics recommendation for solid food introduction was 4 months. However, in 2012 the AAP changed that to 4 to 6 months, which would equate to a rate of early introduction of 92.9%, the researchers note.
Limitations of the study include the fact that most mothers were white and had moderate incomes. The researchers note that because mothers of lower socioeconomic status are at higher risk for early introduction of solid food, the study results may underestimate the true prevalence.
The researchers conclude, "Our study provides key information on why mothers introduced solid food earlier than recommended and how the commonly cited reasons varied by milk feeding type. This information can be used by health professionals to develop targeted interventions to improve adherence with infant feeding recommendations, with the goal of reducing any morbidity associated with early introduction of solid foods."
Pediatrics. Published online March 25, 2013. Abstract