Solid food introduction guidelines in infants ambiguous, can lead to unhealthy weights
Baltimore, Maryland: Portion sizes should be tightened in the current guidelines on complementary feeding, suggests a recent study published in the American Journal of Preventive Medicine. The study identified situations than can lead to unhealthy weights (overweight and underweight) in infants even while following these guidelines.
There are several recommendations that advise caregivers on how and when to introduce solid food to infants. These guidelines vary in terms of recommendations on portions and timings of the food.
On the national level, the CDC, the AAP and the United States Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants and Children have all issued recommendations for introducing solids, otherwise known as complementary foods, into infants’ diets. Additionally, hospitals and infant formula manufacturers have provided recommendations on introducing complementary foods.
Every infant is different, having different body types, sizes and circumstances, so it becomes difficult to have one-size-fits-all recommendations.
Bruce Y. Lee, Public Health Computational and Operations Research (PHICOR), Baltimore, Maryland, and colleagues aimed to determine the impact of following different guidelines on weight trajectories of infants.
For the purpose, the researchers developed a computational simulation model to capture feeding behaviours, activity levels, metabolism, and body size of infants from 6 months to 1 year. The infants’ daily food intake in the simulation model was based on feeding recommendations endorsed by Johns Hopkins Medicine, the Children’s Hospital of Philadelphia, Similac and Enfamil, which changed the infants’ body weight.
Additional simulations were conducted to test the impact of the following complementary feeding recommendations that provided amount, type, and timing of foods: Children's Hospital of Philadelphia, Johns Hopkins Medicine, Enfamil, and Simi. They found that:
- When virtual caregivers fed infants according to the four different guides, none of the simulated situations resulted in normal weight at 12 months when infants were also being breastfed along average observed patterns.
- Reducing breast milk portions in half while caregivers fed infants according to complementary feeding guidelines resulted in overweight BMIs between 9 and 11 months for Children's Hospital of Philadelphia, Johns Hopkins Medicine, and Enfamil guidelines.
- Cutting breast milk portions in half also led to infants reaching unhealthy underweight BMI percentiles between 7 and 11 months for female and male infants when caregivers followed Children's Hospital of Philadelphia, Johns Hopkins Medicine, and Similac guidelines.
"Parents should be mindful of their child’s responses before, during and after eating to look for signs that their child is no longer hungry," advise the researchers.
"This study shows that existing complementary feeding guidelines have a high likelihood of resulting in overfeeding within the first year of life. Feeding experts and paediatricians should focus on providing tighter complementary feeding guidelines to caregivers, particularly in the later months of the first year of life," they concluded.
To read the complete study follow the link: https://doi.org/10.1016/j.amepre.2019.04.011