Original ArticlesThe Impact of Timing of Introduction of Solids on Infant Body Mass Index
Section snippets
Methods
The HealthNuts study is a cross-sectional population-based study that recruited 5276 infants at 1 year of age from council-run immunization sessions in metropolitan Melbourne, Australia, between September 2007 and August 2011. The study design and sample recruitment have been described previously.21 In this study, we included 3153 participants with feeding information, weight and length measurements at age 9 to 15 months (1 year) (Figure 1; available at www.jpeds.com). Approval was obtained
Results
Compared with infants excluded in this analysis, those included were less likely to be of a lower SES status and less likely to have siblings (Table I; available at www.jpeds.com). Included infants were also more likely to be fully breastfed for 4-5 months, to be any breastfed for ≥12 months, and to have introduced solids at 5 months, and less likely to be fully breastfed for 2-3 months, to be any breastfed for 0-2 months, and introduced to solids at ≥7 months. Mothers of included infants were
Discussion
In this large population-based cohort of 1-year-old infants in Melbourne, Australia, we found that the relationship between age at introduction of solid foods and infant with an above normal BMI was U-shaped with introduction of solids at 5-6 months the lowest risk with regard to the development of above normal BMI at 1 year of age. The infants to whom solids were introduced before or at 4 months, compared with thoseintroduced to solids at 6 months, were about 3 times as likely to have an above
References (43)
- et al.
Global prevalence and trends of overweight and obesity among preschool children
Am J Clin Nutr
(2010) - et al.
Can infant feeding choices modulate later obesity risk?
Am J Clin Nutr
(2009) - et al.
Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 y: evidence from a large randomized trial
Am J Clin Nutr
(2007) - et al.
Population response to change in infant feeding guidelines for allergy prevention
J Allergy Clin Immunol
(2014) - et al.
Maternal prepregnant body mass index, duration of breastfeeding, and timing of complementary food introduction are associated with infant weight gain
Am J Clin Nutr
(2004) - et al.
Late introduction of complementary feeding, rather than duration of breastfeeding, may protect against adult overweight
Am J Clin Nutr
(2010) - et al.
Lower protein content in infant formula reduces BMI and obesity risk at school age: follow-up of a randomized trial
Am J Clin Nutr
(2014) - et al.
Protein intake during the period of complementary feeding and early childhood and the association with body mass index and percentage body fat at 7 y of age
Am J Clin Nutr
(2007) - et al.
How early should obesity prevention start?
N Engl J Med
(2013) Fat babies and fat children. The prognosis of obesity in the very young
Arch Dis Child
(1966)
Infant BMI or weight-for-length and obesity risk in early childhood
Pediatrics
Tracking of overweight status from childhood to young adulthood: the Bogalusa Heart Study
Eur J Clin Nutr
Breast-feeding and childhood obesity–a systematic review
Int J Obes
Timing of the introduction of complementary feeding and risk of childhood obesity: a systematic review
Int J Obes
Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence
Pediatrics
Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy
Arch Dis Child
Duration of breastfeeding and risk of overweight: a meta-analysis
Am J Epidemiol
Effects of promoting longer-term and exclusive breastfeeding on adiposity and insulin-like growth factor-I at age 11.5 years: a randomized trial
JAMA
Breastfeeding and body composition in children: will there ever be conclusive empirical evidence for a protective effect against overweight?
Am J Clin Nutr
The optimal duration of exclusive breastfeeding
American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas
Pediatrics
Cited by (41)
Timing of Introduction to Solid Food, Growth, and Nutrition Risk in Later Childhood
2022, Journal of PediatricsCitation Excerpt :Taken together, these findings support current AAP and WHO recommendations for introducing solid food around 6 months of age. Although previous studies have examined the relationship between timing of introduction to solid food and child growth,4-9 few have differentiated initiating solid food between 4 and 6 months of age. There is little evidence that introduction to solid food at 4 vs 6 months was associated with differences in weight or length in childhood; the authors noted a number of limitations of the existing literature, including lack of granularity on the timing of introduction to solid food between 4 and 6 months of age, poor understanding of the effect of early milk feeding (ie, breast or formula), and lack of evaluation of multiple outcomes (ie, weight, height, and feeding behavior).37
Effects of Breastfeeding, Formula Feeding, and Complementary Feeding on Rapid Weight Gain in the First Year of Life
2021, Academic PediatricsCitation Excerpt :While previous studies demonstrated interaction between breastfeeding duration and the timing of introduction of complementary foods,8,26 we did not find a significant interaction in our sample. Others have shown that introduction of solid foods before 4 months, compared to after 6 months, is associated with increased BMI for infants breastfed for <4 months as well as those breastfed for ≥4 months.8 Delaying introduction of solids after 7 months, compared to 5 to 6 months, is also associated with increased BMI for infants breastfed for <4 months, but not for infants breastfed ≥4 months of age.
Parental Feeding Beliefs and Practices and Household Food Insecurity in Infancy
2019, Academic PediatricsComplementary feeding practices and their association with adiposity indicators at 12 months of age
2021, Journal of Developmental Origins of Health and DiseaseWHO infant and young child feeding indicators in relation to anthropometric measurements
2020, Public Health Nutrition
Funded by the Australian National Health and Medical Research Council (NHMRC), Ilhan Food Allergy Foundation, Anaphylaxi-Stop, and ANZ Trustees Medical Research & Technology, Victoria. C.S. and J.K. are supported by the NHMRC Early Career Public Health Fellowships. K.A., A-.L.P., M.W., and A.L. are supported by the NHMRC Research Fellowships. Murdoch Childrens Research Institute is supported by the Victorian Government's Operational Infrastructure Support Program. The authors declare no conflicts of interest.
- *
Contributed equally.