糖心vlog

The American Academy of Pediatrics recommends introducing complementary foods to infants at 6 months.^1,2 Although there is no consensus on ideal timing, most agree that introduction of complementary foods before 4 months is too early.^1,2 Early introduction precludes the first 6 months of exclusive breastfeeding and may increase risk of childhood obesity.³ Previous studies reported that 1 in 6 US infants was introduced to complementary foods before 4 months.^4,5 This report analyzes temporal changes in prevalence of early complementary food introduction to US children from 2016 to 2022 and provides up-to-date evidence.

The US National Survey of Children鈥檚 Health (NSCH) is a representative survey for monitoring the health and well-being of noninstitutionalized children 17 years or younger.⁶ Data are collected annually from parents or other primary caregivers. This study used the NSCH data from 2016 to 2022 (released on April 24, 2024) to assess trends in prevalence of early introduction (<4 months) of complementary foods to children aged 1 year or younger. Parents or caregivers provided written informed consent for data collection. Because publicly available, anonymized data were used, the institutional review board of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, deemed this study exempt from review. This study followed the reporting guideline.

Timing of introduction of complementary foods was assessed by asking 鈥淗ow old was this child when he or she was first fed anything other than breast milk or formula?鈥� The survey package in R statistical software, version 4.3.2, was used, taking into account the complex survey design and weights. Weighted data were used to assess sociodemographic characteristics and prevalence of early introduction of complementary foods. Trends and changes in slopes (up to 1 joinpoint) were assessed using Joinpoint, version 5.0.2, by calculating the mean annual percentage change and 95% CI, overall and among subgroups. A 2-tailed P鈥�<鈥�.05 indicates significance.

From 21鈥�860 children, we excluded 566 with missing data on the start of complementary foods, 157 who started after 12 months, and those with implausible feeding patterns (recalled breastfeeding duration, infant formula introduction, and complementary feeding introduction indicated 鈮�2 months with no source of nutrition [n鈥�=鈥�37]; answer for all 3 feeding patterns was 鈥渘o鈥� [n鈥�=鈥�16]). We also excluded 2900 infants younger than 4 months, leaving 18鈥�184 children (51.4% boys and 48.6% girls). Table 1 presents the study population鈥檚 characteristics.

The overall prevalence of early introduction to complementary feeding was 10.7% (95% CI, 9.6%-11.8%) (Table 2). The percentage varied sociodemographically, with a substantially higher prevalence among Black children and children from households with low income, low education, and smoking. There were no significant changes in prevalence of early introduction of complementary foods between 2016 and 2022. However, a significant decrease in this practice was observed among White children, with a decrease from 11.2% (95% CI, 8.8%-13.5%) to 6.2% (95% CI, 4.6%-7.8%), with a 鈭�9.9% (95% CI, 鈭�15.0% to 鈭�4.4%) mean decrease per year cycle (P鈥�=鈥�.006 for trend).

We found that 1 in 10 US children was introduced to complementary foods before 4 months; this was more common among children from households with lower socioeconomic status, suggesting a similar sociodemographic pattern but lower prevalence of early complementary food introduction compared with previous studies.^4,5 In this study, a downward trend became apparent across most groups, but was statistically significant only among White children. The findings suggest more education is needed to reduce early complementary feeding practices among US women of racial and ethnic minority groups. Limitations include that the data do not allow for causal inferences about the effects of other determinants on the introduction of complementary foods. To promote adherence to guidelines for introducing complementary foods, health care professionals may need to assess and address maternal beliefs about feeding infants younger than 6 months old substances other than breast milk or formula.

Accepted for Publication: August 26, 2024.

Published: October 11, 2024. doi:10.1001/jamanetworkopen.2024.40255

Open Access: This is an open access article distributed under the terms of the CC-BY License. 漏 2024 Ding G et al. 糖心vlog Open.

Corresponding Author: Yongjun Zhang, PhD, MD, Department of Pediatrics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 1665 Kong jiang Rd, Shanghai 200092, China (zhangyongjun@sjtu.edu.cn).

Author Contributions: Dr Zhang had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Ding, Peng, and Chen contributed equally to this work.

Concept and design: Ding, Peng, Zhang.

Acquisition, analysis, or interpretation of data: Ding, Peng, Chen, Vinturache.

Drafting of the manuscript: Ding, Peng.

Critical review of the manuscript for important intellectual content: Chen, Vinturache, Zhang.

Statistical analysis: Ding, Peng.

Administrative, technical, or material support: Ding, Peng, Zhang.

Supervision: Zhang.

Conflict of Interest Disclosures: None reported.

Data Sharing Statement: See the Supplement.

Additional Contributions: The National Survey of Children鈥檚 Health team and all participants involved in our study are acknowledged.