Age of introduction of complementary foods and growth of term, low-birth-weight, breast-fed infants : a randomized intervention study in Honduras

• Published in: The American journal of clinical nutrition Vol. 69; no. 4; pp. 679 - 686
• Main Authors: DEWEY, K. G, COHEN, R. J, BROWN, K. H, LANDA RIVERA, L
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 01.04.1999; American Society for Clinical Nutrition, Inc
• Subjects: Adult; Age Factors; Babies; Biological and medical sciences; Birth Weight; Breast Feeding; Breastfeeding & lactation; Child development; Energy Intake; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Health Status; Honduras; Humans; Infant Food; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Small for Gestational Age - growth & development; Male; Nutrition; Social Class; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Central America; Honduras; America; Human; Newborn; Nutrition; Weaning; Low birth weight; Breast feeding; Feeding; Food supplement
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/69.4.679

The optimal age at which to introduce complementary foods is a topic of considerable debate. This study was designed to evaluate this issue in a nutritionally vulnerable population in Honduras. Mothers of low-birth-weight (1500-2500 g) term (ie, small-for-gestational-age) infants were recruited in the hospital and assisted with exclusive breast-feeding during the first 4 mo. At 4 mo, mothers were randomly assigned to either continue exclusive breast-feeding to 6 mo (EBF; n = 59) or to feed complementary solid foods (jarred rice cereal, chicken, and fruit and vegetables) twice daily from 4 to 6 mo while continuing to breast-feed at their initial frequency (SF; n = 60). At 4 and 6 mo, breast milk and total energy intake were measured for a nonrandom subsample (those who could stay overnight in a central unit: 32 EBF and 31 SF). At 4 mo, breast milk intake in the subsample was not significantly different between groups (EBF: 729 +/- 135 g/d; SF: 683 +/- 151 g/d: P >0.2); from 4 to 6 mo it increased (by 28 g/d) in the EBF group but decreased (by 39 g/d) in the SF group (P < 0.005). Nonetheless, total energy intake (including solid foods) increased more from 4 to 6 mo in the SF than in the EBF group. However, there were no significant differences between groups in weight or length gain during the intervention or subsequently (6-12 mo). There was no growth advantage of complementary feeding of small-for-gestational-age, breast-fed infants between 4 and 6 mo of age.