A recent study that investigated when infants are first given solid foods has found that more than half of babies receive non-milk products earlier than recommended.
Introducing babies to complementary foods, or anything other than breast milk or formula, too early can mean that a baby may miss out on important nutrients from milk.
Similarly, if complementary foods are introduced too late, there is an increased risk of allergies, micronutrient deficiencies, and a poorer diet during adulthood.
For these reasons, it is vital that guidelines are correct, understood, and adhered to by the majority of the population.
In the past 60 years, recommendations have shifted significantly. In 1958, for example, guidelines were released saying that babies should be introduced to complementary foods in their third month of life.
In the 1970s, however, this was pushed back to their fourth month. And in the 1990s, the timing was pushed back further to 6 months old, which is where it stands today, according to the American Academy of Pediatrics.
Given these fluctuations, the lack of adherence to current guidelines is perhaps unsurprising.
Modern timing of solid food introduction
A study published this week in the Journal of the Academy of Nutrition and Dietetics delved into data from the 2009–2014 National Health and Nutrition Examination Survey. The researchers wanted to explore whether or not the current 6-month guideline was being adhered to.
The team was led by Chloe M. Barrera, of the Division of Nutrition, Physical Activity, and Obesity at the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA.
In total, data were taken from 1,482 children aged 6–36 months. Information was gathered through household interviews: the parent or guardian was asked at what age the child was given anything other than breast milk or formula. This includes sugar water, cow's milk, and baby food.
The researchers found that only 32.5 percent of babies in the United States were introduced to complementary foods at around the 6-month mark. And, more than half of infants (54.6 percent) were introduced to complementary foods before 6 months of age.
Breaking it down still further, 16.3 percent received complementary foods before 4 months, 38.3 percent at 4–5 months, and 12.9 percent at 7 months or older.
Babies who were not breast-fed, or who were breast-fed for 4 months or under, were more likely to be introduced to complementary foods earlier than 6 months. This link remained significant even after controlling for various factors, including sex of the baby, age of mother, race, and smoking during pregnancy.
New guidelines to come
However, these studies did not use a nationally representative sample, and some of them are now a decade old, which might explain the substantial differences in their findings.
Additionally, the older studies did not take into account the introduction of fluids other than milk or formula; they only focused on solids. This distinction is important, as the authors explain:
"The timing of when non-milk liquids are introduced is important to consider, as early introduction of non-milk liquids is thought to compromise adequate intake of nutrients that come from breast milk and infant formula, and reduce the duration of breast-feeding among breast-fed infants."
The findings mark the first study to have looked at this question using a nationally representative dataset, and there is still a worrying deviation from the guidelines.
As the authors explain, "Efforts to support caregivers, families, and healthcare providers may be needed to ensure that U.S. children are achieving recommendations on the timing of food introduction."
For the very first time, the U.S. Department of Agriculture and Department of Health and Human Services are writing federal dietary guidelines for children under 2 years of age. Barrera and colleagues hope that this might help to rectify the situation.
They write, "Inclusion of children under 2 in the 2020–2025 Dietary Guidelines for Americans may promote consistent messaging of when children should be introduced to complementary foods."
Hopefully, as the message becomes clearer and the guidelines are disseminated more thoroughly, the gap between recommendation and reality will steadily close.