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Age of introduction of first complementary feeding for infants: a systematic review.

Qasem W, Fenton T, Friel J - BMC Pediatr (2015)

Bottom Line: Meta-analysis showed significantly higher hemoglobin levels in infants fed solids at 4 months versus those fed solids at 6 months in developing countries [mean difference [MD]: 5.0 g/L; 95% CI: 1.5, 8.5 g/L; P = 0.005].Meta-analysis also showed higher serum ferritin levels in the 4-month group in both developed and developing countries [MD: 26.0 μg/L; 95% CI: -0.1, 52.1 μg/L, P = 0.050], [MD: 18.9 μg/L; 95% CI: 0.7, 37.1 μg/L, P = 0.040].Short follow-up periods and small sample sizes of the included studies were the major limitations.

View Article: PubMed Central - PubMed

Affiliation: Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada. wafaaqasem@yahoo.com.

ABSTRACT

Background: Despite a World Health Organization recommendation for exclusive breastfeeding of all full-term infants to 6 months of age, it is not clear what the health implications may be. Breast milk alone may not meet the nutrition needs for all growing infants, leaving them at risk for deficiencies. The objective of this study was to investigate the relationship between moderate (4 months) versus late (6 months) introduction of complementary foods to the full-term breastfed infant on iron status and growth.

Methods: An electronic search of peer-reviewed and gray-literature was conducted for randomized control trials (RCTs) and observational studies related to the timing of introduction of complementary foods. Iron status and growth data from the relevant RCTs were analyzed using RevMan 5.2.11.

Results: Three RCTs and one observational study met the inclusion criteria. Meta-analysis showed significantly higher hemoglobin levels in infants fed solids at 4 months versus those fed solids at 6 months in developing countries [mean difference [MD]: 5.0 g/L; 95% CI: 1.5, 8.5 g/L; P = 0.005]. Meta-analysis also showed higher serum ferritin levels in the 4-month group in both developed and developing countries [MD: 26.0 μg/L; 95% CI: -0.1, 52.1 μg/L, P = 0.050], [MD: 18.9 μg/L; 95% CI: 0.7, 37.1 μg/L, P = 0.040]. Short follow-up periods and small sample sizes of the included studies were the major limitations.

Conclusions: RCT evidence suggests the rate of iron deficiency anemia in breastfed infants could be positively altered by introduction of solids at 4 months.

No MeSH data available.


Related in: MedlinePlus

Iron status analysis from developed countries
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Fig2: Iron status analysis from developed countries

Mentions: A total of two RCTs assessed iron status outcomes (Table 1). Meta-analysis (Fig. 2.1) suggested that introduction of solids at 4 months of age did not improve hemoglobin status of breastfed infants in developed countries compared with introduction at 6 months of age [mean difference [MD]: 0.2 g/L; 95 % CI: -2.4, 2.8 g/L; P = 0.88]. In developing countries, however (Fig. 3.1), significant improvement was detected with the earlier introduction of solids [MD: 5.0 g/L; 95 % CI: 1.5, 8.5 g/L; P = 0.005]. Plasma ferritin concentration was improved with introduction of solids at 4 months of age for infants living in both developed and developing countries [MD: 26.0 μg/L; 95 % CI: −0.1, 52.1 μg/L, P = 0.050], [MD: 18.9 μg/L; 95 % CI: 0.7, 37.1 μg/L, P = 0.040] (Figs. 2.2 & 3.2). The included observational study did not include iron parameters.Fig. 2


Age of introduction of first complementary feeding for infants: a systematic review.

Qasem W, Fenton T, Friel J - BMC Pediatr (2015)

Iron status analysis from developed countries
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4557230&req=5

Fig2: Iron status analysis from developed countries
Mentions: A total of two RCTs assessed iron status outcomes (Table 1). Meta-analysis (Fig. 2.1) suggested that introduction of solids at 4 months of age did not improve hemoglobin status of breastfed infants in developed countries compared with introduction at 6 months of age [mean difference [MD]: 0.2 g/L; 95 % CI: -2.4, 2.8 g/L; P = 0.88]. In developing countries, however (Fig. 3.1), significant improvement was detected with the earlier introduction of solids [MD: 5.0 g/L; 95 % CI: 1.5, 8.5 g/L; P = 0.005]. Plasma ferritin concentration was improved with introduction of solids at 4 months of age for infants living in both developed and developing countries [MD: 26.0 μg/L; 95 % CI: −0.1, 52.1 μg/L, P = 0.050], [MD: 18.9 μg/L; 95 % CI: 0.7, 37.1 μg/L, P = 0.040] (Figs. 2.2 & 3.2). The included observational study did not include iron parameters.Fig. 2

Bottom Line: Meta-analysis showed significantly higher hemoglobin levels in infants fed solids at 4 months versus those fed solids at 6 months in developing countries [mean difference [MD]: 5.0 g/L; 95% CI: 1.5, 8.5 g/L; P = 0.005].Meta-analysis also showed higher serum ferritin levels in the 4-month group in both developed and developing countries [MD: 26.0 μg/L; 95% CI: -0.1, 52.1 μg/L, P = 0.050], [MD: 18.9 μg/L; 95% CI: 0.7, 37.1 μg/L, P = 0.040].Short follow-up periods and small sample sizes of the included studies were the major limitations.

View Article: PubMed Central - PubMed

Affiliation: Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada. wafaaqasem@yahoo.com.

ABSTRACT

Background: Despite a World Health Organization recommendation for exclusive breastfeeding of all full-term infants to 6 months of age, it is not clear what the health implications may be. Breast milk alone may not meet the nutrition needs for all growing infants, leaving them at risk for deficiencies. The objective of this study was to investigate the relationship between moderate (4 months) versus late (6 months) introduction of complementary foods to the full-term breastfed infant on iron status and growth.

Methods: An electronic search of peer-reviewed and gray-literature was conducted for randomized control trials (RCTs) and observational studies related to the timing of introduction of complementary foods. Iron status and growth data from the relevant RCTs were analyzed using RevMan 5.2.11.

Results: Three RCTs and one observational study met the inclusion criteria. Meta-analysis showed significantly higher hemoglobin levels in infants fed solids at 4 months versus those fed solids at 6 months in developing countries [mean difference [MD]: 5.0 g/L; 95% CI: 1.5, 8.5 g/L; P = 0.005]. Meta-analysis also showed higher serum ferritin levels in the 4-month group in both developed and developing countries [MD: 26.0 μg/L; 95% CI: -0.1, 52.1 μg/L, P = 0.050], [MD: 18.9 μg/L; 95% CI: 0.7, 37.1 μg/L, P = 0.040]. Short follow-up periods and small sample sizes of the included studies were the major limitations.

Conclusions: RCT evidence suggests the rate of iron deficiency anemia in breastfed infants could be positively altered by introduction of solids at 4 months.

No MeSH data available.


Related in: MedlinePlus