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Meta-Analysis
. 2015 Sep 2:15:107.
doi: 10.1186/s12887-015-0409-5.

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

Wafaa Qasem  1   2 , Tanis Fenton  3 , James Friel  4   5
Affiliations
Meta-Analysis

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

Wafaa Qasem et al. BMC Pediatr. .

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.

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Figures

Fig. 1
Fig. 1
Study flow of the systematic review
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Iron status analysis from developed countries
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Iron status analysis from developing countries
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Weight analysis from developed countries
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Length analysis from developed countries
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Head circumference analysis from developed countries
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Growth analysis from developing countries
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References

    1. World Health Organization. Infant and young child feeding. 2010. http://www.who.int/mediacentre/factsheets/fs342/en/. Accessed November 17 2013.
    1. Health Canada Nutrition for healthy term infants: recommendations from birth to six months. Can J Diet Pract Res. 2012;73:204. doi: 10.3148/73.4.2012.204. - DOI - PubMed
    1. Rowland MG. The weanling’s dilemma: are we making progress? Acta Paediatr Scand Suppl. 1986;323:33–42. doi: 10.1111/j.1651-2227.1986.tb10348.x. - DOI - PubMed
    1. Shrimpton R, Victora CG, de Onis M, Lima RC, Blossner M, Clugston G. Worldwide timing of growth faltering: implications for nutritional interventions. Pediatrics. 2001;107:E75. doi: 10.1542/peds.107.5.e75. - DOI - PubMed
    1. Lozoff B, Beard J, Connor J, Barbara F, Georgieff M, Schallert T. Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev. 2006;64:S34–43. doi: 10.1301/nr.2006.may.S34-S43. - DOI - PMC - PubMed