Complementary feeding practices in preterm infants: an observational study in a cohort of Italian infants

There are no evidence-based guidelines for weaning preterm infants, and the timing of weaning and the diet offered tend to reflect tradition and marketing rather than medical advice.

In a survey of complementary feeding practices in preterm infants conducted at the University Hospital of Ferrara, Italy, we evaluated the effect of sex, gestational age (GA), birth weight (BW), and milk feeding, and of the mother's age, education, and professional status, on weaning.

Complete data were available for 156 infants. Solid food was introduced, on average, 22.2 weeks after birth and 15.1 weeks after term; 6.5% of infants (considering chronological age) and 60.9% (considering corrected age) were weaned before 4 months; 18% of infants weighed <5 kg at weaning (most had low GA and BW). Among maternal factors, only age significantly influenced the weaning schedule. Milk feeding did not affect initiation of weaning; however, formula-fed infants, most of whom had lower GA and BW, were lighter and younger (from term) than were their counterparts. The first solid food was mashed fruit in 46.8% of cases. Meat and gluten were offered 5 and 7 weeks (average) after the initiation of weaning.

A matter of concern emerging from our study is that in almost 50% of cases, the first solid food offered to infants is low in energy density, and its protein, iron, and zinc content is negligible. It is evident that despite the lack of a general consensus, mothers of preterm babies should receive customized instructions from family pediatricians and health caregivers about weaning.