[Infant food diversification: Is the information available on the Internet valid?]

The Internet provides easy access to information on health, but the quality and validity of this information are variable.

To evaluate the quality of websites and the information provided on the timing and consequences of food diversification for infants.

We analyzed the websites addressing infant food diversification that appeared on the first two pages of the search engines Google, Yahoo, and Bing. The websites were selected from four different queries. We initially assessed (a) the structure of the websites with two instruments (the Criteria for Assessing the Quality of Health Information on the Internet (HITI) and NetScoring) and (b) the presence of certification (quality label Health on the Net [HON] Code). Secondly, we evaluated the content of the websites concerning the time of introducing five classes of foods (gluten, fat, allergenic foods, solid foods, and animal protein), the duration of breastfeeding, and four potential consequences of food diversification (allergy, nutritional, autoimmune, and cardiovascular). Our repository was based on the most recent recommendations of the French Society of Pediatrics published in 2008.

In all, 19 websites were included. Six of 19 websites scored above average on the two instruments (average: 131.26/312 with NetScoring and 46.73/104 with HITI). No correlation was observed between the referencing of websites analyzed and the notes obtained with both instruments. A majority of the websites analyzed were consistent with the recommendation favoring breast milk (100%), the age of introducing meat proteins (74%), and the age of introducing gluten (63%). A majority of the websites disagreed on the age of introducing solid foods (16%). As four consequences, only the risk of allergy (63%) was cited by a majority of the sites. There was a small nonsignificant correlation between the results obtained for the website about introducing solid foods and the results obtained for the websites analyzed with the NetScoring and HITI instruments (Pearson coefficient 41%, p=0.07).

The websites were in partial agreement with the French recommendations. To date, the pediatrician remains the main actor in guiding parents on food diversification.