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The timing of complementary feeding in preterm infants and the effect on overweight: study protocol for a systematic
Karin M Vissers1, Edith J M Feskens2, Johannes B van Goudoever3
1Department of Pediatrics, Hospital Gelderse Vallei, Ede, The Netherlands.
Insights
This systematic review examines the impact of complementary feeding timing on overweight in preterm infants. It aims to clarify conflicting research and inform future feeding guidelines for this vulnerable population.
Area of Science:
- Pediatrics
- Nutrition Science
- Public Health
Background:
- Early complementary feeding is linked to childhood obesity in term infants.
- Current guidelines from WHO and ESPGHAN for complementary feeding are not directly applicable to preterm infants.
- Conflicting literature exists regarding the optimal timing of complementary feeding for preterm infants.
Purpose of the Study:
- To systematically review the existing literature on the timing of complementary feeding in preterm infants.
- To analyze the effect of the timing of complementary feeding on the risk of overweight (including obesity) in preterm infants.
Main Methods:
- A comprehensive electronic systematic literature search will be conducted across multiple databases (Cochrane, PubMed, EMBASE, Web of Science, Scopus, CINAHL).
- Randomized controlled trials (RCTs) will be the primary data source, with no time restrictions.
- Independent review by three researchers, including risk of bias assessment, and use of Body Mass Index standard deviation score (BMI-SDS) for comparisons.
Main Results:
- This section is to be populated upon completion of the systematic review and data analysis.
Conclusions:
- This systematic review will consolidate current knowledge on complementary feeding timing in preterm infants and its association with overweight.
- Findings will provide evidence to support the development of tailored guidelines for complementary feeding in preterm infants.
Background:
In term infants, there is evidence that early complementary feeding is a risk factor for childhood obesity. Therefore, timely introduction of complementary feeding during infancy is necessary. The World Health Organization (WHO) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) both developed recommendations for the start of complementary feeding for term-born infants. However, these guidelines cannot be directly translated to preterm infants. Recent literature looking at the introduction of complementary feeding in preterm infants gives contrasting information. Given these contrasting reports on the introduction of solid foods in premature born infants, a systematic review is needed. The primary objective of this study is to analyze the effect of the time starting complementary feeding on overweight (including obesity) in preterm infants.
Methods:
An electronic systematic literature search with pre-defined terms will be conducted in Cochrane, PubMed, EMBASE, Web of Science, Scopus, and CINAHL. There will be no restriction for time period. Primarily, data from randomized controlled trials (RCTs) will be included in this systematic review. Search terms will include preterm infants, complementary feeding, overweight, and their synonyms. Article selection, including risk of bias assessment, will be performed by three reviewers independently. Body mass index standard deviation score (BMI-SDS or BMI-Z-score) will be used to compare studies. The consistency of results across the studies will influence the decision whether or not to combine results in a meta-analysis. Studies that cannot be included in the meta-analysis will be described in a narrative analysis.
Discussion:
This systematic review will give an overview of the existing knowledge on the timing of complementary feeding in preterm infants and the effect on overweight. It will form a basis for future guidelines for complementary feeding for preterm infants.
Systematic Review Registration:
PROSPERO CRD42015014215.
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