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Quality of complementary feeding and its effect on nutritional status in preterm infants: a cross-sectional study
S A Ribas1, M C C de Rodrigues2, M C Mocellin3
1Department of Nutrition in Public Health, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Insights
The quality of complementary feeding (CF) in the first two years impacts infant growth. Poor diet quality in preterm infants was linked to lower weight-for-age scores at two years old.
Area of Science:
- Pediatrics
- Nutritional Science
- Public Health
Background:
- The first two years of life are critical for infant development.
- Dietary quality during this period has lifelong health implications.
- Preterm infants may face unique nutritional challenges.
Purpose of the Study:
- To develop an Index for Measuring the Quality of Complementary Feeding (IMQCF).
- To assess diet quality in preterm infants up to two years corrected age.
- To evaluate the impact of diet quality on preterm infant nutritional status.
Main Methods:
- Cross-sectional study at a Brazilian University Hospital.
- Dietary data collected via 24-hour recalls from preterm infants at 2 years corrected age.
- Diet quality assessed using the IMQCF, with growth indicators analyzed using regression.
Main Results:
- Median IMQCF score was 72.2; factors like shorter breastfeeding and early introduction of certain foods reduced diet quality.
- Poor complementary feeding quality was associated with lower weight-for-age Z-scores (WAZ).
- Specifically, an association was found between diet quality score and WAZ (0.44; P=0.03).
Conclusions:
- Suboptimal complementary feeding in early life negatively affects preterm infants' diet quality.
- This can impact their nutritional status at two years corrected age.
- Potential long-term health consequences warrant further investigation.
Background:
The first 2 years of life represent a critical phase for growth and development, with the quality of the diet at this stage having repercussions throughout adulthood. The present study aimed to develop an Index for Measuring the Quality of Complementary Feeding (IMQCF) for infants, as well as to evaluate diet quality and its effects on the nutritional status of preterm infants.
Methods:
This cross-sectional study was conducted at a Brazilian University Hospital. The data were extracted by care protocol of outpatient preterm infants at 2 years of corrected age (CA). Dietary data were collected from 24-h recalls. The diet quality was assessed by the IMQCF composed of nine items based on a Brazilian Food Guide for children aged <2 years. Response options were scored 0-100, with scores closer to 100 representing a better quality diet. Association with growth indicators (Z-scores for weight- and length-for-age (WAZ and LAZ) were evaluated via tests of mean difference and multiple linear regression.
Results:
The median complementary feeding (CF) score was 72.2 (61.1-77.8) A shorter breastfeeding duration or infant formula use and the early introduction of wheat-based foods, ultra-processed foods and cow's milk in the preterm's diet were the main factors interfering in the adequacy of diet. There was an association between the quality of the diet score and WAZ (0.44; 95% confidence interval = 0.03-0.85; P = 0.03).
Conclusions:
The introduction of poor quality food in the first 2 years of life interfered with the CF quality of preterm infants and can affect nutritional status at 2 years of CA, possibly in the long term.
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