Recommendations on Complementary Food Introduction Among Pediatric Practitioners

Area of Science:

• Pediatric Nutrition
• Infant Feeding Practices
• Food Allergy Prevention

Background:

• Current guidelines from the American Academy of Pediatrics and CDC recommend a 3-5 day waiting period between introducing new complementary foods to infants.
• Advances in understanding infant food diversity and allergy prevention necessitate a review of current pediatric practitioner recommendations.

Purpose of the Study:

• To characterize pediatric practitioner recommendations on complementary food introduction timing and waiting periods between new foods.
• To assess alignment between current pediatric practice and existing feeding guidelines.

Main Methods:

• A 23-item electronic survey was distributed to pediatric health care professionals.
• The survey targeted physicians, resident physicians, and nurse practitioners providing care to infants aged 12 months or younger.
• Data were collected from February 1 to April 30, 2019, from members of the Illinois Chapter of the American Academy of Pediatrics and the national AAP Council on Early Childhood.

Main Results:

• A response rate of 27.3% was achieved, with 563 final analyses.
• Only 38.6% of practitioners recommended waiting 3 days or longer between food introductions, compared to 66.3% for infants at risk for food allergy.
• Significant variation existed in recommendations for the first complementary food, introduction order, and age of introduction based on breastfeeding status.

Conclusions:

• Most pediatric practitioners do not adhere to the 3-day waiting period recommendation unless infants are at high risk for food allergy.
• Current practices may restrict infant food diversity and delay timely introduction of allergenic foods like peanuts.
• Reevaluation of published infant feeding guidelines is suggested in light of updated food allergy prevention approaches.