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Infant feeding practices and later parent-reported feeding difficulties: a systematic review
Katarzyna Bąbik1,2, Bernadeta Patro-Gołąb1, Bartłomiej M Zalewski1
1Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.
Insights
Early feeding practices like breastfeeding duration and complementary feeding timing show no strong link to childhood feeding difficulties. More rigorous studies are needed to confirm these findings in children over one year old.
Area of Science:
- Pediatrics
- Nutrition Science
- Child Development
Background:
- Early feeding practices can impact food acceptance and lead to later feeding difficulties.
- Understanding these associations is crucial for child health and development.
Purpose of the Study:
- To systematically review the association between breastfeeding duration, complementary feeding timing, and feeding techniques with feeding difficulties in children over one year old.
- To evaluate subtypes of feeding difficulties including picky eating, food refusal, and food neophobia.
Main Methods:
- A systematic review following Cochrane Collaboration and Centre for Reviews and Dissemination guidance.
- Searched MEDLINE, Embase, and PsycINFO databases up to December 2019, screening references of included articles.
- Included 21 observational studies and 1 randomized controlled trial, synthesizing results narratively.
Main Results:
- Longer breastfeeding duration showed a trend towards fewer feeding problems, though differences were often small and not significant.
- Inconsistent results were found regarding the timing of complementary feeding introduction.
- Baby-led weaning was associated with less fussiness compared to spoon-feeding in one study.
Conclusions:
- This review found no strong evidence that early feeding practices significantly contribute to specific parent-reported feeding difficulties in children over one year of age.
- Methodologically rigorous studies are required to confirm these findings.
- Further research is needed to elucidate the complex relationship between early feeding and later feeding behaviors.
Context:
Early feeding practices may influence the acceptance of new foods and contribute to the development of feeding difficulties later in childhood.
Objective:
The aim of this systematic review was to evaluate the association of breastfeeding duration, timing of complementary feeding introduction, and feeding techniques with feeding difficulties or their subtypes, namely picky or fussy eating, food refusal, and food neophobia, in children older than 1 year of age.
Data Sources:
Guidance from the Cochrane Collaboration and the Centre for Reviews and Dissemination was followed. MEDLINE, Embase, and PsycINFO databases were searched up to December 2019. Additionally, references from included articles were screened.
Study Selection:
Interventional and observational studies were eligible. Of the 3653 records obtained after the search strategy was applied, 21 observational studies (cohort, case-control, cross-sectional), many with important methodological limitations, and 1 randomized controlled trial were included.
Data Extraction:
Three authors extracted data independently.
Results:
Results were synthesized narratively. Twelve observational studies assessed the association of breastfeeding duration with parent-reported feeding difficulties. Longer duration of breastfeeding tended to be associated with fewer childhood feeding problems in the majority of studies, but the differences were often small and not significant. Eight observational studies that examined the timing of complementary feeding introduction in relation to parent-reported feeding difficulties showed inconsistent results. Baby-led weaning, as compared with spoon-feeding, was significantly associated with less fussiness at age 12 to 36 months in 1 of 5 studies.
Conclusions:
This review showed no strong evidence to support the hypothesis that early feeding practices contribute significantly to specific parent-reported feeding difficulties in children older than 1 year of age. Additional methodologically rigorous studies are needed to confirm these findings.
Systematic Review Registration:
PROSPERO registration number CRD42018115792.
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