Related Experiment Video
Updated: Sep 30, 2025
A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Randomized Controlled Trial of Two Timepoints for Introduction of Standardized Complementary Food in Preterm Infants
Nadja Haiden1, Margarita Thanhaeuser2, Fabian Eibensteiner2
1Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria.
Insights
Introducing solids to very low birth weight (VLBW) infants should align with neurological readiness, not just age. Early or late introduction showed no significant long-term growth differences in VLBW infants.
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
Background:
- Standard infant feeding guidelines recommend introducing solids between 17-26 weeks for term infants.
- Limited data exists on optimal complementary feeding timing for preterm infants, specifically very low birth weight (VLBW) infants.
Purpose of the Study:
- To investigate the longitudinal growth of VLBW infants based on the timing of complementary food introduction.
- To compare growth outcomes between VLBW infants introduced to solids early (10-12 weeks corrected) versus late (16-18 weeks corrected).
Main Methods:
- A prospective, two-arm interventional study involving 177 VLBW infants.
- Infants were randomized into early or late complementary feeding groups.
- Primary outcome: height at one year corrected for term; secondary outcomes: weight, head circumference, BMI, and z-scores.
Main Results:
- No significant differences in height at one year corrected for term between early and late feeding groups (74.7 cm vs. 74.4 cm).
- No significant differences in other anthropometric parameters, except for a transient effect on weight z-score at 6 months.
- Mean birthweight and gestational age were similar in both groups.
Conclusions:
- For VLBW infants, the timing of solid food introduction should prioritize neurological ability over strict nutritional or growth considerations.
- Current feeding guidelines for term infants may not directly apply to preterm infants regarding complementary feeding schedules.
Abstract:
In term infants it is recommended to introduce solids between the 17th and 26th week of life, whereas data for preterm infants are missing. In a prospective, two-arm interventional study we investigated longitudinal growth of VLBW infants after early (10-12th) or late (16-18th) week of life, corrected for term, introduction of standardized complementary food. Primary endpoint was height at one year of age, corrected for term, and secondary endpoints were other anthropometric parameters such as weight, head circumference, BMI, and z-scores. Among 177 infants who underwent randomization, the primary outcome could be assessed in 83 (93%) assigned to the early and 83 (94%) to the late group. Mean birthweight was 941 (SD ± 253) g in the early and 932 (SD ± 256) g in the late group, mean gestational age at birth was 27 + 1/7 weeks in both groups. Height was 74.7 (mean; SD ± 2.7) cm in the early and 74.4 cm (mean; SD ± 2.8; n.s.) cm in the late group at one year of age, corrected for term. There were no differences in anthropometric parameters between the study groups except for a transient effect on weight z-score at 6 months. In preterm infants, starting solids should rather be related to neurological ability than to considerations of nutritional intake and growth.
