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Developmental Readiness for Complementary Feeding: Associations with Initiation Before Age 6 Months

Diane L Putnick1, Akhgar Ghassabian2, Priscilla K Clayton1

  • 1Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.

The Journal of Pediatrics
|July 12, 2025
PubMed

Insights

Parents use infant developmental milestones, like sitting and head control, to decide when to introduce complementary foods. Developmental readiness also helps explain racial and ethnic differences in early feeding practices.

Area of Science:

  • Pediatrics
  • Infant Nutrition
  • Developmental Psychology

Background:

  • Early introduction of complementary foods before six months is a concern for infant health.
  • Parental perceptions of infant developmental readiness may influence feeding timing.
  • Racial and ethnic disparities exist in the introduction of complementary foods.

Purpose of the Study:

  • To investigate if parents' assessment of infant development predicts earlier introduction of complementary foods.
  • To determine if infant developmental readiness explains racial and ethnic differences in complementary feeding initiation.

Main Methods:

  • A cohort study of 5475 infants in New York assessed nine developmental markers and complementary feeding timing.
  • Mixed-effects models were used to analyze associations between developmental markers and early feeding.
  • Direct and indirect effects of race/ethnicity on feeding via a total development score were calculated.

Main Results:

  • Infant sitting, head control, reaching, mouthing, and good appetite were significantly associated with introducing complementary foods before six months.
  • A higher total infant development score correlated with increased odds of early complementary feeding.
  • The development score partially explained racial and ethnic disparities in complementary feeding timing.

Conclusions:

  • Parents appear to use infant developmental cues to guide the timing of complementary feeding.
  • Perceived developmental readiness may account for some observed racial and ethnic differences in early feeding.
  • Future research should include infant developmental readiness assessments in studies on complementary feeding.
Abstract

Keywords:
complementary feedinginfant developmentrace and ethnic differences

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