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Impact of complementary feeding methods on infant nutritional status: A randomized clinical trial
Cátia Regina Ficagna1, Elma Izze da Silva Magalhães1, Abby Branchini Chacón1
1Graduate Program in Food, Nutrition, and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Insights
Different infant feeding methods impact growth. Baby-led introduction to solids (BLISS) was linked to lower BMI, while mixed feeding reduced overweight risk in infants up to 12 months.
Area of Science:
- Pediatrics
- Nutrition Science
- Public Health
Background:
- Complementary feeding (CF) practices significantly influence infant growth and long-term health.
- Understanding the impact of different CF methods on anthropometric outcomes is crucial for early obesity prevention.
Purpose of the Study:
- To evaluate the impact of three complementary feeding (CF) methods—parent-led weaning (PLW), baby-led introduction to solids (BLISS), and a mixed approach—on infant anthropometric outcomes at 9 and 12 months of age.
Main Methods:
- A randomized clinical trial involving 140 mother-infant pairs in Brazil.
- Participants were randomized to PLW, BLISS, or mixed CF methods, with standardized guidance provided.
- Infant anthropometric measurements (weight, length) and derived z-scores (weight-for-age, length-for-age, weight-for-length, BMI-for-age) were assessed at 9 and 12 months.
Main Results:
- Infants in the BLISS group exhibited lower mean BMI-for-age z-scores at 12 months compared to the PLW group (adjusted β: -0.53, P = 0.035).
- The mixed CF method was associated with a reduced risk of overweight/obesity between 9 and 12 months (adjusted HR: 0.11, P = 0.048).
- No significant associations were found for other primary or secondary anthropometric outcomes.
Conclusions:
- Infant-guided complementary feeding methods, such as BLISS and mixed feeding, show potential for favorable short-term anthropometric outcomes.
- These findings suggest a possible role for infant-guided approaches in early obesity prevention, warranting further investigation.
- Longer-term studies with larger cohorts are necessary to confirm the sustained impact of these CF methods on preventing childhood obesity.
Objective:
To evaluate the impact of different CF methods on infant anthropometric outcomes at 9 and 12 mo.
Methods:
This randomized clinical trial (Brazilian Clinical Trials Registry-ReBEC: RBR-229SCM N° U1111-1226-9516) included mother-infant pairs recruited at 5.5 mo in Porto Alegre, Brazil. Participants were randomized to one of three CF methods: food introduction through parent-led weaning (PLW), baby-led introduction to solids (BLISS), or mixed. At 5.5 mo, mothers attended a workshop led by nutritionists and speech therapists with verbal and written guidance on the assigned CF method (PLW: n = 46; BLISS: n = 47; Mixed: n = 46). Infants were followed up at 9 and 12 mo, and weight and length measurements were taken. Primary outcomes were z-scores of the anthropometric indexes weight-for-age, length-for-age, weight-for-length, and body mass index (BMI)-for-age. Secondary outcomes were nutritional status classifications based on these indices.
Results:
Of the 140 mother-infant pairs who participated, anthropometric data were collected from 130 children at 9 mo and 131 at 12 mo. Children in the BLISS group had lower mean BMI-for-age z-scores at 12 mo than those in the PLW group (adjusted β: -0.53; 95% CI: -1.03 to -0.03; P = 0.035). The mixed method reduced the risk of overweight/obesity across 9-12 mo (adjusted HR: 0.11; 95% CI: 0.01 to 0.97; P = 0.048). No statistically significant associations were observed for the other outcomes.
Conclusion:
Infant-guided CF methods were associated with favorable short-term anthropometric outcomes; however, further studies with longer follow-up and larger sample sizes are needed to confirm their role in obesity prevention.
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