Impact of complementary feeding methods on infant nutritional status: A randomized clinical trial

To evaluate the impact of different CF methods on infant anthropometric outcomes at 9 and 12 mo.

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.

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.

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.