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Complementary Feeding Practices of Former Neonatal Intensive Care Children: A Cohort Study
Simone Augusta Ribas1, José Guilherme de Santana Santos2, Michelle Teixeira Teixeira3
1Department of Food and Nutrition in Public Health, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
Insights
Infant feeding practices in high-risk children are often suboptimal, with early weaning and high ultra-processed food consumption negatively impacting growth and development. Targeted interventions are crucial for improving diet quality in this vulnerable group.
Area of Science:
- Pediatrics
- Nutrition Science
- Public Health
Background:
- Healthy infant and young child feeding (IYCF) practices are critical for optimal growth and development during the first two years of life.
- High-risk populations, such as former Neonatal Intensive Care Unit (NICU) graduates, may face unique challenges in achieving adequate nutrition.
Purpose of the Study:
- To evaluate infant and young child feeding (IYCF) practices among high-risk children up to 24 months of age.
- To assess dietary quality, including consumption of ultra-processed foods (UPF) and adherence to WHO feeding recommendations.
Main Methods:
- A cohort study followed 155 former NICU children from birth to 24 months.
- Dietary intake was assessed using 24-hour recalls and evaluated against WHO IYCF indicators.
- Linear mixed-effects models analyzed changes in UPF consumption and dietary diversity over time.
Main Results:
- Early weaning before 6 months occurred in 82.9% of participants.
- While minimum dietary diversity increased with age, vitamin A-rich food intake remained low.
- Consumption of added sugar, sugar-sweetened beverages, and UPF significantly increased between 6 and 24 months.
Conclusions:
- The diet quality of high-risk children is suboptimal, characterized by early weaning, insufficient vitamin A intake, and high UPF exposure.
- These findings underscore the necessity for targeted interventions to promote healthier feeding practices in this vulnerable population.
Background:
Healthy feeding practices during the first 2 years of life are crucial for ensuring adequate growth and development.
Objective:
To evaluate infant and young child feeding (IYCF) practices among high-risk children during the first 2 years of life.
Methods:
Cohort study including former Neonatal Intensive Care Unit children followed at two University hospitals from birth until 24 months of age. Dietary data were collected using 24-h recalls, and diet quality was assessed based on the World Health Organization's IYCF indicators, including the consumption of ultra-processed foods (UPF). Early weaning was defined as the interruption of exclusive breastfeeding before 6 months of age, according to World Health Organization recommendations. Linear mixed-effects models were used to evaluate changes over time in the proportion of ultra-processed food consumption and dietary diversity.
Results:
Among the 155 children included in the study, early weaning occurred in 82.9% of participants. Minimum dietary diversity increased with age (58.0%-85.0%; p < 0.001), while consumption of vitamin A-rich foods remained stable (average 63%; p = 0.90) and below recommended levels. Significant increases were observed in the intake of added sugar (26.0%-67.0%; p < 0.001), sugar-sweetened beverages (17.0%-57.0%; p < 0.001), and ultra-processed foods (41.0%-78.0%; p < 0.001) between 6 and 24 months. Full-term children were less likely to achieve dietary diversity compared with preterm infants (OR: 0.27; 95% CI: 0.09-0.80; p = 0.02).
Conclusion:
The diet quality of children was suboptimal during the first 2 years of life, marked by early weaning, insufficient intake of vitamin A-rich foods, and high exposure to ultra-processed products. These results highlight the urgent need for targeted interventions to promote healthier feeding practices in this vulnerable population.
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