This article is more than 5 years old. Information may no longer be current.
Adhering to infants’ solid food guidelines can still result in unhealthy weight
Infants aged 6 months to 1 year who follow existing complementary feeding guidelines could still reach unhealthy weights, according to findings from a computational simulation model recently published in the American Journal of Preventive Medicine.
“There are concerns that caregivers may be overfeeding infants and thus overlooking natural feeding cues. Such overfeeding and larger portion sizes may be a key driver of weight gain among infants,” Marie C. Ferguson, MSPH, of the Global Obesity Prevention Center at Johns Hopkins, Baltimore, and colleagues wrote.
“As the nature of food changes, with more calorie-dense food items available, and with the increase of distractions, caregivers may need more guidance on how much to feed their infants. Therefore, type and quantity of recommended portions listed in Children’s Hospital of Philadelphia [CHOP], Johns Hopkins Medicine, Enfamil, Similac, and other guidelines may have increasing importance,” they continued.
In their model, Ferguson and colleagues found that reducing breast milk portions in half while caregivers fed infants based on solid food feeding guidelines from CHOP, Johns Hopkins and Similac resulted in unhealthy underweight BMI percentiles in infants aged 7 to 11 months. Moreover, cutting breast milk portions in half and following guidelines from CHOP, Johns Hopkins and the manufacturer Enfamil resulted in overweight BMIs in infants aged 9 to 11 months.
“Feeding experts and pediatricians should focus on providing tighter complementary feeding guidelines to caregivers, particularly in the later months of the first year of life. In addition, expert organizations and governing bodies could develop guidelines on how to adjust complementary feeding portion sizes and food types when the primary feeding method (ie, breast milk or formula) diverges from recommendations around duration, intensity, or form,” Ferguson and colleagues concluded.
Disclosures: The authors report no relevant financial disclosures.
Perspective
Back to Top
In light of the current obesity epidemic and multiplying pediatric obesity rates, the role of evidenced-based nutritional guidance has never been more important. Obesity is a significant public health priority given its rampant prevalence and future medical and psychosocial consequences. Given this risk, it is never too early to focus on attaining and maintaining a healthy weight, even in our youngest patients. Every well-child check is an opportunity to monitor weight and intervene when weight gain is excessive.
Often families are bombarded with information from friends, family and well-meaning blogs that can convolute the true goal of solid food introduction — a nourished healthy infant. Our role as pediatricians is to provide scientific and evidence-based guidelines during critical well-child exams. But current guidelines are routinely not being followed, and the ones available have proved in simulation to result in excessive weight gain.
According to the AAP Institute for Healthy Childhood Weight, “responsive feeding” can set infants up for healthy growth and development. Care to not overfeed should be a priority. Structured dietary plans ignore the role of biologic hunger and fullness cues, and override our innate ability to self-regulate our eating, emotions and portions. Parents should monitor closely for cues of fullness, which include fidgeting, distraction and pushing away or playing with food. The stresses of the modern family allow for less direct observation of satiation cues resulting in distracted feeding and overeating beyond the state of fullness. The prevalence of screen time during meals takes our focus away from our natural feedback loop of appreciating fullness. In addition, it detracts from a chance for bonding, socialization and developmentally rich interaction.
It is essential to establish good eating habits even at a young age. Infants should be sitting up, resting between bites, and stopping when full. Parents should offer a variety of nutrient-dense healthy foods. Too often children are being introduced early to processed food that is high in salt, calories, sugar and preservatives. Babies do not need juice. This is a missed chance at the ingestion of nourishing breastmilk and formula, and can result in excessive weight gain, diarrhea and tooth decay. Obesity is a public health priority and as such, pediatricians have a responsibility to provide appropriate screening, education and interventions to help mold the overall health of the children in our community.
Read more about