Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.
Department of Pediatrics, St Michael's Hospital, Toronto, ON, Canada.
BMC Pediatr. 2023 Oct 16;23(1):514. doi: 10.1186/s12887-023-04262-0.
The timing of introduction to solid food has been associated with eczema and wheezing in childhood. Our aim was to determine whether differences persist within the recommended 4 to 6 month age range.
A longitudinal cohort study with repeated measures was conducted among children from birth to 10 years of age who were participating in the TARGet Kids! practice based research network in Toronto, Canada. The primary exposure was the timing of introduction to infant cereal as the first solid food. The primary outcome was eczema and the secondary outcome was wheezing collected by parent report using the validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Multinomial generalized estimating equations were used and effect modification by family history of asthma and breastfeeding duration were explored.
Of the 7843 children included, the mean (standard deviation) age of introduction to infant cereal was 5.7 (1.9) months. There was evidence for family history of asthma and breastfeeding duration to be effect modifiers in the eczema (P = 0.04) and wheezing (P = 0.05) models. Introduction to infant cereal at 4 vs. 6 months of age was associated with higher odds of eczema (OR 1.62; 95% CI: 1.12, 2.35; P = 0.01) among children without a family history of asthma who were not breastfeeding when solid foods were introduced. Introduction to infant cereal at 4 vs. 6 months of age was associated with a higher odds of wheezing (OR 1.31; 95% CI: 1.13, 1.52; P < .001) among children without a family history of asthma who were breastfeeding when solid foods were introduced. There was little evidence of an association among the remaining strata for either outcome.
The findings of this study support recommendations to introduce solid food around 6 months of age.
固体食物的引入时间与儿童时期的湿疹和喘息有关。我们的目的是确定在推荐的 4 至 6 个月的年龄范围内是否存在差异。
这是一项在加拿大多伦多的 TARGet Kids！实践研究网络中进行的从出生到 10 岁儿童的纵向队列研究，该研究采用重复测量的方法。主要暴露因素是婴儿谷物作为第一种固体食物的引入时间。主要结局是湿疹，次要结局是通过父母使用经过验证的国际儿童哮喘和过敏研究（ISAAC）问卷报告的喘息。采用多项广义估计方程，并探讨家族哮喘史和母乳喂养持续时间的效应修饰作用。
在纳入的 7843 名儿童中，婴儿谷物的引入年龄为 5.7（1.9）个月。家族哮喘史和母乳喂养持续时间在湿疹（P=0.04）和喘息（P=0.05）模型中均为效应修饰因素。对于没有家族哮喘史且引入固体食物时未进行母乳喂养的儿童，4 个月时引入婴儿谷物与湿疹的发生风险较高（OR 1.62；95%CI：1.12，2.35；P=0.01）有关。对于没有家族哮喘史且引入固体食物时进行母乳喂养的儿童，4 个月时引入婴儿谷物与喘息的发生风险较高（OR 1.31；95%CI：1.13，1.52；P<0.001）有关。对于其他剩余亚组，这两种结局的关联证据很少。
本研究结果支持在 6 个月左右引入固体食物的建议。
