Putnick Diane L, Ghassabian Akhgar, Clayton Priscilla K, Sundaram Rajeshwari, Yeung Edwina H
Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Departments of Pediatrics, Environmental Medicine, and Population Health, New York University Grossman School of Medicine, New York, NY.
J Pediatr. 2025 Jul 10;286:114722. doi: 10.1016/j.jpeds.2025.114722.
To evaluate whether parents who assess their infants as more developmentally advanced are more likely to begin feeding their infants complementary foods before 6 months, and whether developmental readiness explains racial and ethnic differences in complementary food introduction.
In a cohort of mothers of 5475 infants from New York state, 9 markers of infant development and timing of initiating complementary feeding were assessed. Mixed effect models assessed associations between developmental markers and initiation of complementary feeding before 6 months term-corrected age. Direct and indirect effects of racial and ethnic differences in complementary feeding through a total development score were computed.
In a fully adjusted model, infant sitting (aOR: 1.60, 95% CI: 1.32, 1.93), head control (aOR: 1.51, 95% CI: 1.26, 1.81), reaching (aOR: 1.19, 95% CI: 1.04, 1.37), mouthing (aOR: 1.26, 95% CI: 1.08, 1.46), and having a good appetite (aOR: 1.61, 95% CI: 1.15, 2.24) were uniquely associated with complementary feeding before age 6 months. A 1-point increase in a total development score was also associated with higher odds of complementary feeding (aOR: 1.26, 95% CI: 1.19, 1.33). The development score explained some racial and ethnic differences in the odds of complementary feeding before 6 months.
Results suggest that parents are using their children's developmental markers to decide when to begin complementary feeding. Furthermore, observations of racial and ethnic differences in the timing of complementary feeding may be explained by perceptions of developmental readiness, in line with recommendations. Future research on complementary feeding should incorporate assessments of infant developmental readiness.
评估那些认为自己婴儿发育更超前的父母是否更有可能在婴儿6个月前开始喂辅食，以及发育准备情况是否能解释辅食添加方面的种族和民族差异。
在一组来自纽约州的5475名婴儿的母亲中，评估了9项婴儿发育指标和开始添加辅食的时间。混合效应模型评估了发育指标与经矫正年龄6个月前开始添加辅食之间的关联。通过总发育得分计算了辅食添加方面种族和民族差异的直接和间接影响。
在一个完全调整的模型中，婴儿独坐（调整后比值比：1.60，95%置信区间：1.32，1.93）、头部控制（调整后比值比：1.51，95%置信区间：1.26，1.81）、够物（调整后比值比：1.19，95%置信区间：1.04，1.37）、口部动作（调整后比值比：1.26，95%置信区间：1.08，1.46）以及食欲良好（调整后比值比：1.61，95%置信区间：1.15，2.24）与6个月前添加辅食有独特关联。总发育得分每增加1分也与更高的添加辅食几率相关（调整后比值比：1.26，95%置信区间：1.19，1.33）。发育得分解释了6个月前添加辅食几率方面的一些种族和民族差异。
结果表明，父母在利用孩子的发育指标来决定何时开始添加辅食。此外，辅食添加时间上的种族和民族差异观察结果可能可以用对发育准备情况的认知来解释，这与建议相符。未来关于辅食添加的研究应纳入对婴儿发育准备情况的评估。
