Dietary and Complementary Feeding Practices of US Infants, 6 to 12 Months: A Narrative Review of the Federal Nutrition Monitoring Data

Authors

Regan L Bailey
Jaime S Stang
Teresa A Davis
Timothy S Naimi
Barbara O Schneeman
Kathryn G Dewey
Sharon M Donovan
Rachel Novotny
Ronald E Kleinman
Elsie M Taveras
Lydia Bazzano
Linda G Snetselaar
Janet de Jesus
Kellie O Casavale
Eve E Stoody
Joseph D Goldman
Alanna J Moshfegh
Donna G Rhodes
Kirsten A Herrick
Kristin Koegel
Cria G Perrine
TusaRebecca Pannucci

Publication Date

12-1-2022

Journal

Journal of the Academy of Nutrition and Dietetics

DOI

10.1016/j.jand.2021.10.017

PMID

34688966

PMCID

PMC10851078

PubMedCentral® Posted Date

2-8-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Infant, Female, Animals, Cattle, Humans, Infant Nutritional Physiological Phenomena, Feeding Behavior, Diet, Infant Formula, Milk, Human, Dietary guidelines, Birth to 24 months, Pediatrics, Nutrition policy, Breastfeeding, Complementary feeding

Abstract

Complementary foods and beverages (CFBs) are key components of an infant’s diet in the second 6 months of life. This article summarizes nutrition and feeding practices examined by the 2020 Dietary Guidelines Advisory Committees during the CFB life stage. Breastfeeding initiation is high (84%), but exclusive breastfeeding at 6 months (26%) is below the Healthy People 2030 goal (42%). Most infants (51%) are introduced to CFBs sometime before 6 months. The primary mode of feeding (ie, human milk fed [HMF]; infant formula or mixed formula and human milk fed [FMF]) at the initiation of CFBs is associated with the timing of introduction and types of CFBs reported. FMF infants (42%) are more likely to be introduced to CFBs before 4 months compared with HMF infants (19%). Different dietary patterns, such as higher prevalence of consumption and mean amounts, were observed, including fruit, grains, dairy, proteins, and solid fats. Compared with HMF infants of the same age, FMF infants consume more total energy (845 vs 631 kcal) and protein (22 vs 12 g) from all sources, and more energy (345 vs 204 kcal) and protein (11 vs 6 g) from CFBs alone. HMF infants have a higher prevalence of risk of inadequate intakes of iron (77% vs 7%), zinc (54% vs <3%), and protein (27% vs <3%). FMF infants are more likely to have an early introduction (<12 months) to fruit juice (45% vs 20%) and cow’s milk (36% vs 24%). Registered dietitian nutritionists and nutritional professionals should consider tailoring their advice to caregivers on dietary and complementary feeding practices, taking into account the primary mode of milk feeding during this life stage to support infants’ nutrient adequacy. National studies that address the limitations of this analysis, including small sample sizes and imputed breast milk volume, could refine findings from this analysis.