Weaning Onto Solid foods: Some of the Challenges

Weaning the transition from milk to solid food influences life-long health. Dietary challenges during weaning include providing sufficient critical nutrients such as iron with minimal added sugar and fat and no added salt. This study assessed the inclusion of iron-containing red meat in infant diets before age one year, and the Irish commercial baby food environment. Of mothers with an infant under 30 months of age who were surveyed in shopping centres in Ireland (n195), 82% (n159) reported wanting more weaning information. A quarter (n24) of infants over age 12 months (n97) received no iron-containing red meat before age one year. A scan of commercial baby foods in Ireland identified 448 products. While all complied with baby food legislation, 15% (n69) were intrinsically high in sugar and fat, or contained added salt. This study indicates the need for specific guidance on best infant feeding practice in Ireland. Introduction Weaning, defined as the transition from milk to solid food during the first year of life, is a process important for not only nutritional and developmental reasons, but also for its potential influence on life-long feeding patterns and health. It is currently recommended that the weaning process commence around six months of age, when the volume of milk ingested by exclusively breastfed infants becomes insufficient to meet their nutritional requirements. Studies suggest that flavour experiences and food preferences during infancy track into childhood and adolescence. Since infants have an innate preference for sweet and salty tastes, best practice in infant feeding advises non-bulky savoury and plain-tasting foods to help set the infant’s threshold for these tastes at lower levels later in life. However, infants’ high nutritional requirements coupled with their capacity to consume relatively small amounts of food presents the challenge of providing sufficient nutrients with minimal added sugar and fat and no added salt. Recent Irish research has highlighted suboptimal feeding practices during this transition, to include weaning as early as six weeks of age and introducing foods at variance with best practice infant feeding guidelines, such as chocolates, biscuits, crisps and carbonated drinks. Such weaning practices may increase the risk of childhood obesity, the seriousness of which stems from its association with cardiovascular disease, type II diabetes mellitus, and cancer. Ireland has high rates of childhood obesity, with a quarter of children aged four to sixteen years being overweight or obese. Furthermore, children are not equipped to handle the prejudice and stereotyping associated with obesity, resulting in adverse social and psychological functioning. As such, this is a critical period for developing obesity, but equally an opportune time to intervene on, or preferably prevent, it. The food environment must be considered when addressing the burden of obesity and associated chronic disease. An infant’s food environment is determined by direct (micro-level) and indirect (macro-level) influences. A highly influential micro-level influence is the home feeding environment, which is in turn affected by macro-level factors such as food availability, price, marketing, and societal issues. The increasing burden of childhood obesity makes it essential that parents have the correct knowledge to make positive food choices on behalf of their children, ideally within an environment that promotes optimal food choices. The introduction of dietary sources of haem iron from six months of age to coincide with the depletion of iron stores from birth is an important infant feeding issue. Iron deficiency anaemia has been reported as an issue of concern amongst infants in Ireland. Evidence suggests that even mild anaemia in infancy can adversely affect long-term mental and psychomotor development. The primary aim of this study was to examine the introduction of haem iron-containing foods, particularly red meat, into infant diets during the first year of life. The secondary aim was to assess the range of commercial infant foods available in Ireland. Methods The study sample was obtained in three urban and two rural shopping centres across Dublin and Laois. Census data were used to categorise each shopping centre location according to relative deprivation in Ireland. The resulting categories were: Disadvantaged Inner City Area, Affluent City Area, and Socioeconomically Mixed Rural District. Women passing the survey stand who appeared to be of child-bearing age were invited to participate if they had an infant less than 30 months of age. A standardised, pilot-tested questionnaire obtained information on the age of the youngest child, mother’s age group, and age of first non-milk food. The inclusion of 9 common dietary sources of iron, including foods recommended for infants (beef, lamb, pork, chicken, oily fish, white fish) and foods not recommended for infants (ham, sausages, liver) was assessed. Mothers’ awareness of the age at which iron is important in the infant diet and their use of commercial infant foods were also assessed. A scan of commercial infant foods marketed by infant food companies in supermarket multiples in Ireland was conducted. Information such as the product name, meal category, age grouping, presence of gluten, and available nutritional information per 100 grams of product was tabulated. Information was gathered from products on supermarket shelves, and website, telephone, and email services offered by manufacturers. All products were compared with European Union legislation 2006/125/EC to ensure compliance with essential composition. Commercial infant desserts and snacks which were not fruitor dairybased and commercial infant foods containing cured meats were listed as being at variance with best practice infant feeding guidelines, which advise minimal added sugar and fat and no added salt. SPSS Statistics version 18.0 was used. Statistical significance was p<0.05. Normally distributed categorical data were analysed using cross-tabulations and chi-squared statistical tests. Independent-samples t-tests assessed considerations mothers had on providing meat to an infant.