Differences in Early Childhood Dietary Behaviors by Infant Feeding Type and Sex

Abstract

ABSTRACT Background Type of infant feeding has been linked to later nutritional outcomes, including dietary diversity and obesity in childhood. Little is known about how introduction to complementary feeding and diet quality in early childhood vary by infant feeding type and sex. Objective Our objective was to investigate whether early childhood dietary patterns vary by infant feeding type and sex. Methods Data from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infants and Toddler Feeding Practices Study 2 (ITFPS-2) was used, including children with complete information on the WIC infant food package received at ages 1, 7, and 11 mo (N = 2839). Based on this information, children were grouped as fully breastfed, mostly breastfed, mostly formula fed, and fully formula fed. Outcomes include introduction of complementary foods; caloric intake aged between 1 and 36 mo; and Healthy Eating Index (HEI)-2015 between 13 and 36 mo. Mixed models were used adjusting for child's, mother's, and family's sociodemographic characteristics. Results Across all infant feeding groups, the mean age of introduction to any solids was before the age of 6 mo; fully breastfed children were introduced to complementary foods closer to the recommended age (mean 5.1–5.2 mo) compared with other feeding groups (mean 4.6–4.8 mo). Fully formula fed infants consumed significantly more energy than fully breastfed infants at ages 1 mo (boys = 55 kcal/d, girls = 47 kcal/d), 12 mo (boys = 68 kcal/d, girls = 59 kcal/d), 24 mo (boys = 81 kcal/d, girls = 71 kcal/d), and 36 mo (boys = 95 kcal/d, girls = 83 kcal/d). No meaningful differences were observed for HEI-2015 between infant feeding groups or child sex, with average scores of HEI-2015 for all children being 61–63 out of 100. Conclusion Early childhood dietary patterns were slightly better among children who were fully breastfed as infants, compared with children in other infant feeding groups. The diets of all WIC-participating children could be improved.