Relationship between complementary feeding approaches and child development in the first two years of life: a longitudinal study

The introduction of solid foods into infants’ diet is a crucial phase for their development. In recent years, an increasing attention has been raised about the impact on child health of baby led - weaning (BLW), a way of introducing solids alternative to feeding infants puréed foods on a spoon. Although it has been hypothesized that there is a positive relationship between baby-led weaning and psychomotor development, this aspect has not been yet investigated. We carried out a longitudinal study on a sample of 194 infants at the beginning of the study, which were tested at 4, 8, 12, 18 and 24 months of age. Mothers were asked to fill out questionnaires about their infants’ psychomotor development (Developmental Profile-3 – DP-3; Alpern 2007) and, starting at 8 months of age, about the type of complementary feeding approach and meal habits of their child. We also collected data about infants’ pacifier use, day care attendance and sociodemographic aspects, as control variables. Additionally, we observed a typical meal for each participant, from which we scored the proportion of self-feeding (i.e., the number of episodes in which the infant ate independently divided by the total number of feeding episodes, including spoon feeding and independent feeding). Concurrent and longitudinal regression analysis were run. Results showed that infants who were exposed to BLW at 8 months of age obtained higher scores on the DP-3 Adaptive Behaviors Scale at 12 (t=4.322, p<0.001) and 24 months (t=2.388 z=0.018). In addition, infants who sat more often with their family during the meal at 8 months, obtained higher scores on the DP-3 Adaptive Behaviors Scale at 8 (t=3.890, p<0.001) and 18 months (t=2.078, p=0.039) and on the DP3 Cognitive Scale (t=2.573, p=0.011) at 8 months. Likewise, children who sat more with their family at 12 months obtained higher scores on the Adaptive Behaviors Scale at 24 months (t=3.595, p<0.001). Moreover, there was a positive relationship between the proportion of self-feeding scored during the meal (i) at 8 months and the scores in the DP-3 Motor Scale at the same age (t=1.997, p=0.047), (ii) at 12 months and the scores on the DP-3 Adaptive Behaviors scale at 18 months (t=2.069, p = 0.040), (iii) at 18 months and the scores of the DP-3 Adaptive Behaviors Scale at the same age (t=2.390, p=0.018) and at 24 months (t=2.330, p=0.021), (iv) at 24 months and the scores of the DP-3 Adaptive Behaviors Scale at the same age (t=2.653, p=0.009). In conclusion, we found both concurrent and longitudinal significant relationships between a baby-led complementary feeding approach and several aspects of children’s development, mainly adaptive behaviors and cognitive skills. As at 4 months of age (i.e., before the onset of complementary feeding), DP-3 scores did not significantly differ between groups of infants which were exposed to different complementary feeding approaches (i.e., traditional, baby-led, or mixed) at 8 months of age, a baby-led complementary feeding approach seems to booster important skills during infant development.