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The importance of early nutrition

31 July 2014

This paper combines all the published papers form the ALSPAC study (Children of the 90s) looking at diet and growth during infancy. Some major themes have immerged that help us to identify where infant feeding practices may go wrong.

This paper combines all the published papers form the ALSPAC study (Children of the 90s) looking at diet and growth during infancy. Some major themes have immerged that help us to identify where infant feeding practices may go wrong.

Fast growth in the first year of life was consistently identified as being associated with the development of obesity in later childhood. This is where a baby’s weights when plotted on thegrowth charts cross more than two of the major chart lines upwards. This fast growth may indicate that the baby is being over fed. ALSPAC has shown that over feeding is more likely in bottle-fed than breastfed babies at both 4 and 8 months of age. In 8-month olds, breastfed babies seemed to be able to compensate for extra milk intake whereas bottle-fed babies fed more than 600ml (21oz or one pint) of formula milk over the day ended up taking in more energy (calories) than they needed. By this age some babies were being given cow’s milk instead of breast milk or formula ALSPAC showed that this practice was likely to lead to anaemia and high salt intake. Mother’s sometimes changed to cow’s milk if they had financial difficulties because of the expense of buying formula but our research showed that this is not an economy worth making because it is detrimental to the child.

There were inequalities in the way infants were fed which started at the beginning of life and these are likely to lead to later health inequality. For example, mothers with low educational attainment were less likely to follow infant feeding guidelines than those with more education. The guidelines include breast feeding for at least 6 months and preferably the whole of the first year, introducing solid foods at around 6 months and definitely not before 4 months of age, not using cow’s milk as the main drink until after 12 months of age, introducing fresh fruit and vegetables as first foods and using home-prepared foods rather than commercial infant foods. Following these guidelines will start children on the road to good health in later life.

Health professionals and health education material should concentrate on helping vulnerable mothers to understand the reasons for the guidelines and support them in following them. This paper combining ALSPAC findings has helped to clarify and extend the evidence on which the guidelines are based.

Emmett PM and Jones LR. Diet and growth in infancy: relationship to socioeconomic background and to health and development in the Avon Longitudinal Study of Parents and Children. Nutrition Reviews 2014 doi:10.1111/nure.12122

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