A cross-national survey of patterns of complementary foods for infants

Abstract

Purpose

Cultural differences in complementary infant foods across countries and regions are unclear. Therefore, this study aimed to clarify the differences in guidelines and recommendations for complementary infant foods worldwide, especially focusing on foods that infants eat first and the order in which they are consumed.

Methods

Web questionnaires were sent to midwifery associations or nurses' associations in 166 countries that are members of the International Council of Midwives (ICM) or the International Council of Nursing (ICN). Midwives or nurses were asked about recommended foods for infants to eat first and recommendations for the order in which they should be eaten. For the analysis, we categorized the recommendations for complementary foods in each country, focusing on the order in which they were consumed. Chi-square test was used to analyze the differences in eating order classification and region.

Results

Responses were received from a total of 46 countries. Thirty-seven out of 46 countries, or 80.4%, responded that they had guidelines on complementary foods. Six patterns were found for complementary diets, including 2 patterns starting with grains and 3 with vegetables and patterns of parents' and infant-led diets. Grains were the most common starting pattern in Asia and Africa, while vegetables were the most common in Europe and America.

Conclusion

We believe that international nutritional intake and disease prevention guidelines should be considered as recommendations for complementary foods suitable for each country and region.