Was your baby born prematurely? When should you start feeding complementary foods, semi-solid and solid foods along with breast milk?
At six months corrected age, says this study conducted by All India Institute of Medical Sciences (AIIMS). Corrected age is the baby’s age based on the due date, meaning, if your baby was born at 28 weeks or seven months, the baby would be six months corrected age eight months after the delivery.
“Normally, when the baby is born on time, they are started on solid and semi-solid food at six months. But, premature babies have problems with growth and are usually smaller than the babies born on time. So, you really do not know when to start complementary foods,” said Dr Ramesh Agarwal, assistant professor of neonatology in the paediatrics department of AIIMS.
The World Health Organisation recommends that full-term infants be exclusively breastfed for six months, followed by complementary foods. “However, none of the organisations, including WHO, provide evidence-based guideline for optimal time of initiation of complementary feeding in pre-term infants,” the study said.
“This study will fill the evidence gap,” said Dr Agarwal.
The study found no difference in the height, weight or head circumference of the babies who started feeding at four months or six months of corrected age. However, babies that were started on complementary food at four months corrected age were hospitalised more frequently.
In the group that received complementary food at four months corrected age, 18% had to be hospitalised as compared to 9% in the other group.
“Most of the children were admitted with diarrhoea and infections. Our assumption is that this is because of reduced consumption of breast milk, which is known to provide immunity to the child,” said Dr Agarwal.
“Even for the premature babies, we usually counsel parents to start complementary feeding at six months chronological age, meaning the actual age of the baby. Around seven or eight years ago, the general consensus was to start the feed at four months in premature babies as the complementary food is nutritious and calorie dense and may help in their growth. But, there were increased incidences of infections,” said Dr Monica Juneja, professor of paediatrics at Lok Nayak hospital.
“I don’t know whether starting the feed at six months adjusted age would be very different from chronological age,” she said.
The study, funded by Indian Council of Medical Research, randomly assigned 203 infants to receive complementary food at four months adjusted age and 197 people at six months adjusted age. The study was published in The Lancet –Global Health.