Reduction in the Introduction of Complementary Foods Prior to 4 Months and Prior to 6 Months: An Examination of the U.S. National Survey of Children’s Health 2016–2023

Abstract

Background:

Early introduction of complementary foods (CF) before 4 months of age is associated with potential negative health outcomes for infants and is not nutritionally necessary prior to 6 months. This study examined trends in the introduction of CF prior to 4 months and prior to 6 months among U.S. children.

Methods:

This study utilized National Survey of Children’s Health data from 2016 to 2023, pooling data into 2-year increments. The analytic sample was restricted to children aged 9 months to 1 year old living with a biological or adopted mother. CF introduction before 4 months and before 6 months of age were constructed as binary indicators. Percent change in demographic characteristics was calculated alongside descriptive statistics to examine time trends in population characteristics between 2016/2017 and 2022/2023. Data were weighted to be nationally representative.

Results:

Between 2016/2017 and 2022/2023, the percentage of infants introduced to CF before 4 months decreased from 11.6% (95% CI: 0.09, 0.14) to 6.0% (95% CI: 0.05, 0.07), a 48.1% percentage reduction. Similarly, CF introduction before 6 months decreased from 43.1% (95% CI: 0.39, 0.46) to 30.7% (95% CI: 0.28, 0.32); a 28.9% percentage reduction. These decreases were accompanied by increases in mothers who were older, had higher education, and were in higher-income households.

Conclusion:

The United States has seen a decrease in the introduction of CF prior to 4 months and prior to 6 months. While this trend is promising, clinicians should consider providing additional education to parents on assessing infant readiness for CF and the importance of introducing CF at approximately 6 months of age.