Associations Between Complementary Feeding Approach, Dietary Intake, and Growth: A Secondary Analysis of the Maternal and Infant Nutrition Trial.

BackgroundMinimal research has assessed the adequacy of baby-led weaning (BLW) as a complementary feeding (CF) approach in infant nutrient intake and growth.ObjectiveThis study assesses growth between infants following BLW and conventional weaning (CW) and compares at-home energy, macronutrient, and micronutrient intake by weaning approach and relative to the Dietary Reference Intakes.DesignThis is a secondary analysis of 5- to 12-month-old full-term infants from Denver, CO, recruited for an ongoing longitudinal randomized controlled trial.Participants/settingOne hundred forty-four participants with complete dietary intake and anthropometric data from August 2021 through August 2024 from the Maternal and Infant Nutrition Trial were included in this analysis. Infants were classified as following BLW if puréed foods accounted for ≤10% of total energy intake (n = 52); all other infants were classified as CW (n = 92).Main outcome measuresDietary intakes of energy, macronutrients, and selected micronutrients at ages 5, 9, and 12 months using weighed 3-day diet records and anthropometrics, including odds of rapid weight gain.Statistical analysis performedThe χ2 test was used to compare demographic data between BLW and CW groups. Linear regression and independent t tests were utilized to compare unadjusted and adjusted dietary intake means and growth z scores between groups. Logistic regression was used to calculate odds ratios for rapid weight gain.ResultsNo significant differences in nutrient intakes were observed at baseline (infant age 5 months). Total energy intake was not different between groups at any age. At age 9 months, BLW infants had higher reported dietary sodium (437 vs 294 mg; P < .001), a higher percent energy from fat (47% vs 43%; P < .001), and a lower percent energy from carbohydrate (43% vs 50%; P < .001) than CW infants, with no significant differences at age 12 months for any nutrient. Both groups had reported dietary sodium higher than the Adequate Intake at age 12 months. No significant differences in rapid weight gain or growth z scores were observed. Results were consistent after adjusting for mode of feeding, infant sex, and study arm.ConclusionsThe findings indicate that BLW and CW are associated with different macronutrient and micronutrient intakes at infant age 9 months but not age 12 months. BLW and CW may promote similar growth outcomes during complementary feeding.