title: Lactation Consultant Support from Late Pregnancy with an Educational Intervention at 4 Months of Age Delays the Introduction of Complementary Foods in a Randomized Controlled Trial.
abstract: BACKGROUND
  Although the WHO recommends that complementary feeding in infants should begin at 6 mo of age, it often begins before this in developed countries.
  
  
  OBJECTIVE
  Our objective was to determine whether lactation consultant (LC) support, with educational resources given at 4-mo postpartum, can delay the introduction of complementary foods until around 6 mo of age.
  
  
  METHODS
  A total of 802 mother-infant pairs were recruited from the single maternity hospital serving Dunedin, New Zealand (59% response rate) and randomly assigned to the following: 1) usual care (control group); 2) infant sleep education intervention (Sleep); 3) food, activity, and breastfeeding intervention (FAB); or 4) combination (both) intervention (Combo). Certified LCs delivered 3 intervention sessions (late pregnancy and 1-wk and 4-mo postpartum). The 4-mo contact used educational resources focused on developmental readiness for complementary foods. Age when complementary foods were introduced was obtained from repeated interviews (monthly from 3- to 27-wk postpartum).
  
  
  RESULTS
  A total of 49.5% and 87.2% of infants received complementary foods before 5 and 6 mo of age, respectively. There was evidence of group differences in the number of infants introduced to complementary foods before 5 mo (P = 0.006), with those receiving support and resources (FAB and Combo groups combined; 55.6%) more likely to wait until at least 5 mo compared with controls (control and Sleep groups combined; 43.3%) (OR: 1.52; 95% CI: 1.08, 2.16). However, there was no evidence they were more likely to wait until 6 mo of age (P = 0.52). Higher maternal age, higher parity, and a less positive attitude toward breastfeeding were positively associated, and drinking alcohol during pregnancy was negatively associated, with later age of introduction of complementary foods.
  
  
  CONCLUSIONS
  Providing an LC and educational resources at 4-mo postpartum to predominantly well-educated, mainly European, women can delay the introduction of complementary foods until 5 mo of age, but not until the WHO recommendation of 6 mo. This trial was registered at clinicaltrials.gov as NCT00892983.
authors.affiliation: Departments of Human Nutrition, Women's and Children's Health, and.
authors.forename: Sonya L
authors.initials: SL
authors.lastname: Cameron
authors.affiliation: Departments of Human Nutrition.
authors.forename: Anne-Louise M
authors.initials: AL
authors.lastname: Heath
authors.affiliation: Preventive and Social Medicine.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Gray
authors.affiliation: Women's and Children's Health, and.
authors.forename: Barbara
authors.initials: B
authors.lastname: Churcher
authors.affiliation: Women's and Children's Health, and.
authors.forename: Rhondda S
authors.initials: RS
authors.lastname: Davies
authors.affiliation: Departments of Human Nutrition.
authors.forename: Alana
authors.initials: A
authors.lastname: Newlands
authors.affiliation: Women's and Children's Health, and.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Galland
authors.affiliation: Women's and Children's Health, and.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Sayers
authors.affiliation: Women's and Children's Health, and.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Lawrence
authors.affiliation: Women's and Children's Health, and.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Taylor
authors.affiliation: Medicine, University of Otago, Dunedin, New Zealand rachael.taylor@otago.ac.nz.
authors.forename: Rachael W
authors.initials: RW
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000639:trends*; D003253:Consultants; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D007774:Lactation; D016015:Logistic Models; D009520:New Zealand; D010298:Parity; D049590:Postpartum Period; D011247:Pregnancy; D012944:Social Support; D012959:Socioeconomic Factors; D013997:Time Factors; D014944:World Health Organization
keywords: 6 months of age; World Health Organization; complementary feeding; lactation consultant; randomized controlled trial