title: Prechewing infant food, consumption of sweets and dairy and not breastfeeding are associated with increased diarrhoea risk of 10-month-old infants in the United States.
abstract: Prechewing of food by caregivers is a common infant feeding practice both globally and in the United States, where the highest rates of the practice are found among African-Americans and Alaska Natives. The objective of this study was to determine if prechewing of infant food is associated with increased diarrhoea prevalence of 10-month-old infants in the United States. The study used cross-sectional data from the Infant Feeding Practices Study II to test for associations between prechewing and 2-week-period prevalence of infant diarrhoea. At 10 months of age, infants who received prechewed food (n = 203) had a diarrhoea prevalence of 16.1%, compared with 10.9% of children who did not receive prechewed food (n = 1567) [relative risk (RR) = 1.48, 95% confidence interval (CI) 1.03-2.11]. After adjusting for covariates, including breastfeeding and consuming sweets and dairy, prechewing was associated with a 58% higher risk (RR = 1.58, 95% CI 1.10-2.26) of 2-week diarrhoea prevalence. Consumption of sweets (RR = 1.35, 95% CI 1.03-1.78) and dairy (RR = 1.41, 95% CI 1.03-1.93) was also associated with increased diarrhoea risk. Continued breastfeeding at 10 months of age was associated with a reduced risk of diarrhoea (RR = 0.68, 95% CI 0.50-0.91). Prechewing of infant food is associated with increased diarrhoea among 10-month-old infants. The high RR found in this study suggests that prechewing may be an important factor in public health efforts to reduce the burden of diarrhoeal disease. However, further research is needed to establish that prechewing causes increased diarrhoea risk and to explore potential benefits of prechewing.
authors.affiliation: Nutrition and Health Sciences, Emory University, Atlanta, Georgia, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Conkle
authors.affiliation: Global Health, Emory University, Atlanta, Georgia, USA.
authors.forename: Usha
authors.initials: U
authors.lastname: Ramakrishnan
authors.affiliation: Environmental Health, Emory University, Atlanta, Georgia.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Freeman
mesh_terms: D000328:Adult; D001942:Breast Feeding; D002182:Candy; D003430:Cross-Sectional Studies; D003611:Dairy Products; D003968:Diarrhea, Infantile / Q000453:epidemiology*; D019317:Evidence-Based Medicine; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food; D016015:Logistic Models; D008297:Male; D008409:Mastication; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: behaviour; care-giving; child feeding; childhood infections; cultural issues; diarrhoea