title: Introduction of complementary foods with respect to French guidelines: description and associated socio-economic factors in a nationwide birth cohort (Epifane survey).
abstract: We described the introduction of complementary food (ICF) during the first year of life and identify associations observed with maternal and infant characteristics. We studied 3368 children included in the Epifane cohort, France, 2012. Maternal and infant characteristics and age at introduction of 28 complementary foods were collected at birth and at 1, 4, 8 and 12 months. Kaplan-Meier plots were used to represent probabilities of ICF. A score was used as tertiles in multinomial logistic regression to identify maternal and infant factors associated with ICF agreement with French recommendations. Median age of ICF was 152 days. While 12.6% of infants received complementary food before the age of 4 months, 95% of them were introduced after 7 months. Recommendations were generally followed, except for eggs and added fats, introduced in only 23.2% and 53.1% of 1-year-old infants, respectively. Factors significantly associated with the first ICF score tertile (low agreement with recommendations) vs. third tertile were as follows: maternal age 18-24 years (OR = 2.24 [1.49-3.35]) or 25-29 years (OR = 1.57 [1.21-2.04]), education less than or equal to high school graduation (OR = 1.94[1.51-2.48]), birthplace in France (OR = 2.13 [1.41-3.21]), three or more children (OR = 1.70 [1.15-2.51]), no follow-up antenatal classes (OR = 1.58 [1.22-2.04]), unemployment before and after pregnancy (OR = 1.64 [1.04-2.59]), unemployment before pregnancy and return to work within 12 months (OR = 2.06 [1.05-4.02]), no breastfeeding (OR = 2.08 [1.55-2.79]) or lasting <28 days (OR = 1.68 [1.22-2.31]) or 1-4 months (OR = 1.45 [1.08-1.96]). Recommendations concerning complementary food were generally followed. However, guidelines should be clarified and adapted to families who have difficulties in adopting them.
authors.affiliation: Unité de Surveillance Périnatale et Nutritionnelle (USPEN), Institut de Veille Sanitaire, Université Paris 13, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Boudet-Berquier
authors.affiliation: Unité de Surveillance Périnatale et Nutritionnelle (USPEN), Institut de Veille Sanitaire, Université Paris 13, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Salanave
authors.affiliation: Unité de Surveillance Périnatale et Nutritionnelle (USPEN), Institut de Veille Sanitaire, Université Paris 13, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: de Launay
authors.affiliation: Unité de Surveillance Périnatale et Nutritionnelle (USPEN), Institut de Veille Sanitaire, Université Paris 13, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France.
authors.forename: Katia
authors.initials: K
authors.lastname: Castetbon
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015331:Cohort Studies; D004032:Diet; D005602:France; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D016015:Logistic Models; D015596:Nutrition Assessment; D018673:Nutrition Policy; D011446:Prospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: birth cohort; complementary food; infant feeding recommendations; national sample; social inequalities; socio-economic factors