Young Child Feeding Transitions Vary by Birthweight, Income, and Race: Evidence from a National Survey

Introduction: Ages when young child feeding (YCF) transitions occur have strong impact on health. Even though parents may modify YCF to suit birth outcome, evidence is lacking especially from large national surveys. The objectives of this study are to determine ages when children transitioned to different foods and any associations with birthweight, income, and race. Methods: Existing cross-sectional data from the U.S. National Health and Nutrition Examination Survey 2011- 2018 were analyzed to meet research objectives. Multinomial logistic regression models were used to estimate adjusted odds ratios after controlling for other determinants. The analytical sample comprised 10,169 children, aged 0-5 years. Results: Low birthweight significantly associated with early cessation of breastfeeding, early transition to formula, longer months of feeding formula, and delayed start of complementary feeding. Low-income and middle-income parents were more likely to transition their children from breastmilk to formula, complementary food, or cowmilk at a younger age than high-income parents. Black parents were less likely to breastfeed, and like Mexican parents were more likely to transition from breastfeeding before their children reached 6 months of age. Conclusion: Birthweight, income, and race are significant influential factors of child feeding transition. Perinatal nutrition programmers should integrate birthweight, income and racial factors into efforts to improve YCF.