The effect of the Baby-Feed website intervention on diet quality in healthy infants: a randomized controlled trial

BACKGROUND: Current infant diet recommendations are often not followed by caregivers, impacting their infant's diet quality. Incorporating diet guidelines with real-time feedback via technology may improve infant diet quality, helping mitigate future obesity risk. This study reports the effectiveness of the Baby-Feed website in improving diet quality among US infant caregivers compared to controls. This website was designed using trusted behavior-change theories to provide real-time feedback on infant diets, show current infant diet recommendations, and monitor progress. METHODS: Primary infant caregivers (English or Spanish-literate) with internet access, cellphone text capability, and willing to participate in the full study were enrolled into a parallel-group, randomized controlled trial. Infant diet quality was assessed by the total Diet Quality Index Score (DQIS) at baseline (~ 4 months old) and at the end of the study (~ 9 months old). The DQIS (0-55) is scored as: for 0-5.9 months, 15 points for exclusive and 10 points for partial breastfeeding, and 5 points for formula, while other foods score 5 if not introduced and 0 if introduced; for 6-12 months, appropriate intake of each food group (including formula) scores 5 (2.5 if slightly off, 0 if outside recommendations), with same score for breastfeeding. Total DQIS was categorized as ≥45 (excellent) or below. Data were analyzed with ANCOVA or logistic regression, adjusting for infant age and energy intake. RESULTS: One hundred fifty-five participants were randomized, and 150 were included in the analysis (76 in the intervention group and 74 in the control group). At the end of the intervention, infant total DQIS was higher in the intervention group (44.6 ± 6.53) than in the control group (42.5 ± 7.5) in both the unadjusted (p = 0.036) and adjusted models (p = 0.046). Also, infants in the control group had twice the odds of having an infant total DQIS below excellent (adjusted OR = 2.00; 95% CI: 1.012-3.950; p = 0.046) compared to the intervention group. CONCLUSIONS: Using the Baby-Feed website for 6 months improved the quality of infant diets. This could be a tool to help caregivers follow current infant diet recommendations with real-time feedback. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT05990439.