PURPOSE OF THE STUDY.
To investigate the differences in early food introduction in urban versus suburban populations.
The study included 200 caregiver questionnaires. The questionnaires were distributed among an urban Medicaid-based population affiliated with Cincinnati Children’s Hospital Medical Center and a suburban private insurance–based population from Montgomery, Ohio (14 miles outside of Cincinnati, Ohio).
A caregiver questionnaire was dispersed at 4-month-old to 3-year-old well-child checkups between January and March 2010. A total of 200 questionnaires were given out evenly among urban and suburban populations. Families were asked the age at which formula and solid foods were introduced and what food was introduced. The questionnaire also included questions relating to demographic characteristics, child’s history of atopy, family history, practitioner recommendations on food introduction, and type of insurance. Data were analyzed by using the random forest method to determine which factors affecting the age of introduction were most significant.
Of the 200 questionnaires distributed, 185 were returned (99 from the suburban setting and 86 from the urban setting). The urban population included African Americans with public insurance primarily, whereas the suburban population was largely made up of white non-Hispanics with private health care insurance. In comparing the 2 groups, solids were introduced at similar ages. However, allergenic foods were introduced earlier in the urban population versus the suburban population. Specifically, whole cow’s milk, peanut, fish, and egg were all introduced at a statistically significant earlier age in the urban population. The suburban population delayed the introduction of egg, fish, and peanut to 12 months or older on average. The recommended age of introduction by health care professionals was the most significant variable in the introduction of all foods.
Urban populations introduced allergenic foods earlier than suburban populations. Recommendations made by health care professionals were the most influential factors in food introduction.
Recent guidelines regarding food introduction have dramatically changed our recommendations to families. As health care providers, we may forget the influence our advice has on many young lives and families. These results emphasize the significance and effectiveness of having clear and concise guidelines in practice. Additionally, this study highlights the gap and need for continued research into appropriate timing for the introduction of allergenic foods, so as to minimize disparities between different populations.
- Copyright © 2017 by the American Academy of Pediatrics