Child, Caregiver, and Household Factors Associated With Children's Dietary Diversity During the Complementary Feeding Period.

Abstract

Objective: To assess dietary diversity among foods offered to infants and toddlers in the US and to identify child, caregiver, and household characteristics associated with patterns of diversity in children's dietary exposures during the complementary feeding period.

Design: Cross-sectional survey of complementary feeding practices.

Setting: Participants were recruited via Qualtrics in January 2022.

Participants: Caregivers (n = 344 [70.3%] female; aged 31.5 ± 6.3 years) of children aged 4-26 months (aged 17.1 ± 6.7 months; 41.6% female) completed the survey.

Main outcomes measures: Foods offered over the last month by food frequency questionnaire and patterns of diet diversity identified via latent class analysis.

Analysis: Multinomial ordinal logistic regression models tested associations between child, caregiver, and household variables and patterns of children's diet diversity.

Results: Three patterns of diet diversity were identified: low, moderate, and high. Child age, sex, and type of milk feeding were significantly associated with high diet diversity, such that older child age (odds ratio [OR], 1.10 [95% confidence interval (CI), 1.06-1.14]) and receiving combined human milk and formula (vs none; OR, 2.91 [95% CI, 1.60-5.38]) were associated with high diet diversity, and being female was negatively associated with high diet diversity (vs male; OR, 0.55 [95% CI, 0.36-0.85]).

Conclusions and implications: Although older children were offered a greater diversity of complementary feeding, the kinds of complementary foods included to arrive at the high level of diversity varied considerably. Messaging focused on the introduction of a diversity of nutrient-dense foods is recommended.