How Does Household Food Insecurity Impact Complementary Feeding, in High Income Countries, in a Cost-of-Living Crisis? A Systematic Scoping Review.

Complementary feeding, when infants are introduced to solid foods, is an important stage of learning new tastes, textures and eating behaviours. Austerity, post-BREXIT (in the UK) and the COVID-19 pandemic have created a cost-of-living crisis, exacerbating prevalence of food insecurity in high-income countries. Understanding how this may impact upon parents' experience of complementary feeding is important. This systematic scoping review therefore examined how food insecurity impacts diet and feeding practices during the complementary feeding period for infants aged 6-18 months. Four electronic databases were searched, identifying 5822 articles. 3293 titles and abstracts, from which 30 full texts were screened by two independent reviewers. The final review included five articles (two qualitative and three quantitative). Three articles were conducted in Australia, one in America, one in New Zealand with 1044 parent/child dyads in total. Strategies such as encouraging children to finish their food, avoiding foods that might not be accepted and reducing food variety were common. These strategies may ensure children are fed but may reduce elements of complementary feeding that we know are important such as exposing infants to wide varieties of tastes, textures and nutrients and adopting a responsive feeding style. The sparsity of evidence in this review, particularly for research based in the UK, highlights the need for further research in high-income countries to explore the impact of household food insecurity on complementary feeding. This will help to identify priorities for those working in policy and practice to support families with complementary feeding during the cost-of-living crisis and beyond.