(P23-35-26) Complementary Feeding Approach Is Associated With Infant Neurodevelopmental Outcomes at 12 Months of Age

Objectives: Compare neurodevelopmental outcomes at 12 months of age in U.S. breastfed infants by complementary feeding approach.

Methods: This secondary analysis of a randomized controlled trial includes 60 breastfed, healthy, full-term infants recruited at 5 months from Denver, CO; the trial had two arms, a meat protein-based intervention arm and a control arm, combined for this analysis. Infant diet records were obtained at 5, 9, and 12 months to quantify complementary food intake and were analyzed using the Nutrition Data System for Research. Infants were classified as following baby-led weaning (BLW) if receiving ≤ 10% of calories from purees, creating three groups: full BLW (BLW at 9 and 12 mo, n=16), conventional weaning (CW) (CW at 9 and 12 mo, n=31), and late BLW (L-BLW) (CW at 9 mo, BLW at 12 mo, n=13). Neurodevelopment was assessed at 12 mo using the Bayley’s Scales of Infant and Toddler Development (BSID-III) at Children’s Hospital Colorado. Relationships between BSID composite scores and weaning approach were compared using linear regression, controlling for study arm, sex, ferritin, and mode of feeding (if formula was introduced after enrollment). Adjusted mean scores between groups were assessed using Tukey-corrected pairwise comparisons.

Results: In linear regression models, BLW was significantly associated with a lower Social Emotional score (beta = -10.5 ± 5, p=0.04) compared to CW, with no differences seen in L-BLW; adjusted means between groups were not different (p=0.16). Social score, a sub-domain of Adaptive Behavior (BLW: 114±15, CW: 101±14, L-BLW: 100±12, p=0.01), was significantly different by weaning approach, while cognitive score trended toward significance (BLW: 116±13, CW: 108±13, L-BLW: 105±10, p=0.10). No associations or mean differences were found between other BSID-III domain scores (Language, Motor, and overall Adaptive Behavior) and weaning approach.

Conclusions: As BLW was associated with lower Social-Emotional, but higher Social and Cognitive, scores, these preliminary findings may suggest that while BLW promotes autonomy in exploring and engaging in social aspects of routines, infants may experience challenges with emotional regulation. These findings should be confirmed in long-term follow-up studies with larger sample sizes.

Funding Sources: National Pork Board, CCTSI, Foundation for Meat & Poultry Research and Education