J Acad Nutr Diet

BackgroundAlthough there has been inconsistency in recommendations regarding the optimal time for introducing complementary foods, most experts agree that introduction should not occur before 4 months. Despite recommendations, studies suggest that 20% to 40% of US infants are introduced to foods at younger than 4 months. Previous studies focused on the introduction of solid foods and are not nationally representative.ObjectiveOur aims were to provide a nationally representative estimate of the timing of introduction of complementary foods and to describe predictors of early (<4 months) introduction.DesignWe conducted a cross-sectional analysis of 2009\u20132014 National Health and Nutrition Examination Survey data.ParticipantsThe study included 1,482 children aged 6 to 36 months.Main outcome measuresTiming of first introduction to complementary foods (anything other than breast milk or formula) was analyzed.Statistical analyses performedPrevalence estimates of first introduction to complementary foods are presented by month. Logistic regression was used to assess characteristics associated with early (<4 months) introduction.ResultsIn this sample, 16.3% of US infants were introduced to complementary foods at <4 months, 38.3% between 4 and <6 months, 32.5% between 6 and <7 months, and 12.9% at 657 months of age. In unadjusted analyses, early introduction varied by breastfeeding status; race/Hispanic origin; Special Supplemental Nutrition Program for Women, Infants, and Children participation; and maternal age. In adjusted analyses, only breastfeeding status remained significant; infants who never breastfed or stopped at