Complementary feeding: recommendations of pediatricians for infants with
and without allergy risk
Abstract
Background Recommendations have been issued on healthy
complementary feeding (CF) strategies for infants, to reduce food
allergy. This is a study of routine guidance provided by Greek
pediatricians on the timing of CF for healthy infants and those at high
risk for allergy. Methods Pediatricians in Greece completed an
anonymous online questionnaire covering demographic information and
recommended CF, specifically the foods, preparation methods,
supplements, time interval between introduction of new foods for infants
at low and high risk for allergy, and foods delayed in the case of high
allergy risk. Results The respondents (n=233) recommended
introducing: at 6 months, fruits, starchy non-gluten-grains, vegetables,
olive oil and meat; at 7 months, gluten-rich grains; at 8 months,
yogurt, hard-boiled egg and legumes; at 8.5 months, fish; at 9 months,
nuts. A longer interval between new foods (≥ 4 days) was recommended,
for low-risk infants, by male pediatricians (p=0.04), and for infants at
high risk of allergy, by pediatricians with no subspecialty
(p<0.001) and those practicing in a rural/semi-urban area
(p=0.002). Pediatric practice of < 15 years was a predictor
for earlier introduction of egg, seafood, gluten-rich grains, legumes
and nuts for infants at high risk of allergy, and parenthood and male
sex for egg and grains. Conclusions Greek pediatricians use a
food introduction schedule for CF of infants, and, although not
explicitly recommended in current guidelines, they delay introduction of
common food allergens and suggest longer time intervals between
introduction of new foods, especially for infants at high risk of
allergy.