Canadian Journal of Public Health

, Volume 90, Issue 6, pp 403–407 | Cite as

Infant Feeding Practices in Ottawa-Carleton: The Introduction of Solid Foods

  • Beth S. KwavnickEmail author
  • Debra J. Reid
  • Michel R. Joffres
  • Judith Read Guernsey


Infant feeding guidelines regarding the introduction of solid foods are generally not well known in Canada. The guidelines recommend that solid foods be introduced between four to six months of age, depending on the developmental readiness of the infant. In order to understand the underlying factors and patterns which contribute to the introduction of solid foods in infants, data were analyzed from three cross-sectional surveys of parents of six-month-old infants from the Ottawa-Carleton region (n=373, 1988; n=330, 1992; n=338, 1996) conducted by the Ottawa-Carleton Health Department. Multivariable analysis showed that mothers who: did not breastfeed, were younger, had lower education, smoked or had partners that smoked, and lacked support after birth, were more likely to introduce solid foods before four months of age. These data support the need for nutrition education programs to increase adherence to the new Nutrition for Healthy Term Infants guidelines.


Les directives concernant l’introduction des solides dans l’alimentation des enfants ne sont généralement pas bien connues au Canada. Ces directives recommandent l’introduction des solides alimentaires entre quatre et six mois, en fonction du développement de l’enfant. Pour essayer de comprendre les facteurs et les tendances qui contribuent à l’introduction des aliments solides chez les enfants, les données de trois enquêtes transversales (n=373, 1988; n=330, 1992; n=338, 1996) auprès de parents de la région d’Ottawa-Carleton ayant des enfants de six mois, réalisées par le département de Santé d’Ottawa-Carleton, ont été analysées. Les analyses à variables multiples ont montré que les mères qui n’allaitent pas leur enfant, qui sont jeunes, ont un niveau bas d’éducation, qui fument ou ont des partenaires qui fument, et qui ont peu de soutien après la naissance sont plus à même d’introduire des aliments solides avant l’âge de quatre mois. Ces données mettent en valeur le besoin de programmes d’éducation nutritionnelle pour encourager l’adoption des nouvelles directives sur la nutrition des enfants sains.


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  1. 1.
    Fomon SJ. What are infants fed in the United States? Pediatrics 1975;56(3):350–54.PubMedGoogle Scholar
  2. 2.
    Fomon SJ. Reflections on infant feeding in the 1970s and 1980s. Am J Clin Nutr 1987;46:171–82.CrossRefGoogle Scholar
  3. 3.
    Myres AW. A retrospective look at infant feeding practices in Canada: 1965–1978. J Can Dietet Assoc 1979;40(3):201–10.Google Scholar
  4. 4.
    Health and Welfare Canada. Canadian Infant Feeding Patterns. Ottawa, 1982.Google Scholar
  5. 5.
    Mackey A, Orr RD. Infant feeding practices in metropolitan, urban and small communities in Newfoundland. J Can Dietet Assoc 1978;39(3):236.Google Scholar
  6. 6.
    Vobecky J, Kelly A, Munan L. Étude épidémi-ologique des habitudes alimentaires pendant les premières années de vie: allaitement et aliments solides. La vie médicale 1972;1:934.Google Scholar
  7. 7.
    Escott J. Time to Introduction of Solids and Development [thesis]. Guelph, ON: University of Guelph, 1976.Google Scholar
  8. 8.
    Yeung DL, Leung M, Hall J, et al. Longitudinal survey of infant nutrition. J Can Dietet Assoc 1979;40(4):288–95.Google Scholar
  9. 9.
    Yeung DL, Pennell MD, Leung M, et al. Infant feeding practices. Nutrition Reports International 1981;23(2):249–60.Google Scholar
  10. 10.
    Clark LL, Beal VA. Age of introduction of solid foods to infants in Manitoba. J Can Dietet Assoc 1981;42:72–78.Google Scholar
  11. 11.
    Sauve RS, Geggie JH. Growth and dietary status of preterm and term infants during the first two years of life. Can J Public Health 1991;82:95–100.PubMedGoogle Scholar
  12. 12.
    Tanaka PA, Yeung DL, Anderson GH. Infant feeding practices: 1984–85 versus 1977–78. Can Med Assoc J 1987;136:940–44.Google Scholar
  13. 13.
    Greene-Finestone L, Feldman W, Heick H, et al. Infant feeding practices and socio- demographic factors in Ottawa-Carleton. Can J Public Health 1989;80:173–76.PubMedGoogle Scholar
  14. 14.
    Williams PL, Innis SM, Vogel AMP. Breastfeeding and weaning practices in Vancouver. Can J Public Health 1996;87(4):231–36.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Valaitis RK, Ciliska DK, Sheeshka JD, et al. Surveying infant feeding practices. Can Nurse 1996;92(4):21.PubMedGoogle Scholar
  16. 16.
    Bourgoin GL, Lahaie NR, Rheaume BA, et al. Factors influencing the duration of breastfeeding in the Sudbury region. Can J Public Health 1997;88(4):238–41.PubMedGoogle Scholar
  17. 17.
    Canadian Paediatric Society, Dietitians of Canada, Health Canada. Nutrition for Healthy Term Infants. Ottawa, 1998.Google Scholar
  18. 18.
    Roy CC. Food allergies and gastrointestinal disorders. Dialogues Infant Nutr Jan 1979;8.Google Scholar
  19. 19.
    Halken S. The effect of hypo-allergenic formulas in infants at risk of allergic disease. European Journal of Clinical Nutrition 1995;49(suppl1):S77–S83.PubMedGoogle Scholar
  20. 20.
    Kajosaari M. Atopy prevention in childhood: The role of diet. Prospective 5-year follow-up of high-risk infants with six months exclusive breastfeeding and solid food elimination. Pediatr Allergy Immunol 1994;5(6Suppl):26–28.CrossRefGoogle Scholar
  21. 21.
    Forsyth JS, Ogston SA, Clark A, et al. Relation between early introduction of solid food to infants and their weight and illnesses during the first two years of life. BMJ 1993;306(6892):1572–76.CrossRefGoogle Scholar
  22. 22.
    Fergusson DM, Horwood LJ. Early solid food diet and eczema in childhood: A 10-year longitudinal study. Pediatr Allergy Immunol 1994;5(6 Suppl):44–47.CrossRefGoogle Scholar
  23. 23.
    Saarinen UM, Siimes MA. Iron absorption from breast milk, cow’s milk, and iron-supplemented formula: An opportunistic use of changes in total body iron determined by hemoglobin, ferritin, and body weight in 132 infants. Pediatric Research 1979;12:143–47.CrossRefGoogle Scholar
  24. 24.
    Oski FA, Landaw SA. Inhibition of iron absorption from human milk by baby food. Am J Dis Child 1980;134:459–60.PubMedGoogle Scholar
  25. 25.
    Davies DP, Behjat MA, Mandal BK. The declining incidence of infantile hypernatremic dehydration in Great Britain. Am J Dis Child 1979;133:148–50.PubMedGoogle Scholar
  26. 26.
    Wilkinson PW, Davies DP. When and why are babies weaned? BMJ 1978;1:1682–83.CrossRefGoogle Scholar
  27. 27.
    ESPGAN Committee on Nutrition. Guidelines on infant nutrition. III. Recommendations for infant feeding. Acta Paediatr Scand 1982;302(suppl):1–27.Google Scholar
  28. 28.
    Pam Fitzgerald, Midwifery Group of Ottawa. Personal communication. June 1997.Google Scholar
  29. 29.
    Suzanne Ledbetter, Midwifery Collective. Personal communication. June 1997.Google Scholar
  30. 30.
    Debora Dover, Ottawa-Carleton Health Department. Personal communication. June 1997.Google Scholar
  31. 31.
    Statistics Canada. Telephone Statistics 1988. Ottawa: Industry, Science and Technology Canada, 1990. Catalogue number 56–203.Google Scholar
  32. 32.
    Statistics Canada. Telephone Statistics 1992. Ottawa: Industry, Science and Technology Canada, 1994. Catalogue number 56–203.Google Scholar
  33. 33.
    Statistics Canada. Telephone Statistics 1996. Ottawa: Industry, Science and Technology Canada, 1997. Catalogue number 56-203-XPB.Google Scholar
  34. 34.
    Ottawa-Carleton Health Department. Infant Care Survey. 1996.Google Scholar
  35. 35.
    Ottawa-Carleton Health Department. Infant Care Survey. 1992.Google Scholar
  36. 36.
    Ottawa-Carleton Health Department. Parent Child Health Survey. 1990.Google Scholar
  37. 37.
    Kwavnick BS. An Investigation of Infant Feeding Practices: The Relationship Between Maternal and Infant Factors and the Introduction of Solid Foods [thesis]. Halifax, NS: Dalhousie University, 1998.Google Scholar
  38. 38.
    Health Canada. Breastfeeding in Canada: A Review and Update (draft). Ottawa, 1997.Google Scholar
  39. 39.
    Ford RPK, Mitchell EA, Scragg R, et al. Factors adversely associated with breast feeding in New Zealand. J Paediatr Child Health 1994;30:483–89.CrossRefGoogle Scholar
  40. 40.
    Visness CM, Kennedy KI. Maternal employment and breast-feeding: Findings from the 1988 National Maternal and Infant Health Survey. Am J Public Health 1997;87(5):945–50.CrossRefGoogle Scholar
  41. 41.
    Neumann CG, Alpaugh M. Birthweight doubling time: A fresh look. Pediatrics 1976;57(4):469–73.PubMedGoogle Scholar
  42. 42.
    Peters DC, Worthington-Roberts B. Infant feeding practices of middle-class breastfeeding and formula-feeding mothers. Birth 1982;9(2):91–95.CrossRefGoogle Scholar
  43. 43.
    Hoffmans MDAF, Obermann-de Boer GL, Florack EIM, et al. Energy, nutrient and food intake during infancy and early childhood: The Leiden preschool children study. Human Nutrition: Applied Nutrition 1986;40A:421–30.Google Scholar
  44. 44.
    Lerebours B, Czernichow P, Pellerin AM, et al. L’alimentation du nourrisson jusqu’a 4 mois en Seine-Maritime. Arch Fr Pediatr 1991;48:391–95.PubMedGoogle Scholar
  45. 45.
    Whitehead RG, Paul AA, Ahmed EA. Weaning practices in the United Kingdom and variations in anthropometric development. Acta Paediatr Scand 1986;323:14-23 (Suppl).Google Scholar
  46. 46.
    Persson LA, Samuelson G. From breastmilk to family food: Infant feeding in three Swedish communities. Acta Paediatr Scand 1984;73:685–92.CrossRefGoogle Scholar
  47. 47.
    Owles EN, Hitchcock NE, Gracey M. Feeding patterns of Australian infants: Birth to one year. Human Nutrition: Applied Nutrition 1982;36A:202–7.Google Scholar
  48. 48.
    Ford RK, Schluter PJ, Mitchell EA, et al. Factors associated with the age of introduction of solids into the diet of New Zealand infants. J Paediatr Child Health 1995;31:469–72.CrossRefGoogle Scholar
  49. 49.
    Spigelblatt L, Laine-Ammara G, Arsenault L, et al. Influence d’une éducation suivie auprès des mères sur l’introduction trop rapide des solides dans l’alimentation du nourrisson. Pédiatrie 1991;46(5):475–79.PubMedGoogle Scholar
  50. 50.
    Debra Reid, Ottawa-Carleton Health Department. Personal communication. October 1997.Google Scholar
  51. 51.
    Nafstad P, Jaakkola JK, Hagen JA, et al. Weight gain during the first year of life in relation to maternal smoking and breast feeding in Norway. J Epidemiol Commun Health 1997;51:261–65.CrossRefGoogle Scholar
  52. 52.
    Horta BL, Victora CG, Menezes AM, et al. Environmental tobacco smoke and breastfeeding duration. Am J Epidemiol 1997;146(2):128–33.CrossRefGoogle Scholar
  53. 53.
    Lyon AJ. Effects of smoking on breast feeding. Arch Dis Child 1983;58:378–80.CrossRefGoogle Scholar
  54. 54.
    Andersen AN, Lund-Andersen C, Larsen JF, et al. Suppressed prolactin but normal neurophysin levels in cigarette smoking breast-feeding women. Clinical Endocrinology 1982;17:363–68.CrossRefGoogle Scholar
  55. 55.
    Baron JA, Bulbrook RD, Wang DY, et al. Cigarette smoking and prolactin in women. BMJ 1986;293:482–83.CrossRefGoogle Scholar
  56. 56.
    Blake CA, Sawyer CH. Nicotine blocks the suckling-induced rise in circulating prolactin in lactat-ing rats. Science 1972;177:619–21.CrossRefGoogle Scholar
  57. 57.
    Weitzman M, Gortmaker S, Sobol A. Maternal smoking and behavior problems of children. Pediatrics 1992;90(3):342–49.PubMedGoogle Scholar
  58. 58.
    Nafstad P, Jaakkola JJK, Hagen JA, et al. Breasfeeding, maternal smoking and lower respiratory tract infections. Eur Respir J 1996;9:2623–29.CrossRefGoogle Scholar
  59. 59.
    Stoddard JJ, Miller T. Impact of parental smoking on the prevalence of wheezing respiratory illness in children. Am J Epidemiol 1995;141:96–102.CrossRefGoogle Scholar
  60. 60.
    Weinburger MM. Environmental tobacco smoke and pediatric illnesses. In: American Council on Science and Health. Cigarettes: What the Warning Label Doesn’t Tell You: The First Comprehensive Guide to the Health Consequences of Smoking. New York: Prometheus Books, 1997.Google Scholar
  61. 61.
    Wright AL, Holberg C, Martinez FD, et al. Relationship of parental smoking to wheezing and nonwheezing lower respiratory tract illnesses in infancy. J Pediatr 1991;118:207–14.CrossRefGoogle Scholar
  62. 62.
    Palmer G. The Politics of Breastfeeding. London: Pandora Press, 1993.Google Scholar
  63. 63.
    Levitt CL. Canada urged to ban free infant-formula samples. Can Med Assoc J 1995;152(10):1587.Google Scholar
  64. 64.
    Position of the American Dietetic Association. Promotion of breast-feeding. J Am Dietet Assoc 1997;97(6):662–66.CrossRefGoogle Scholar
  65. 65.
    American Academy of Pediatrics Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 1997;100(6):1035–39.CrossRefGoogle Scholar
  66. 66.
    Levitt CL, Kaczorowski J, Hanvey L, et al. Breast-feeding policies and practices in Canadian hospitals providing maternity care. Can Med Assoc J 1996;155(2):181–88.Google Scholar
  67. 67.
    Burglehaus MJ, Smith LA, Sheps SB, et al. Physicians and breastfeeding: Beliefs, knowledge, self-efficacy and counselling practices. Can J Public Health 1997;88(6):383–87.PubMedPubMedCentralGoogle Scholar
  68. 68.
    Dettwyler KA. Beauty and the breast: The cultural context of breastfeeding in the United States. In: Stuart-Macadam P, Dettwyler KA (Eds.), Breastfeeding — Biocultural Perspectives. New York: Aldine de Gruyter, 1995.Google Scholar
  69. 69.
    Persson LA, Carlgren G. Measuring children’s diets: Evaluation of dietary assessment techniques in infancy and childhood. Int J Epidemiol 1984;13(4):506–17.CrossRefGoogle Scholar
  70. 70.
    Kleinbaum DG, Kupper LL. Applied Regression Analysis and Other Multivariable Methods. Massachussetts: Duxbury Press, 1978.Google Scholar

Copyright information

© The Canadian Public Health Association 1999

Authors and Affiliations

  • Beth S. Kwavnick
    • 1
    Email author
  • Debra J. Reid
    • 2
  • Michel R. Joffres
    • 1
  • Judith Read Guernsey
    • 1
  1. 1.Department of Community Health and EpidemiologyDalhousie UniversityHalifaxCanada
  2. 2.Region of Ottawa-Carleton Health DepartmentOttawaCanada

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