Consensus Study Report

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International Standard Book Number-13: 978-0-309-71017-6
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2023. Complementary feeding interventions for infants and young children under age 2: Scoping of promising interventions to implement at the community or state level. Washington, DC: The National Academies Press. https://doi.org/10.17226/27239.

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COMMITTEE ON COMPLEMENTARY FEEDING INTERVENTIONS FOR INFANTS AND CHILDREN UNDER AGE 2

DAVID A. SAVITZ (Chair), Professor, Brown University School of Public Health, Providence, Rhode Island

LAURA E. CAULFIELD, Professor, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

VALERIE J. FLAHERMAN, Professor, University of California, San Francisco

FRANK R. GREER, Professor Emeritus, University of Wisconsin School of Medicine, Madison

ELIZABETH YAKES JIMENEZ, Professor, University of New Mexico Health Sciences Center, Albuquerque

RAFAEL PÉREZ-ESCAMILLA, Professor, Yale School of Public Health, New Haven, Connecticut

LORRENE D. RITCHIE, Director, Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources, Oakland, California

CHARLENE M. RUSSELL-TUCKER, Commissioner of Education, Connecticut State Department of Education, Hartford

SHANNON E. WHALEY, Director of Research and Evaluation, PHFE WIC, Irwindale, California

Study Staff

KATHERINE M. DELANEY, Study Director

JENNIFER STEPHENSON, Research Associate (since April 2023)

MELANIE ARTHUR, Senior Program Assistant

ANNE MARIE HOUPPERT, Senior Librarian

MELISSA MAITIN-SHEPARD, Science Writer

ANN L. YAKTINE, Director, Food and Nutrition Board

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Reviewers

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by RONALD KLEINMAN, Harvard Medical School, and CATHERINE E. WOTEKI, Iowa State University. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

Foreward

The translation of research findings into policy is a challenging but essential step in the pathway by which scientific evidence advances societal goals, in this case, promoting the nutritional health of young children. The particular challenge for the Committee on Complementary Feeding Interventions for Infants and Young Children Under Age 2 (years) was to identify, describe, evaluate, and apply relevant research to future efforts to optimize complementary feeding in infants and children under 2 years of age. The committee was asked not just to assess the quality of the research, but, just as importantly, to offer our perspective on how the insights could be used to develop public health programs that could be scaled up for the entire population and mitigate health disparities.

The committee members have an abundance of diverse disciplinary expertise, with an unusually wide range of professional homes, but a shared desire to straddle the divide between academic research and programmatic interventions. There were considerable challenges in connecting a heterogeneous body of studies to promising strategies for implementation, but through the individual, and particularly the collective, insights of the committee, we believe we have identified a constructive way forward. The influences on complementary feeding are diverse and complex, involving caregivers, health care providers, educators, and a wide range of government agencies, and the committee believes that by working toward a complementary and coherent engagement of all these entities, there is an exciting opportunity for progress.

The conscientious efforts of the committee that made it possible to develop this report over a relatively brief period are remarkable. Despite

many competing demands, all members contributed creative ideas combined with hard work to develop a harmonized document that provides a unified perspective. The same combination of innovative thinking and substantive contributions from the study director, Katie Delaney, and the talented colleagues at the Academies with whom she worked, Jen Stephenson, Melanie Arthur, and Anne Marie Houppert, as well as Melissa Maitin-Shepard (science writer), were essential at every step along the way from identifying the literature to refining the document and everything in between. It is always remarkable and highly gratifying to watch the process unfold, the way that each of the committee members and staff finds a rhythm for working together toward a common goal, each of us adding an instrument to the orchestra toward our shared goal of creating a symphony. Despite the seriousness of our purpose and demands in developing the report, the committee and staff made the process enjoyable as well as gratifying.

David A. Savitz, Chair
Committee on Complementary Feeding Interventions
for Infants and Young Children Under Age 2

Contents

SUMMARY

1 INTRODUCTION

Complementary Feeding of Infants and Children

Background for the Study

The Committee’s Task and Approach

Organization of the Report

References

2 METHODOLOGICAL APPROACH

Committee’s Interpretation of the Task

Search Approach

Screening and Data Extraction

Assessment of the Evidence

References

3 CONSIDERATIONS

Factors Considered in Mapping All Interventions

Factors Considered in Assessing Informative Examples

Summary

References

4 OVERVIEW OF INTERVENTIONS IDENTIFIED IN THE SCOPING REVIEW

Overall Description of Identified Studies

Description of Identified Studies by Setting

Summary

References

5 IDENTIFIED INFORMATIVE STUDIES AND ELEMENTS

Informative Studies

Select Informative Elements from Identified Studies in This Report

Summary

References

6 CONSIDERATIONS FOR SCALING INFANT AND YOUNG CHILD FEEDING INTERVENTIONS

Shifting Perspective from Settings to Systems

Factors for Successful Scaling of Infant and Young Child Feeding Interventions

Next Steps for Scaling Complementary Feeding Interventions

Summary

References

7 IMPLICATIONS AND CONSIDERATIONS FOR DESIGN OF INTERVENTIONS TO IMPROVE INFANT AND YOUNG CHILD FEEDING BEHAVIOR IN THE UNITED STATES

Building from Existing Systems and Infrastructure: Opportunities and Challenges

Collection and Application of Standardized Infant and Young Child Feeding Outcomes

Reaching Underserved Populations

Additional Considerations

Going Forward: Final Considerations

Summary

References

APPENDIXES

A Committee Member Biographies

B Open Session Materials

C Literature Search Strategies and Results

D Data Extraction Criteria

E Data Extraction Tables

F Scalability Assessments for Informative Studies

Acronyms and Abbreviations