Complementary Feeding Caregivers' Practices and Growth, Risk of Overweight/Obesity, and Other Non-Communicable Diseases: A Systematic Review and Meta-Analysis

Nutrients. 2022 Jun 26;14(13):2646. doi: 10.3390/nu14132646.


Several institutions propose responsive feeding (RF) as the caregivers' relational standard when nurturing a child, from breast/formula feeding onwards. Previous systematic reviews (SRs) on caregivers' feeding practices (CFPs) have included studies on populations from countries with different cultures, rates of malnutrition, and incomes, whereas this SR compares different CFPs only in healthy children (4-24 months) from industrialized countries. Clinical questions were about the influence of different CFPs on several important outcomes, namely growth, overweight/obesity, risk of choking, dental caries, type 2 diabetes (DM2), and hypertension. The literature review does not support any Baby Led Weaning's or Baby-Led Introduction to SolidS' (BLISS) positive influence on children's weight-length gain, nor their preventive effect on future overweight/obesity. RF-CFPs can result in adequate weight gain and a lower incidence of overweight/obesity during the first two years of life, whereas restrictive styles and coercive styles, two kinds of non-RF in CF, can have a negative effect, favoring excess weight and lower weight, respectively. Choking risk: failure to supervise a child's meals by an adult represents the most important risk factor; no cause-effect relation between BLW/BLISS/RF/NRCF and choking could be found. Risks of DM2, hypertension, and caries: different CFPs cannot be considered as a risky or preventive factor for developing these conditions later in life.

Keywords: BLISS; baby led weaning; choking; complementary feeding; growth; non-responsive feeding; obesity; overweight; responsive feeding; weaning.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Airway Obstruction*
  • Caregivers
  • Child
  • Dental Caries*
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / etiology
  • Diabetes Mellitus, Type 2* / prevention & control
  • Feeding Behavior
  • Humans
  • Hypertension* / epidemiology
  • Hypertension* / etiology
  • Hypertension* / prevention & control
  • Infant
  • Infant Nutritional Physiological Phenomena
  • Noncommunicable Diseases*
  • Obesity / epidemiology
  • Obesity / etiology
  • Overweight / epidemiology
  • Overweight / etiology
  • Weight Gain

Grants and funding

This article was written as part of the scientific activities of the Italian Society of Preventive and Social Paediatrics (Società Italiana di Pediatria Preventiva e Sociale—SIPPS). The costs of this Systematic Review have been covered by the Società Italiana di Pediatria Preventiva e Sociale. This research received no external funding. All contributors worked free of charge.