Complementary Feeding Practices of Former Neonatal Intensive Care Children: A Cohort Study

BACKGROUND: Healthy feeding practices during the first 2 years of life are crucial for ensuring adequate growth and development. OBJECTIVE: To evaluate infant and young child feeding (IYCF) practices among high-risk children during the first 2 years of life. METHODS: Cohort study including former Neonatal Intensive Care Unit children followed at two University hospitals from birth until 24 months of age. Dietary data were collected using 24-h recalls, and diet quality was assessed based on the World Health Organization's IYCF indicators, including the consumption of ultra-processed foods (UPF). Early weaning was defined as the interruption of exclusive breastfeeding before 6 months of age, according to World Health Organization recommendations. Linear mixed-effects models were used to evaluate changes over time in the proportion of ultra-processed food consumption and dietary diversity. RESULTS: Among the 155 children included in the study, early weaning occurred in 82.9% of participants. Minimum dietary diversity increased with age (58.0%-85.0%; p < 0.001), while consumption of vitamin A-rich foods remained stable (average 63%; p = 0.90) and below recommended levels. Significant increases were observed in the intake of added sugar (26.0%-67.0%; p < 0.001), sugar-sweetened beverages (17.0%-57.0%; p < 0.001), and ultra-processed foods (41.0%-78.0%; p < 0.001) between 6 and 24 months. Full-term children were less likely to achieve dietary diversity compared with preterm infants (OR: 0.27; 95% CI: 0.09-0.80; p = 0.02). CONCLUSION: The diet quality of children was suboptimal during the first 2 years of life, marked by early weaning, insufficient intake of vitamin A-rich foods, and high exposure to ultra-processed products. These results highlight the urgent need for targeted interventions to promote healthier feeding practices in this vulnerable population.