Discussion
allergic disease
DISEASE, TOLERANCE, ALLERGY
In a general population of >2000 infants, >85% of infants were breastfed throughout the first 6 mo of life, and half of the population was still breastfed at 12 mo. The mean age of complementary food introduction in the NFI group was 4.5 mo. Most infants were introduced to complementary foods, mainly fruits, vegetables, and porridge, between 4 and 6 mo. The food intervention did not affect breastfeeding rates, whereas the dietary diversity score at 9 and 12 mo was significantly higher in infants subjected to the early food intervention compared with the infants who were not.Breastfeeding rates in our study are consistent with recent findings in Spedkost 3, a Norwegian nationwide survey from 2019, including 2182 infants [A study from 2019 [Most infants in the NFI group were introduced to complementary foods between 4 and 6 mo of age, in line with the European Society for for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines [Breastfeeding rates in our study were not affected by the food intervention, similar to 2 other large early allergenic food introduction RCTs, the Enquiring About Tolerance study in a general population [The finding that early introduction of complementary foods was associated with significantly increased dietary diversity at 9 and 12 mo of age is novel, to the best of our knowledge. Dietary diversity in infancy has gained significant attention because of its role in modulating allergic disease outcomes. Given the complexities and challenges of dietary diversity research, the European Academy of Allergy and Clinical Immunology Task Force recently provided an expert consensus regarding multiple aspects of diet diversity research and highlighted the need for more clinical trials with agreed definitions [Major strengths of the present study include the prospective design and robust sample size from a general population and the systematic collection of detailed questionnaires, which limits the likelihood of recall bias and ensures high accuracy of timing of solid food introduction and milk-feeding practices [The Norwegian Directorate of Health recommends exclusive breastfeeding for 6 months, in line with the WHO [An infant’s readiness to start complementary feeding will depend on the individual’s development [As breastfeeding is the best for the infant, early introduction of solid foods should not come at the expense of breastfeeding. The results from our study suggest that early complementary introduction is beneficial for increased dietary diversity with no negative impact on breastfeeding rates. Further studies are needed to address the potential impact on disease prevention, as well as potential underlying mechanisms.In summary, in this general population-based mother–child birth cohort, most infants were breastfed throughout the first 6 mo of life, and half were still breastfed at 12 mo. The mean age of complementary food introduction was 4.5 mo, and most infants received complementary foods by 6 mo. Our data provide novel information that introducing small amounts of complementary foods from 3 mo of age increased dietary diversity but not at the expense of breastfeeding rates or breastfeeding duration.