Early solid feeding and recurrent childhood eczema: a 10-year longitudinal study

The relationship between early solid feeding practices and risks of recurrent or chronic eczema in childhood was examined in a birth cohort of New Zealand children studied to the age of 10. By the age of 10 years, 7.5% of children had chronic or recurrent eczema. There were clear and consistent associations between the diversity of the child's diet during the first 4 months and risks of eczema. Even when due allowance was made for a range of confounding factors--including parental atopic illness, atopic illness in siblings, the child's early milk diet, and family social background--children exposed to four or more different types of solid food before 4 months had risks of recurrent or chronic eczema that were 2.9 times those of children who were not exposed to early solid feeding. It is concluded that early exposure to a diet diverse in potential food antigens may act to predispose susceptible children to recurrent or chronic childhood eczema.     

Eczema and early solid feeding in preterm infants.

AIMS: To establish whether development of eczema is influenced by feeding practices in preterm infants, while taking account of confounding factors. METHODS: Data were assembled from 257 infants born prematurely and studied to 12 months post-term. Logistic regression analysis was performed to establish the association between feeding practices and eczema, allowing for potential confounding factors including the infants' gender, parental atopic status, social background, and parental smoking habits. RESULTS: For the development of eczema (with or without other symptoms) by 12 months post-term, the introduction of four or more solid foods by or before 17 weeks post-term was a significant risk (odds ratio 3.49). Male infants were at significantly higher risk (odds ratio 1.84). In addition, having non-atopic parents who introduced solid foods before 10 weeks post-term or having at least one atopic parent represented a significant risk scenario (odds ratio 2.94). CONCLUSIONS: Early introduction of a diverse range of solid foods may predispose the preterm infant to eczema development by 12 months post-term. Furthermore, non-atopic parents who practice early as opposed to late introduction of solid foods may be exposing preterm infants to a greater risk of eczema by 12 months post-term.     

Eczema and early solid feeding in preterm infants

Aims: To establish whether development of eczema is influenced by feeding practices in preterm infants, while taking account of confounding factors. Methods: Data were assembled from 257 infants born prematurely and studied to 12 months post-term. Logistic regression analysis was performed to establish the association between feeding practices and eczema, allowing for potential confounding factors including the infants'' gender, parental atopic status, social background, and parental smoking habits. Results: For the development of eczema (with or without other symptoms) by 12 months post-term, the introduction of four or more solid foods by or before 17 weeks post-term was a significant risk (odds ratio 3.49). Male infants were at significantly higher risk (odds ratio 1.84). In addition, having non-atopic parents who introduced solid foods before 10 weeks post-term or having at least one atopic parent represented a significant risk scenario (odds ratio 2.94). Conclusions: Early introduction of a diverse range of solid foods may predispose the preterm infant to eczema development by 12 months post-term. Furthermore, non-atopic parents who practice early as opposed to late introduction of solid foods may be exposing preterm infants to a greater risk of eczema by 12 months post-term.     

Early fish introduction is associated with less eczema,but not sensitization,in infants

Objective: To investigate if the development of allergic diseases during the child’s first 18 months of life is influenced by the time at which different food items were introduced into the child’s diet. Method: A birth cohort of 184 children was followed to 18 months of age. Diaries were used to document feeding practices, and parental interviews were performed at 6 and 12 months of age, probing for symptoms suggesting allergic disease, general health‐related issues and food introduction regimes. Symptoms promoted prompt clinical examination, and all children were examined clinically, and tested for sensitization to common airborne and food allergens at 18 months of age. Results: The earlier the fish was introduced into the child’s diet the lower was the frequency of eczema. This association remained after control for confounding factors. The timing of fish introduction and asthma development showed a similar pattern, but did not reach statistical significance. Sensitization was not influenced by the timing of fish introduction. Other food items or feeding practices did not seem to influence allergy development. Conclusion: Early introduction of fish into the child’s diet was associated with less eczema development, and a tendency to less asthma. Sensitization was not associated with the timing of fish introduction.     

Systematic review of the relationship between early introduction of solid foods to infants and the development of allergic disease

OBJECTIVE: To assess the evidence that early solid feeding (before age 4 months) increases the risk of allergic disease. DATA SOURCES: MEDLINE, the Cochrane Library, and the Drugs and Pharmacology section of EMBASE with key words "infant," "food," and "allergy." STUDY SELECTION: We found 2719 article citations and reviewed references of relevant articles. We critically evaluated the methods and results of articles that met inclusion criteria. We identified 13 studies that met inclusion criteria. There was only 1 controlled trial. DATA EXTRACTION: Allergic disease. DATA SYNTHESIS: Five studies found a positive association between early solid feeding and eczema, with a persistence of the association for 10 years in 1 study. Four studies found no association. One study found an association between early solid feeding and pollen allergy. We found no strong evidence to support the association between early solid feeding and the development of persistent asthma, persistent food allergy, allergic rhinitis, or animal dander allergy. CONCLUSIONS: Systematic review of available evidence suggests that early solid feeding may increase the risk of eczema. However, there are little data supporting an association between early solid feeding and other allergic conditions. Since many studies had problematic methods, additional controlled trials are needed to help guide physicians as they advise parents about the allergic risks of early introduction of solids.     

Determinants of inappropriate complementary feeding practices in young children in Sri Lanka: secondary data analysis of Demographic and Health Survey 2006-2007

Inappropriate complementary feeding increases risk of undernutrition, illness and mortality in infants and children. This paper aimed to determine the factors associated with inappropriate complementary feeding practices in Sri Lanka. The Sri Lanka Demographic and Health Survey 2006-2007 used a stratified two-stage cluster sample of ever-married women 15-49 years, and included details about foods given to children aged 6-23 months during the last 24 h. The new World Health Organization indicators for infant and young child feeding (IYCF) - (introduction of solid/semi-solid or soft foods; minimum dietary diversity; minimum meal frequency; and minimum acceptable diet) were calculated for 2106 children aged 6-23 months. These indicators were examined against explanatory variables with multivariate analyses to identify factors associated with inappropriate practices. Eighty-four per cent of infants aged 6-8 months were introduced to complementary food. The proportion of infants aged 6-8 months who consumed eggs (7.5%), fruits and vegetables other than those rich in vitamin A (29.6%) and flesh foods (35.2%) was low. Of children aged 6-23 months, minimum dietary diversity was 71%, minimum meal frequency 88% and minimum acceptable diet 68%. Children who lived in tea estate sector had a lower dietary diversity and minimum acceptable diet than children in urban and rural areas. Other determinants of not receiving a diverse or acceptable diet were lower maternal education, shorter maternal height, lower wealth index, lack of postnatal visits, unsatisfactory exposure to media and acute respiratory infections. In conclusion, complementary feeding indicators were adequate except in the 6-11 months age group. Subgroups with inappropriate feeding practices should be the focus of IYCF promotion programs.     

PROPHYLAXIS OF ATOPIC DISEASE BY SIX MONTHS' TOTAL SOLID FOOD ELIMINATION

ABSTRACT. One hundred and thirty-five infants of atopic parents were exclusively breast-fed for 6 months without any cow's milk based supplements. Of these infants 70 received no nourishment except breast milk during the 6 months, and 65 were started on solid foods at the age of 3 months. The diet of all the infants was similar during 6 to 12 months of age. The children were examined at the age of one year. In the exclusive breast milk group atopic eczema and food allergy were less frequent than in the solid food group. The results suggest that total solid food elimination for the first 6 months of life, in addition to exclusive breast milk feeding, is prophylactic for atopic disease in children who are at hereditary risk.     

Prevalence and overlap of known undernutrition risk factors in children in Nairobi Kenya

We aimed to describe the co-occurrence of known risk factors for undernutrition and the prevalence of modifiable risks in wasted, stunted and healthy children. Quota sampling was used to recruit healthy [weight for age Z scores (WAZ) > ?2 SD] and undernourished [weight for length (WLZ) or WAZ scores ≤ ?2 SD] children aged 6–24 months from seven clinics in low-income areas of Nairobi. Structured interviews were used to identify exposure to socioeconomic, water and hygiene, infant feeding, dietary and behavioural risks (low interest in food, high food refusal and force feeding). We recruited 92 wasted WLZ ≤ ?2 SD, 133 stunted (length for age Z scores LAZ ≤ ?2 SD) and 172 healthy (LAZ and WLZ > 2SD) children. Nearly all children were exposed to hygiene risks (90%) and low dietary diversity (95%) regardless of nutritional status. Stunted children were more likely to be exposed to socio-economic risks (54% healthy, 64% wasted and 72% stunted; P = 0.001). Compared with healthy children, wasted and stunted children were more likely to be exposed to infant feeding (25% healthy, 40% wasted and 41% stunted; P = 0.02) and behaviour risks (24% healthy, 49% wasted, and 44% stunted; P = 0.004). Overall, wasted and stunted children were twice as likely to be exposed to more than three risks (23% healthy, 48% wasted, and 50% stunted; P = <0.001). They were also more likely to be exposed to more than three modifiable risks (dietary, handwashing and behaviour risks). Wasting and stunting are associated with exposure to multiple risk factors, many of which are potentially modifiable using targeted advice.     

Dietary patterns in infancy and cognitive and neuropsychological function in childhood

Background: Trials in developing countries suggest that improving young children’s diet may benefit cognitive development. Whether dietary composition influences young children’s cognition in developed countries is unclear. Although many studies have examined the relation between type of milk received in infancy and subsequent cognition, there has been no investigation of the possible effect of variations in the weaning diet. Methods: We studied 241 children aged 4 years, whose diet had been assessed at age 6 and 12 months. We measured IQ with the Wechsler Pre‐School and Primary Scale of Intelligence, visual attention, visuomotor precision, sentence repetition and verbal fluency with the Developmental Neuropsychological Assessment (NEPSY), and visual form‐constancy with the Test of Visual Perceptual Skills. Results: In sex‐adjusted analyses, children whose diet in infancy was characterised by high consumption of fruit, vegetables and home‐prepared foods (‘infant guidelines’ dietary pattern) had higher full‐scale and verbal IQ and better memory performance at age 4 years. Further adjustment for maternal education, intelligence, social class, quality of the home environment and other potential confounding factors attenuated these associations but the relations between higher ‘infant guidelines’ diet score and full‐scale and verbal IQ remained significant. For a standard deviation increase in ‘infant guidelines’ diet score at 6 or 12 months full‐scale IQ rose by .18 (95% CI .04 to .31) of a standard deviation. For a standard deviation increase in ‘infant guidelines’ diet score at 6 months verbal IQ rose by .14 (.01 to .27) of a standard deviation. There were no associations between dietary patterns in infancy and 4‐year performance on the other tests. Conclusions: These findings suggest that dietary patterns in early life may have some effect on cognitive development. It is also possible that they reflect the influence of unmeasured confounding factors.     

Factors associated with maternal dietary intake,feeding and weaning practices,and the development of food hypersensitivity in the infant

Maternal diet during pregnancy and breastfeeding, as well as infant feeding and weaning practices, may play a role in the development of sensitization to food and food hypersensitivity (FHS) and need further investigation. Pregnant women were recruited at 12 wk pregnancy. Information regarding family history of allergy was obtained by means of a questionnaire. A food frequency questionnaire was completed at 36 wk gestation. Information regarding feeding practices and reported symptoms of atopy was obtained during the infants’ first 3 yr of life. Children were also skin‐prick tested at 1, 2 and 3 yr to a pre‐defined panel of food allergens. Food challenges were conducted where possible. Maternal dietary intake during pregnancy, and breast‐feeding duration did not influence the development of sensitization to food allergens or FHS, but weaning age (≥16 wk) did for sensitization at 1 yr (p = 0.03), FHS by 1 yr (p = 0.02), sensitization at 3 yr (p = 0.01) and FHS by 3 yr (p = 0.02). In contrast, children who were not exposed to a certain food allergen before the age of 3–6 months were less likely to become sensitized or develop FHS. Women with a family history of allergic disease were more likely to breastfeed exclusively at 3 months (p = 0.008) and avoid peanuts from the infant’s diet at 6 months (p = 0.03). Maternal dietary intake during pregnancy, and breast‐feeding duration did not appear to influence the development of sensitization to food allergens or FHS. Weaning age may affect sensitization to foods and development of FHS. A history of allergic disease has very little impact on maternal dietary, feeding, and weaning practices.     

Infant temperament,maternal feeding behaviours and the timing of solid food introduction

Despite guidance from the World Health Organization and the U.K. Department of Health, many mothers introduce solid food before their infant is 6 months old. The current study aimed to investigate relationships between maternal feeding behaviours (preintroduction and postintroduction to solids), infant temperament, and the timing of introduction to solid food. Eighty‐one women were recruited on low‐risk maternity units and were contacted at 1 week, 3, and 6 months postpartum. Mothers of infants (45 males, 36 females, mean birth weight 3.52 kg [SD 0.39]) completed the behaviours component of the Infant Feeding Style Questionnaire via telephone interview at 3 months. At 6 months, they were observed feeding their infant solid food at home and reported infant temperament using the Infant Behaviour Questionnaire‐Revised (short form). Partial correlations (covariates: birth weight, maternal age, breastfeeding duration, and postnatal depression) revealed negative associations between age of introduction to solid food and temperament (smiling and laughter) and laissez‐faire milk feeding behaviours; and positive associations between age of introduction to solid food and restrictive milk feeding behaviours and verbal involvement during an observed mealtime. Hierarchical multiple regression analysis revealed that an infant's birth weight and the degree to which their mothers perceive them to smile and laugh are key predictors of when they will be introduced to solid food, over and above other variables of interest (e.g., maternal milk feeding behaviours, breastfeeding duration, and postnatal depression).     

Effects on later adjustment of living in a stepfamily during childhood and adolescence

This paper examines the effects of living in a stepfamily during childhood and adolescence on a range of psychosocial outcomes at age 18 years. Data collected during an 18-year longitudinal study were used to examine a sample of 907 children with respect to: exposure to living in a stepfamily during the period from age 6 to 16 years; measures of psychosocial outcomes including mental health, antisocial behaviour, substance use, restricted life opportunities, and sexual risk-taking at age 18 years; and measures of prospectively collected confounding factors. The analyses revealed that children exposed to living in a stepfamily for the first time between ages 6-16 years had elevated risks of a range of psychosocial outcomes at 18 years. These included elevated risks of: (1) juvenile offending; (2) nicotine dependence; (3) abuse or dependence on illicit substances; (4) leaving school without qualifications; (5) early onset of sexual activity; and (6) multiple sexual partners. However, these risks were reduced substantially when psychosocial outcomes were adjusted for the confounding effects of antecedent factors such as: family socioeconomic characteristics: family history of instability, adversity, and conflict; mother's age, religiosity, and smoking; child gender; and preexisting child conduct and attentional problems. After adjustment, the odds ratios between exposure to a stepfamily and adolescent outcomes were nonsignificant. Additional analysis revealed that there were no significant differences in outcomes for boys and girls exposed to stepfamilies. It was concluded that although young people exposed to living in a stepfamily had increased risks of poor psychosocial outcomes, much of this association appeared to be spurious, and arose from confounding social, contextual, and individual factors that were present prior to the formation of the stepfamily.     

Atopy in children with and without a family history of atopy. II. Skin reactivity

The influence of prolongation of breast feeding and postponement of introduction of solid food during infancy on skin reactivity at the age of five years was studied. At least one positive skin prick test result was observed in 23% of the 70 children with a family history of atopy and in 17% of the 58 children with no such history. Of the 26 skin-test-positive children, 54% exhibited positive reactions to cat dander and 42% to birch pollen. Of the 6 children with asthma, 6 with rhinitis and 17 with eczema, skin reactivity was observed in 66%, 66% and 35%, respectively. Contact with a cat during the first three to four months of life did not correlate with skin test positivity at the age of five years. Skin test positivity to birch pollen was more common in children born in January to February, probably because they were at a vulnerable age in their first birch pollen season in May. No preventive effect by the diet consumed during infancy was seen on subsequent skin test results in relation to common allergens.     

Timing of solid food introduction and association with later childhood overweight and obesity: The IDEFICS study

This study investigated associations between timing of solid food introduction and childhood obesity and explored maternal characteristics influencing early feeding practices. Cross‐sectional data from children 2–9 years (n = 10,808; 50.5% boys) residing in 8 European countries of the IDEFICS study (2007–2008) were included. Late solid food introduction (≥7 months of age) was associated with an increased prevalence of later childhood overweight/obesity among exclusively breastfed children (OR [odds ratio]: 1.38, 95% CI [confidence interval] [1.01, 1.88]). In contrast, early solid food introduction (<4 months of age) was associated with lower prevalence of overweight/obesity among children that ceased exclusive breastfeeding earlier than 4 months (OR: 0.63, 95% CI [0.47, 0.84]). Children that were introduced to solids right after 6 months exclusive breastfeeding and continued to receive breastmilk (≥12 months) were less likely to become overweight/obese (OR: 0.67, 95% CI [0.51, 0.88]) compared to children that discontinued to receive breastmilk. Analyses were adjusted for age, sex, country, birth weight, parental education level, parental body mass index, tobacco use in pregnancy, gestational weight gain, and gestational diabetes. Underweight mothers, overweight mothers, mothers who reported daily smoking during pregnancy, and low‐educated mothers were less likely to follow recommendations on breastfeeding and timely solids introduction. Future studies should examine whether guidelines for solid food introduction timing have to distinguish between exclusively breastfed, formula fed, and too early exclusive breastfeeding‐ceased infants. There is also need for more prospective studies; recall bias was an important current limitation. In conclusion, health professionals should emphasize benefits of breastfeeding and appropriate solid food introduction, especially to mothers that are less likely to follow recommendations.     

Premastication and length for age among children under 24 months in Laos

Premastication of infant food by caregivers is common in Laos. Premastication is hypothesized to have both positive and negative implications for children, but the net effect of premastication on child health and nutrition is largely unknown because of a lack of research. This study quantitatively describes premastication in 5 provinces of Laos and examines the associations between premastication and the length of young children. We analyzed cross‐sectional data from the Laos 2015 Food and Nutrition Security Survey to characterize premastication among children under 2 years of age (n = 1,661) and to test associations between premastication and child length‐for‐age z‐score. We explored associations using multilevel mixed effects linear regression. Among children 0–23 months, 27.2% of mothers reported giving premasticated food in the past week. Receipt of premasticated food was inversely associated with length‐for‐age z‐score after controlling for potential confounders (child's age, ethno‐linguistic group, wealth, and parity) among children 6–13 months (β ?0.36, CI [?0.68, ?0.04]) and among children 14–23 months (β ?0.43, CI [?0.81, ?0.05]). For breastfed children 0–5 months who received complementary food, the coefficient was similar, but the association was not statistically significant (β ?0.42, CI [?1.2, 0.37]). Premastication is a common feeding practice for children 0–23 months of age, and many infants consume premasticated food on a daily basis. There was a negative relationship between premastication and child length. However, given the cross‐sectional nature of this study and potential unmeasured confounding factors, reverse causality or confounding cannot be ruled out. Longitudinal studies are needed to develop recommendations on premastication.     

Social and familial factors in the development of early childhood asthma

The role of social and familial factors in the development of childhood asthma by age 6 years was studied in a birth cohort of New Zealand children. Rates of asthma varied markedly with the child's sex; boys had twice the rate of asthma as girls. In addition, the factors associated with asthma varied with the child's sex. For boys, wheeze during infancy, early eczema, and parental asthma were all significant risk factors; for girls, the only risk factor was early eczema. Proportional hazards modeling of the data failed to show any significant associations between the development of asthma and a large range of other social and familial factors including breast-feeding, parental smoking habits, pets in the child's family, stress in the family, or family social background. It was concluded that asthma in early childhood appeared to be inherited to some extent, its age of expression was related to the child's sex, and it had a complex interaction with other forms of allergic disease. There was no evidence to suggest that the structure, practices, or dynamics of the child's family played a significant role in the development of asthma for children in this birth cohort.     

Family interaction and a supportive social network as salutogenic factors in childhood atopic illness

The role of psycho‐social factors in the development of allergy was studied prospectively in 82 infants with a family history of atopy. The family participated in a standardized family test when the children were 18 months old. The ability to adjust to demands of the situation (‘adaptability’), and the balance between emotional closeness and distance (‘cohesion’), were assessed from videotapes by independent raters. Families rated as functional in both of these aspects were classified as ‘functional’, otherwise as ‘dysfunctional’. The social network, life events, atopic symptoms (based on postal inquiries regarding symptoms answered by the parents, and on physical examinations), psychiatric symptoms, and socio‐economic circumstances of the families were evaluated when the children were 18 months and 3 years of age. The children were classified as atopic (asthmatic symptoms or eczema) or as non‐atopic. All but two children with atopic disease at 3 years of age had atopic disease before 18 months of age, while 32 of 60 children with atopic disease at 18 months of age had no problems by 3 years of age. An unbalanced family interplay at 18 months was associated with a relative risk (RR) of 1.99 for continuing atopic illness at 3 years of age (1.18 < RR < 3.37, p = 0.01). There was a weak positive confounding effect for smoking (RR reduced by 7%), eczema on three or more localizations (RR reduced by 4.5%), and the amount of cat allergen in household dust (RR reduced by 3%). Recovery from atopic illness between 18 months and 3 years of age was four times as probable in families with functional interaction and a good social supportive network when children were 18 months of age, than in dysfunctional families with a poor social network (74% versus 20% p < 0.01). Children with asthmatic symptoms showed more signs of emotional distress than did healthy children (p = 0.02). Dysfunctional family interaction patterns were more commonly observed in families of children who at 3 years of age still had atopic symptoms, than in children who had recovered. The patterns included expression of emotion and reaction to the needs of others, alternating between total disinterest and over‐involvement (p = 0.02), lack of support and rejection of offered support (p = 0.01), a greater number of individual decisions without regard to the other family members (p = 0.04), and indistinct ‘generational boundaries’ (p = 0.04). We conclude that psychosocial factors, such as family interaction and a supportive social network, play a significant role in the course of atopic illness in early childhood and that measures which enhance family interaction and the social network could influence the course of the disease favorably.     

Early anxious/withdrawn behaviours predict later internalising disorders

BACKGROUND: The aim of the study was to examine the association between anxious/withdrawn behaviours at age 8 and the development of internalising disorders in adolescence and young adulthood (ages 16-21). METHODS: Data were gathered over the course of a 21-year longitudinal study of a birth cohort of over 1,000 New-Zealand-born young people. Over the course of the study, data were gathered on: (a) anxious/withdrawn behaviour at age 8; (b) anxiety disorders and major depression at ages 16-18 and 18-21; (c) a range of potential confounding factors, including measures of adversity and family factors during childhood. RESULTS: Increasing anxious/withdrawn behaviour at age 8 was associated with increasing risks of social phobia; specific phobia; panic/agoraphobia; and major depression during adolescence and young adulthood. These associations persisted after adjustment for a series of confounding social, childhood, and family factors. CONCLUSIONS: Anxious/withdrawn behaviour in childhood is associated with elevated rates of anxiety disorders and major depression during adolescence and young adulthood. These data are consistent with, and extend, previous clinical and epidemiologic findings, by showing consistent linkages between childhood anxious/withdrawn behaviours at age 8 and increased risk for anxiety disorders and depression at ages 16-18 and 18-21 among young persons in the community. These results may point to the need to provide support and possibly intervention to children showing early anxious or withdrawn behaviours.     

Attentional Difficulties in Middle Childhood and Psychosocial Outcomes in Young Adulthood

The associations between (dimensionally scored) measures of attentional difficulties at age 8 and psychosocial outcomes at age 18 were examined in a birth cohort of New Zealand children. Increasing attentional difficulties during middle childhood were associated with increased risks of academic failure or difficulties, juvenile offending, and substance use behaviours in young adulthood. However, those with early attentional difficulties were a high-risk group characterised by social disadvantages, early conduct difficulties, lower 1Q, and related characteristics. Statistical adjustments showed: (a) that attentional difficulties were related to later academic success even when due allowance was made for potentially confounding factors; and (b) early attentional difficulties were unrelated to later juvenile offending or substance use behaviours after adjustment for confounding. In all cases there was evidence of consistent dose/response relationships between the extent of early attentional difficulties and later academic outcomes, suggesting that these associations were not confined to those with extreme symptoms.     

Age‐appropriate infant and young child feeding practices are associated with child nutrition in India: insights from nationally representative data

Age‐appropriate infant and young child feeding (IYCF) practices are critical to child nutrition. The objective of this paper was to examine the associations between age‐appropriate IYCF practices and child nutrition outcomes in India using data from ～18 463 children of 0–23.9 months old from India's National Family Health Survey, 2005–06‐3. The outcome measures were child height‐for‐age z‐score (HAZ), weight‐for‐age z‐score (WAZ), weight‐for‐height z‐score, stunting, underweight and wasting. Linear and logistic regression analyses were used, accounting for the clustered survey data. Regression models were adjusted for child, maternal, and household characteristics, and state and urban/rural residence. The analyses indicate that in India suboptimal IYCF practices are associated with poor nutrition outcomes in children. Early initiation of breastfeeding and exclusive breastfeeding were not associated with any of the nutrition outcomes considered. Not consuming any solid or semi‐solid foods at 6–8.9 months was associated with being underweight (P < 0.05). The diet diversity score and achieving minimum diet diversity (≥4 food groups) for children 6–23 months of age were most strongly and significantly associated with HAZ, WAZ, stunting and underweight (P < 0.05). Maternal characteristics were also strongly associated with child undernutrition. In summary, poor IYCF practices, particularly poor complementary foods and feeding practices, are associated with poor child nutrition outcomes in India, particularly linear growth.