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Tournier C, Forde CG. Food oral processing and eating behavior from infancy to childhood: evidence on the role of food texture in the development of healthy eating behavior. Crit Rev Food Sci Nutr 2024; 64:9554-9567. [PMID: 37267128 DOI: 10.1080/10408398.2023.2214227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Eating behaviors develop in early life and refine during childhood, shaping long-term food choice and dietary habits, which underpin optimum growth and health. The development of Food Oral Processing (FOP) is of major importance in the establishment of eating behaviors at two scale levels: for the initial acceptance of food texture and for the longer-term development of eating behaviors associated to food intake. To date, both processes have been studied as independent topics and the current review proposes a parallel vision on their development from the onset of complementary feeding to later childhood. Individual factors affecting these FOP-related behaviors as they relate to food texture acceptance are discussed, alongside examples of interventions aiming at modifying them. Opportunity to better consider food textures when designing foods for children is addressed. Altogether, the review demonstrates the critical role of food texture in the development of a child's FOP skills, eating habits, and dietary patterns. These scientific knowledges need to be considered for the development of healthier eating behavior. We identify research gaps that need to be addressed and highlight the need to design foods that can support the development of healthy oral processing and eating behaviors among infants and children.
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Affiliation(s)
- Carole Tournier
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, Dijon, France
- INRAE, PROBE Research Infrastructure, ChemoSens Facility, Dijon, France
| | - Ciaran G Forde
- Sensory Science and Eating Behaviour, Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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2
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Herrera-Quintana L, Vázquez-Lorente H, Hinojosa-Nogueira D, Plaza-Diaz J. Relationship between Infant Feeding and the Microbiome: Implications for Allergies and Food Intolerances. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1030. [PMID: 39201963 PMCID: PMC11353207 DOI: 10.3390/children11081030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/16/2024] [Accepted: 08/20/2024] [Indexed: 09/03/2024]
Abstract
Childhood is a critical period for immune system development, which is greatly influenced by the gut microbiome. Likewise, a number of factors affect the gut microbiome composition and diversity, including breastfeeding, formula feeding, and solid foods introduction. In this regard, several studies have previously demonstrated that breastfeeding promotes a favorable microbiome. In contrast, formula feeding and the early incorporation of certain solid foods may adversely affect microbiome development. Additionally, there is increasing evidence that disruptions in the early microbiome can lead to allergic conditions and food intolerances. Thus, developing strategies to promote optimal infant nutrition requires an understanding of the relationship between infant nutrition and long-term health. The present review aims to examine the relationship between infant feeding practices and the microbiome, as well as its implications on allergies and food intolerances in infants. Moreover, this study synthesizes existing evidence on how different eating habits influence the microbiome. It highlights their implications for the prevention of allergies and food intolerances. In conclusion, introducing allergenic solid foods before six months, alongside breastfeeding, may significantly reduce allergies and food intolerances risks, being also associated with variations in gut microbiome and related complications.
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Affiliation(s)
- Lourdes Herrera-Quintana
- Department of Physiology, Schools of Pharmacy and Medicine, University of Granada, 18071 Granada, Spain; (L.H.-Q.); (H.V.-L.)
- Biomedical Research Center, Health Sciences Technology Park, University of Granada, 18016 Granada, Spain
| | - Héctor Vázquez-Lorente
- Department of Physiology, Schools of Pharmacy and Medicine, University of Granada, 18071 Granada, Spain; (L.H.-Q.); (H.V.-L.)
- Biomedical Research Center, Health Sciences Technology Park, University of Granada, 18016 Granada, Spain
| | - Daniel Hinojosa-Nogueira
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Laboratorio del Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario de Málaga (Virgen de la Victoria), 29590 Málaga, Spain;
| | - Julio Plaza-Diaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria IBS, GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
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3
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Chow CY, Bech AC, Olsen A, Keast R, Russell CG, Bredie WLP. Oral size perception and texture preferences for particle-containing foods in children aged 5-12. J Texture Stud 2024; 55:e12848. [PMID: 38952148 DOI: 10.1111/jtxs.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/28/2024] [Accepted: 06/08/2024] [Indexed: 07/03/2024]
Abstract
Foods containing bits and pieces are often less liked by children; however, there is a limited understanding of how perceptions and preferences for foods with particles change during childhood. This study aimed to investigate preferences and perceptions of particle-containing foods in children aged 5-12 years. Children (n = 485) completed a forced-choice questionnaire on drawings of six pairs of foods, each available with or without particles. Additionally, children tasted yogurts added with muesli differing in particle size (median diameter: 3.9 or 7.5 mm) and evaluated their perception of particle size in mouth and their liking. The questionnaire results showed that children had a clear preference for foods without particles. The average probability of choosing the 'with-particle' foods was 28%, significantly below the midpoint of 50% (p < .0001). Preferences for particle-containing foods were lowest at age six and increased significantly with age (p = .0007). In the taste test, muesli particle size affected oral size perception (p < .0001) but not liking (p = .60). Older children were better able to differentiate particle size than younger children. However, there was no relationship between individual preferences for particle-containing foods and oral size perception of muesli particles. The observation that children's texture preferences changed with age highlights the role of increased experience in shaping preferences for foods with particles.
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Affiliation(s)
- Ching Yue Chow
- Section for Design and Consumer Behaviour, Department of Food Science, University of Copenhagen, Frederiksberg C, Denmark
- School of Exercise and Nutrition Sciences, CASS Food Research Centre, Deakin University, Geelong, Victoria, Australia
- Arla Innovation Centre, Arla Foods AMBA, Aarhus, Denmark
| | - Anne C Bech
- Arla Innovation Centre, Arla Foods AMBA, Aarhus, Denmark
| | - Annemarie Olsen
- Section for Design and Consumer Behaviour, Department of Food Science, University of Copenhagen, Frederiksberg C, Denmark
| | - Russell Keast
- School of Exercise and Nutrition Sciences, CASS Food Research Centre, Deakin University, Geelong, Victoria, Australia
| | - Catherine G Russell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Wender L P Bredie
- Section for Design and Consumer Behaviour, Department of Food Science, University of Copenhagen, Frederiksberg C, Denmark
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Devezeaux de Lavergne M, Thielecke F, Antille N, Fries LR, Ross CF, Smith-Simpson S. Food texture experiences across nine age groups in Indian infants from urban areas. Front Nutr 2024; 11:1419718. [PMID: 39091683 PMCID: PMC11292795 DOI: 10.3389/fnut.2024.1419718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/01/2024] [Indexed: 08/04/2024] Open
Abstract
The introduction of complementary food plays a fundamental role in dietary behaviours later in life. Little is known about the influences of age on food texture acceptance in young Indian children. Thus, the objective of this cross-sectional study was to describe the relationship between age and food texture experiences in young children aged 4-36 months in India from urban areas using a parental-reported survey. This study relies on a face-to-face parent survey, which was conducted comprising 306 children categorised into 9 age groups. Questions focussed on food texture experience considering 16 textures were analysed. Textures such as dissolvable, sticky, and soupy/liquidy were already accepted by more than half of 4-5-month-old infants. In India, soupy/liquidy is a more common base texture than pureed. Indeed, pureed was found to be introduced to a majority of infants only from 8 to 9 months onwards. Food textures such as rubbery, slippery, and foods with skin were more likely rejected by the youngest children. With increasing age, the refusal probability of food textures decreased. Our survey showed food texture experiences in Indian children aged from 4 to 36 months. It provides useful insights for parents and healthcare professionals by contributing to the understanding of texture acceptance during the transition to complementary foods.
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Affiliation(s)
| | - Frank Thielecke
- Department of Health Promotion, Swiss Distance University of Applied Sciences, Brig, Switzerland
- T2 Bene Ltd., Allschwil, Switzerland
| | - Nicolas Antille
- Nestlé Institute of Food Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Lisa R. Fries
- Nestlé Institute of Health Sciences, Nestlé Research, Beijing, China
| | - Carolyn F. Ross
- School of Food Science, Washington State University, Pullman, WA, United States
| | - Sarah Smith-Simpson
- Nestle Nutrition, Société des Produits Nestlé S.A., Fremont, CA, United States
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5
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Garcia AL, Huang J, Wright CM. Associations between breastfeeding duration and adherence to complementary feeding recommendations in Scotland. MATERNAL & CHILD NUTRITION 2024; 20:e13633. [PMID: 38378946 PMCID: PMC11168353 DOI: 10.1111/mcn.13633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/22/2024]
Abstract
We aimed to describe how breastfeeding relates to adherence to complementary feeding (CF) recommendations, diet diversification and feeding skills development and whether sociodemographic factors explain any differences observed. The Scottish Maternal Infant and Nutrition Survey for infants aged 8-12 months collected breastfeeding history, CF practices, diet and sociodemographic data using a self-completion questionnaire. Non-healthful CF practices were starting CF < 6 months, any consumption of sugar-sweetened beverages (SSBs), sweet or salty snacks (treats) or unmodified cow's milk and regular consumption of commercial baby foods. Diet diversification and feeding skills were assessed by amount of self-feeding and number of food groups, meals and snacks eaten daily. Of the 2730 mothers, 20% were solely infant formula fed (IFF) and 48% continued breastfeeding ≥6 months. Compared to IFF babies, mothers who gave any breast milk ≥6 months were more likely to start CF ≥ 6 months compared to those IFF (66% vs. 37%) and less likely to give treats (15% vs. 45%), SSBs (11% vs. 20%) and commercial baby foods (31% vs. 53%). These associations remained highly significant (p < 0.001) even after sociodemographic factor adjustment. Despite starting CF later, infants breastfed ≥6 months ate the same number of food groups and meals as those IFF, were just as likely to self-feed purees and more likely to self-feed finger foods daily (87% vs. 81% p < 0.001). Mothers who breastfeed beyond 6 months adhere more to CF recommendations and start CF later compared to IFF, but their babies eat a similarly diverse diet and have similar feeding skills.
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Affiliation(s)
- Ada L. Garcia
- Human Nutrition, School of Medicine, Dentistry & NursingUniversity of GlasgowGlasgowUK
| | - Jiali Huang
- Human Nutrition, School of Medicine, Dentistry & NursingUniversity of GlasgowGlasgowUK
| | - Charlotte M. Wright
- Human Nutrition, School of Medicine, Dentistry & NursingUniversity of GlasgowGlasgowUK
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Thompson KL, Clarke EC, Wasser H, Schenkelberg MA, Agrawal S, Willis EA. Complementary feeding practices of caregivers of infants with Down syndrome as compared to caregivers of typically developing infants. Appetite 2024; 198:107356. [PMID: 38636668 DOI: 10.1016/j.appet.2024.107356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
Caregiver feeding practices during the complementary feeding period (6 months-2 years) may be particularly important for infants with Down syndrome (DS) as they are at higher risk for later health conditions (e.g., obesity, diabetes) that can be influenced by early feeding practices. However, how well caregivers of infants with DS are meeting infant feeding evidence-based practices is relatively unknown. Caregivers of infants with DS (N = 75) and caregivers of typically developing (TD) infants (N = 66) aged 0-2 years completed an online survey about their infant feeding practices and information sources. Caregiver practices and information sources were statistically compared between groups. Results indicated that there are significant differences in the feeding practices of caregivers of infants with DS when compared to caregivers of TD infants. Caregivers of infants with DS were less likely to meet infant feeding evidence-based practices than caregivers of TD infants. Caregivers of infants with DS were also more concerned about their infant's food intake and later weight status. Some individual feeding practices also significantly differed between groups, with caregivers of infants with DS more likely to meet evidence-based practices of purchasing iron rich foods and avoiding added salt, but less likely to use responsive feeding practices than caregivers of TD infants. Caregivers of infants with DS were also less likely to receive information about how to navigate the complementary feeding period than caregivers of TD infants. Coupled with existing research, the results of the present study suggest that infant feeding evidence-based practices should be reviewed for their appropriateness for this population and additional support for caregivers of infants with DS should be implemented to help them navigate this important period.
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Affiliation(s)
- Kelsey L Thompson
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr Blvd, Chapel Hill, NC, 27514, USA.
| | - Emily C Clarke
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr Blvd, Chapel Hill, NC, 27514, USA
| | - Heather Wasser
- Gillings School of Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27514, USA
| | - Michaela A Schenkelberg
- School of Health and Kinesiology, University of Nebraska at Omaha, 6001 Dodge Street, Omaha, NE, 68182, USA
| | - Seema Agrawal
- Gillings School of Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27514, USA
| | - Erik A Willis
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr Blvd, Chapel Hill, NC, 27514, USA
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Hirvonen K, Wolle A, Laillou A, Vinci V, Chitekwe S, Baye K. Understanding delays in the introduction of complementary foods in rural Ethiopia. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 5:e13247. [PMID: 34523796 PMCID: PMC11258766 DOI: 10.1111/mcn.13247] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/21/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022]
Abstract
Age-appropriate breastfeeding and introduction to complementary foods can shape child feeding practices, ensure adequate energy and nutrient intake and prevent linear growth faltering. This study aimed to assess mothers' and health workers' knowledge of timely introduction to complementary foods and evaluate the relationship between delays in complementary feeding and subsequent linear growth. We conducted two rounds of surveys (March/August 2017) among 249 health workers (n = 249) and caregivers (n = 2635) of children 6-23 months of age. We collected information about socio-demographic characteristics, knowledge and practice related to timely introduction to complementary foods. The study was conducted in households from the Productive Safety Net Programme (PSNP) districts, in four highland regions of Ethiopia. Delays in the introduction to complementary feeding were widespread with 53% of children 6-8 months of age not consuming solid, semisolid or soft foods in the past 24 h. After controlling for child, caregiver and household characteristics, children not introduced to complementary foods by 6-8 months had a 0.48 SD lower length-for-age z-score at 12-15 months. Caregivers' knowledge was strongly and inversely correlated with untimely introduction of complementary foods in logistic regressions (OR = 0.55, p < 0.01). In turn, local health extension worker's knowledge was strongly correlated with caregiver's knowledge. Consequently, frequent and timely visits by health extension workers emphasising not only on what to feed but also when and how to feed a child are needed. Innovative ways of increasing reach, intensity and frequency of nutrition messaging by using the PSNP interactions as an additional point of contact would need to be explored further.
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Affiliation(s)
- Kalle Hirvonen
- Development Strategy and Governance DivisionInternational Food Policy Research Institute (IFPRI)Addis AbabaEthiopia
| | - Abdulazize Wolle
- Development Strategy and Governance DivisionInternational Food Policy Research Institute (IFPRI)Addis AbabaEthiopia
- Economics DepartmentState University of New York at AlbanyAlbanyNew YorkUSA
| | | | | | | | - Kaleab Baye
- Center for Food Science and Nutrition. College of Natural SciencesAddis Ababa UniversityAddis AbabaEthiopia
- Research Center for Inclusive Development in Africa (RIDA)Addis AbabaEthiopia
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8
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Thompson KL, Graf MD. Environmental Scan of Online Government Complementary Feeding Resources in the United States. MCN Am J Matern Child Nurs 2024:00005721-990000000-00053. [PMID: 38864902 DOI: 10.1097/nmc.0000000000001033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND Parents commonly seek online sources of information on the important complementary feeding period, but the accuracy of these sources varies. The 21st Century Integrated Digital Experience Act (IDEA) states federal government resources should be accurate and user-friendly; however, the quantity, quality, and accuracy of federal resources on complementary feeding is unknown. METHODS An environmental scan of online federal, parent-facing resources about complementary feeding was conducted. The authors reviewed federal resources for concordance of information with the Dietary Guidelines for Americans (DGA). Quality was evaluated using the Patient Education Materials Assessment Tool. RESULTS A total of 112 resources across 2 federal government departments. Overall quality was high as was concordance with recommendations from the DGA for age of complementary food introduction, foods to introduce, and foods to avoid. Allergenic food introduction and textured food progression recommendations were less consistent. Recommendations for improvements to federal resources are made. CLINICAL IMPLICATIONS This environmental scan only included federal resources for CF. Parents may be accessing other, non-federal resources online. However, given the enactment of IDEA, it is expected that these federal resources will be up-to-date and user-friendly, which was not always the case. Nurses should review the DGA guidelines for complementary feeding and provide evidence-based anticipatory guidance to families, focusing especially on allergenic food introduction and textured food progression. Future complementary feeding interventions may benefit from directing families to online exemplars from federal sources.
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Scully M, Jinnette R, Le L, Martin J, Schmidtke A. Compliance of Australian commercial foods for young children (<36 months) with an international nutrient and promotion profile model. Aust N Z J Public Health 2024; 48:100158. [PMID: 38886145 DOI: 10.1016/j.anzjph.2024.100158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 04/18/2024] [Accepted: 04/30/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE To assess how Australian infant and toddler foods compare to a nutrient and promotion profile model (NPPM) developed by the World Health Organization to support the appropriate promotion of commercial food products for children aged 6-36 months. METHODS A cross-sectional audit of infant and toddler foods found at three major Australian supermarkets was conducted in September/October 2022. Using nutrition and promotional data extracted from the packaging, products were classified according to NPPM categories and assessed against relevant compositional, front-of-pack labelling and promotional requirements. RESULTS Of 330 eligible products identified, just 28% met all NPPM compositional requirements. Toddler foods were less compliant than infant foods overall (18% vs. 31%; p=0.021), and for specific nutrients such as sodium (75% vs. 89%; p=0.003). No products met all NPPM front-of-pack labelling/promotional requirements. Only two-thirds and two-fifths of products were compliant with product name and ingredient list requirements, respectively. CONCLUSION Australian infant and toddler foods do not fully comply with the NPPM requirements. While toddler foods performed comparatively worse in terms of their nutritional adequacy, there is considerable scope to improve the nutrient profile of both infant and toddler foods. IMPLICATIONS FOR PUBLIC HEALTH To better support young children's health and development, the introduction of mandatory nutrition standards for Australian toddler foods, and the improvement of nutrition standards for Australian infant foods, in line with the NPPM, is needed. To be most effective, these should be combined with regulations for the labelling and promotion of these foods in line with the NPPM.
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Affiliation(s)
- Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Rachael Jinnette
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Linh Le
- Prevention Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Jane Martin
- Food for Health Alliance, Melbourne, Victoria, Australia
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Boctor DL, Fenton TR, Goulet O, Lambe C. Pediatric Intestinal Failure Associated Eating Disorder: An Overview of the Importance of Oral Feeding in a Population at Risk for Feeding Difficulties. Gastroenterol Clin North Am 2024; 53:309-327. [PMID: 38719381 DOI: 10.1016/j.gtc.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Achieving feeding skills and food acceptance is a multi-layered process. In pediatric intestinal failure (PIF), oral feeding is important for feeding skills development, physiologic adaptation, quality of life and the prevention of eating disorders. In PIF, risk factors for feeding difficulties are common and early data suggests that feeding difficulties are prevalent. There is a unique paradigm for the feeding challenges in PIF. Conventional definitions of eating disorders have limited application in this context. A pediatric intestinal failure associated eating disorder (IFAED) definition that includes feeding/eating skills dysfunction, psychosocial dysfunction, and the influence on weaning nutrition support is proposed.
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Affiliation(s)
- Dana Liza Boctor
- Alberta Children's Hospital, Section of Gastroenterology, Hepatology and Nutrition, University of Calgary, Calgary, 28 Oki Drive NW, Calgary, Alberta T3B-6A8, Canada.
| | - Tanis R Fenton
- Department of Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada
| | - Olivier Goulet
- Department of Pediatric Gastroenterology-Hepatology-Nutrition, National Reference Center for Rare Digestive Diseases, Pediatric Intestinal Failure Rehabilitation Center, Hôpital Necker-Enfants Malades, Université Paris Cité, 149 Rue de Sèvres, Paris 75015, France
| | - Cecile Lambe
- Department of Pediatric Gastroenterology-Hepatology-Nutrition, National Reference Center for Rare Digestive Diseases, Pediatric Intestinal Failure Rehabilitation Center, Hôpital Necker-Enfants Malades, Université Paris Cité, 149 Rue de Sèvres, Paris 75015, France
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Bjørke-Monsen AL. Defining Optimal Cobalamin Status for Neonates and Infants. Food Nutr Bull 2024; 45:S16-S22. [PMID: 38987877 DOI: 10.1177/03795721241227782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
BACKGROUND An optimal cobalamin status is necessary for normal neurodevelopment. OBJECTIVE To give a description of the epidemiology, pathophysiology and diagnostic challenges related to cobalamin insufficiency in neonates and infants in order to prevent its occurence. RESULTS Inadequate cobalamin status is prevalent among neonates and young infants, due to a high prevalence of maternal cobalamin deficiency, exclusive breastfeeding for extended periods and late introduction of animal food. Cobalamin insufficiency is associated with delayed neurodevelopment and subtle clinical symptoms like feeding difficulties, regurgitations and constipation in young infants. Early diagnosis and treatment of impaired cobalamin status is important to prevent neurologic damage. CONCLUSION Clinical suspicion of cobalamin insufficiency in infants should infer immediate biochemical testing and a plasma total homocysteine > 5.0 µmol/L indicate cobalamin insufficiency in need of intramuscular treatment with hydroxycobalamin, followed by introduction of animal food after 4 months of age.
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Affiliation(s)
- Anne-Lise Bjørke-Monsen
- Laboratory of Medical Biochemistry, Innlandet Hospital Trust, Lillehammer, Norway
- Laboratory of Medical Biochemistry, Førde Hospital, Førde, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
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12
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Hopkins J, Merritt R. Strategies to Promote Success in Oral Feedings in Infants and Children with Intestinal Failure due to Short Bowel Syndrome. Gastroenterol Clin North Am 2024; 53:329-341. [PMID: 38719382 DOI: 10.1016/j.gtc.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Infants and children with intestinal failure are at risk for pediatric feeding disorders, which challenge their oral feeding development. This article explores these challenges and offers several practical strategies that can be used by multidisciplinary care teams and at-home caregivers to help support the development of oral feeding in these children and eventually lead to their attaining enteral autonomy.
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Affiliation(s)
- Judy Hopkins
- Division of Occupational Therapy, Children's Hospital Los Angeles, Los Angeles, CA, USA.
| | - Russell Merritt
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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13
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Chebar-Lozinsky A, De Koker C, Dziubak R, Rolnik DL, Godwin H, Dominguez-Ortega G, Skrapac AK, Gholmie Y, Reeve K, Shah N, Meyer R. Assessing Feeding Difficulties in Children Presenting with Non-IgE-Mediated Gastrointestinal Food Allergies-A Commonly Reported Problem. Nutrients 2024; 16:1563. [PMID: 38892497 PMCID: PMC11173616 DOI: 10.3390/nu16111563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 06/21/2024] Open
Abstract
Many guidelines have been published to help diagnose food allergies, which have included feeding difficulties as a presenting symptom (particularly for non-IgE-mediated gastrointestinal allergies). This study aimed to investigate the prevalence of feeding difficulties in children with non-IgE-mediated gastrointestinal allergies and the association of such difficulties with symptoms and food elimination. An observational study was performed at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Children aged 4 weeks to 16 years without non-allergic co-morbidities who improved on an elimination diet using a previously published Likert scale symptom score were included. This study recruited 131 children, and 114 (87%) parents completed the questionnaire on feeding difficulties. Feeding difficulties were present in 61 (53.5%) of the 114 children. The most common feeding difficulties were regular meal refusals (26.9%), extended mealtimes (26.7%), and problems with gagging on textured foods (26.5%). Most children (40/61) had ≥2 reported feeding difficulties, and eight had ≥4. Children with feeding difficulties had higher rates of constipation and vomiting: 60.7% (37/61) vs. 35.8% (19/53), p = 0.008 and 63.9% (39/61) vs. 41.5% (22/53), p = 0.017, respectively. Logistic regression analysis demonstrated an association between having feeding difficulties, the age of the child, and the initial symptom score. Gender and the number of foods excluded in the elimination diet were not significantly associated with feeding difficulties. This study found that feeding difficulties are common in children with non-IgE-mediated gastrointestinal allergies, but there is a paucity of food allergy specific tools for establishing feeding difficulties, which requires further research in the long-term and consensus in the short term amongst healthcare professions as to which tool is the best for food allergic children.
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Affiliation(s)
- Adriana Chebar-Lozinsky
- Department of Allergy and Immune Disorders, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia;
| | - Claire De Koker
- Macassar Community Health Centre, Department of Health and Wellness, Western Cape Government, Elsenburg 7607, South Africa;
| | - Robert Dziubak
- Department of Gastroenterology, Great Ormond Street Hospital for Sick Children, London WC1N 3JH, UK
| | - Daniel Lorber Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3800, Australia;
| | - Heather Godwin
- Department of Gastroenterology, Great Ormond Street Hospital for Sick Children, London WC1N 3JH, UK
| | - Gloria Dominguez-Ortega
- Department of Gastroenterology, Universidad Autonoma de Madrid, 28049 Madrid, Spain;
- Department Gastroenterology and Nutrition, Nino Jesus Univesity Children Hospital, 28009 Madrid, Spain
| | | | - Yara Gholmie
- Department of Nutrition, Simmons University, Boston, MA 02115, USA;
| | - Kate Reeve
- Royal Hospital for Children and Young People in Edinburgh, Edinburgh EH16 4TJ, UK;
| | - Neil Shah
- HCA Healthcare, London W1G 0PU, UK; (A.-K.S.); (N.S.)
| | - Rosan Meyer
- Department Dietetics, University of Winchester, Winchester SO22 4NR, UK
- Department of Medicine, KU Leuven, 3000 Leuven, Belgium
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14
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Montuelle SJ, Williams SH. Prolonged use of a soft diet during early growth and development alters feeding behavior and chewing kinematics in a young animal model. J Morphol 2024; 285:e21696. [PMID: 38639429 PMCID: PMC11177321 DOI: 10.1002/jmor.21696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/20/2024]
Abstract
In infants and children with feeding and swallowing issues, modifying solid foods to form a liquid or puree is used to ensure adequate growth and nutrition. However, the behavioral and neurophysiological effects of prolonged use of this intervention during critical periods of postnatal oral skill development have not been systematically examined, although substantial anecdotal evidence suggests that it negatively impacts downstream feeding motor and coordination skills, possibly due to immature sensorimotor development. Using an established animal model for infant and juvenile feeding physiology, we leverage X-ray reconstruction of moving morphology to compare feeding behavior and kinematics between 12-week-old pigs reared on solid chow (control) and an age- and sex-matched cohort raised on the same chow softened to a liquid. When feeding on two novel foods, almond and apple, maintenance on a soft diet decreases gape cycle duration, resulting in a higher chewing frequency. When feeding on almonds, pigs in this group spent less time ingesting foods compared to controls, and chewing cycles were characterized by less jaw rotation about a dorsoventral axis (yaw) necessary for food reduction. There was also a reduced tendency to alternate chewing side with every chew during almond chewing, a behavioral pattern typical of pigs. These more pronounced impacts on behavior and kinematics during feeding on almonds, a tougher and stiffer food than apples, suggest that food properties mediate the behavioral and physiological impacts of early texture modification and that the ability to adapt to different food properties may be underdeveloped. In contrast, the limited effects of food texture modification on apple chewing indicate that such intervention/treatment does not alter feeding behavior of less challenging foods. Observed differences cannot be attributed to morphology because texture modification over the treatment period had limited impact on craniodental growth. Short-term impacts of soft-texture modification during postweaning development on feeding dynamics should be considered as potential negative outcomes of this treatment strategy.
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Affiliation(s)
- Stéphane J. Montuelle
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Warrensville Heights, OH 44122
| | - Susan H. Williams
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, OH 45701
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15
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Finistrella V, Gianni N, Fintini D, Menghini D, Amendola S, Donini LM, Manco M. Neophobia, sensory experience and child's schemata contribute to food choices. Eat Weight Disord 2024; 29:25. [PMID: 38587606 PMCID: PMC11001701 DOI: 10.1007/s40519-024-01657-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/02/2024] [Indexed: 04/09/2024] Open
Abstract
PURPOSE The aim of the present review is to analyze dynamic interactions between nutrigenomics, environmental cues, and parental influence, which can all lead to children's neophobic reactions and its persistence in time. METHODS We reviewed studies available on electronic databases, conducted on children aged from birth to 18 years. We also considered official websites of Italian Institutions, providing advice on healthy eating during infancy. RESULTS Modern day societies are faced with an eating paradox, which has severe and ever-growing implications for health. In face of a wider availability of healthy foods, individuals instead often choose processed foods high in fat, salt and sugar content. Economic reasons surely influence consumers' access to foods. However, there is mounting evidence that food choices depend on the interplay between social learning and genetic predispositions (e.g., individual eating traits and food schemata). Neophobia, the behavioral avoidance of new foods, represents an interesting trait, which can significantly influence children's food refusal. Early sensory experiences and negative cognitive schemata, in the context of primary caregiver-child interactions, importantly contribute to the priming of children's food rejection. CONCLUSIONS As neophobia strongly affects consumption of healthy foods, it will be relevant to rule definitively out its role in the genesis of maladaptive food choices and weight status in longitudinal studies tracking to adulthood and, in meanwhile, implement early in life effective social learning strategies, to reduce long-term effects of neophobia on dietary patterns and weight status. LEVEL OF EVIDENCE Level II, controlled trials without randomization.
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Affiliation(s)
- Viviana Finistrella
- Unit of Predictive and Preventive Medicine, Bambino Gesù Children's Hospital, IRCCS, Via F. Baldelli 38, 00146, Rome, Italy
| | - Nicoletta Gianni
- Unit of Predictive and Preventive Medicine, Bambino Gesù Children's Hospital, IRCCS, Via F. Baldelli 38, 00146, Rome, Italy
| | - Danilo Fintini
- Endocrinology and Diabetology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neurological and Psychiatric Science, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | - Silvia Amendola
- Child and Adolescent Neuropsychiatry Unit, Department of Neurological and Psychiatric Science, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | | | - Melania Manco
- Unit of Predictive and Preventive Medicine, Bambino Gesù Children's Hospital, IRCCS, Via F. Baldelli 38, 00146, Rome, Italy.
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16
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Hill SA, Nurmatov U, DunnGalvin A, Reese I, Vieira MC, Rommel N, Dupont C, Venter C, Cianferoni A, Walsh J, Yonamine G, Beauregard A, Meyer R, Vazquez-Ortiz M. Feeding difficulties in children with food allergies: An EAACI Task Force Report. Pediatr Allergy Immunol 2024; 35:e14119. [PMID: 38566436 DOI: 10.1111/pai.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
The term "feeding difficulties" refers to a spectrum of phenotypes characterized by suboptimal intake of food and/or lack of age-appropriate eating habits. While it is evident that feeding difficulties are prevalent within healthy children, no consensus has been reached for those with food allergies. The aim of this study was to systematically review all the available literature reporting the prevalence of feeding difficulties within food allergic children. We searched eight international electronic databases for all published studies until June 2022. International experts in the field were also contacted for unpublished and ongoing studies. All publications were screened against pre-defined eligibility criteria and critically appraised by established instruments. The substantial heterogeneity of included studies precluded meta-analyses, so narrative synthesis of quantitative data was performed. A total of 2059 abstracts were assessed, out of which 21 underwent full-text screening and 10 studies met the study criteria. In these, 12 different terms to define feeding difficulties and 11 diagnostic tools were used. Five papers included data of feeding difficulty prevalence in children with food allergies, ranging from 13.6% to 40%. Higher prevalence was associated with multiple food allergies. The current literature suggests that feeding difficulties are prevalent within food allergic children, particularly those with multiple food allergies. However, the heterogeneity of terminologies and diagnostic tools makes drawing conclusions challenging. Consensus guidelines for the diagnosis and management of feeding difficulties within food allergic children and further research on the development and perpetuation of feeding difficulties are needed to appropriately manage such patients.
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Affiliation(s)
- Sarah-Anne Hill
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Ulugbek Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Audrey DunnGalvin
- NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, University of Southampton Faculty of Medicine, Southampton, UK
| | | | - Mario C Vieira
- Center for Pediatric Gastroenterology, Hospital Pequeno Principe, Curitiba, Brazil
| | - Natalie Rommel
- University Hospital Tübingen, Tübingen, Germany
- Therapiezentrum, University Hospital Tübingen, Tübingen, Germany
| | - Christophe Dupont
- Paris Descartes University, Paris, France
- Clinique Marcel Sembat, Ramsay Group, Boulogne Billancourt, France
| | - Carina Venter
- University of Colorado/Children's Hospital Colorado, Denver, Colorado, USA
| | - Antonella Cianferoni
- Allergy and Immunology Division, Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Glauce Yonamine
- Division of Nutrition, Instituto da Criança e do Adolescente, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - Alexia Beauregard
- Faculty, Ellyn Satter Institute, Clinical Dietetics Branch Winn Army Community Hospital, Fort Stewart, Georgia, USA
| | - Rosan Meyer
- Imperial College London, London, UK
- University of Winchester, Winchester, UK
- University of KU Leuven, Leuven, Belgium
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17
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Hörnell A, Lagström H. Infant feeding-a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10456. [PMID: 38370110 PMCID: PMC10870977 DOI: 10.29219/fnr.v68.10456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 12/11/2022] [Accepted: 12/20/2023] [Indexed: 02/20/2024] Open
Abstract
The 2012 edition of the Nordic Nutrition Recommendations (NNR) included recommendations on breastfeeding, based on the most recent guidelines and recommendations from major national food and health authorities and organizations, systematic reviews, and some original research. For NNR 2023, the scope has been expanded and also includes formula feeding and the introduction of solid food. The main focus in this scoping review is on infants aged 0-12 months but also considers parts both before and beyond the first year, as the concept of 'the first 1000 days' emphasizes the importance of factors during pregnancy and the first 2 years of life for immediate and later health: physical as well as emotional and mental health. Breastmilk is the natural and sustainable way to feed an infant during the first months of life. Numerous studies have indicated immediate as well as long-term beneficial effects of breastfeeding on health for both the infant and the breastfeeding mother, and from a public health perspective, it is therefore important to protect, support, and promote breastfeeding. For full-term, normal weight infants, breastmilk is sufficient as the only form of nutrition for the first 6 months, except for vitamin D that needs to be given as supplement. The World Health Organization (WHO) and several other authoritative bodies therefore recommend exclusive breastfeeding during the first 6 months. Starting solids at about 6 months is necessary for both nutritional and developmental reasons. According to the European Food Safety Authority (EFSA) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), solid foods are safe to give from 4 months although exclusive breastfeeding until 6 months is the desirable goal. Breastfeeding can continue together with complementary foods as long as it is mutually desired by the mother and child. If breastfeeding is not enough or for some reason discontinued before the infant is 4 months of age, the infant should be fed infant formula, and, when possible, breastfeeding should be continued alongside the formula feeding. If the infant is 4 months or older, starting with solids together with continued breastfeeding and/or formula feeding is an option. Infant formulas have been developed for infants who are not breastfed or do not get enough breastmilk. Home-made formula should not be given.
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Affiliation(s)
- Agneta Hörnell
- Department of Food, Nutrition and Culinary Science, Umeå University, Umeå, Sweden
| | - Hanna Lagström
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
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18
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Cox AM, Taylor RW, Haszard JJ, Beck KL, von Hurst PR, Conlon CA, Te Morenga LA, Daniels L, McArthur J, Paul R, McLean NH, Jones EA, Katiforis I, Brown KJ, Gash M, Rowan M, Fleming EA, Jupiterwala R, Bruckner BR, Heath ALM. Baby food pouches and Baby-Led Weaning: Associations with energy intake, eating behaviour and infant weight status. Appetite 2024; 192:107121. [PMID: 37972656 DOI: 10.1016/j.appet.2023.107121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
Although concern is frequently expressed regarding the potential impact of baby food pouch use and Baby-Led Weaning (BLW) on infant health, research is scarce. Data on pouch use, BLW, energy intake, eating behaviour and body mass index (BMI) were obtained for 625 infants aged 7-10 months in the First Foods New Zealand study. Frequent pouch use was defined as ≥5 times/week during the past month. Traditional spoon-feeding (TSF), "partial" BLW and "full" BLW referred to the relative proportions of spoon-feeding versus infant self-feeding, assessed at 6 months (retrospectively) and current age. Daily energy intake was determined using two 24-h dietary recalls, and caregivers reported on a variety of eating behaviours. Researchers measured infant length and weight, and BMI z-scores were calculated (World Health Organization Child Growth Standards). In total, 28% of infants consumed food from pouches frequently. Frequent pouch use was not significantly related to BMI z-score (mean difference, 0.09; 95% CI -0.09, 0.27) or energy intake (92 kJ/day; -19, 202), but was associated with greater food responsiveness (standardised mean difference, 0.3; 95% CI 0.1, 0.4), food fussiness (0.3; 0.1, 0.4) and selective/restrictive eating (0.3; 0.2, 0.5). Compared to TSF, full BLW was associated with greater daily energy intake (BLW at 6 months: mean difference 150 kJ/day; 95% CI 4, 297; BLW at current age: 180 kJ/day; 62, 299) and with a range of eating behaviours, including greater satiety responsiveness, but not BMI z-score (6 months: 0.06 (-0.18, 0.30); current age: 0.06 (-0.13, 0.26)). In conclusion, neither feeding approach was associated with weight in infants, despite BLW being associated with greater energy intake compared with TSF. However, infants who consumed pouches frequently displayed higher food fussiness and more selective eating.
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Affiliation(s)
- Alice M Cox
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | | | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Lisa A Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.
| | - Lisa Daniels
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Jenny McArthur
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Rebecca Paul
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Neve H McLean
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Emily A Jones
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Ioanna Katiforis
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Kimberley J Brown
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Madeline Gash
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | - Madeleine Rowan
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
| | | | - Rosario Jupiterwala
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
| | - Bailey R Bruckner
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
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19
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Sdravou K, Printza A, Emmanouilidou-Fotoulaki E, Michou E, Sotiriadou F, Fotoulaki M. Developmental Feeding Stages and Their Impact on Child Feeding Behavior. J Pediatr Gastroenterol Nutr 2023; 77:769-778. [PMID: 37490588 DOI: 10.1097/mpg.0000000000003892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
OBJECTIVES Previous research has shown that critical periods of feeding skills development exist and feeding problems can arise in children due to delays in attaining feeding developmental milestones. This study aims to delineate the transitional process of feeding development in healthy children and children with gastrointestinal diseases (GIDs) and to examine the relationship between feeding milestones and the appearance of later feeding problems. METHODS A cross-sectional case-control study among 711 healthy Greek children and 119 children with GID, aged 2-7 years. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale and "self-reported" questionnaires assessing child's feeding history. RESULTS Differences in feeding behavior of preschoolers between the 2 groups were found concerning the time of introduction of complementary (pureed), lumpy, and table foods as well as finger feeding and regular cup-drinking. Age-specific milestones as proposed by guidelines were not reached. Late introduction of complementary and lumpy foods (>6 months and >9 months, respectively) as well as finger feeding (>9 months) were predictive of more problematic feeding behaviors later on. CONCLUSIONS The trajectory of feeding development, including less studied feeding milestones, both in healthy children and children with GIDs, indicates that there are discrepancies between current feeding practices and infant feeding guidelines, and a tendency to delay the acquisition of all assessed feeding milestones.
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Affiliation(s)
| | - Athanasia Printza
- the 1st Otolaryngology Department, School of Medicine, Aristotle University of Thessaloniki, University Hospital AXEPA, Thessaloniki, Greece
| | - Elpida Emmanouilidou-Fotoulaki
- the 1st Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General Hospital "Ippokrateio", Thessaloniki, Greece
| | - Emilia Michou
- the Speech and Language Therapy Department, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
- the Centre for Gastrointestinal Sciences, The University of Manchester, Manchester, UK
| | - Fotini Sotiriadou
- the 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Maria Fotoulaki
- the 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General "Papageorgiou" Hospital, Thessaloniki, Greece
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20
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Hielscher L, Irvine K, Ludlow AK, Rogers S, Mengoni SE. A Scoping Review of the Complementary Feeding Practices and Early Eating Experiences of Children With Down Syndrome. J Pediatr Psychol 2023; 48:914-930. [PMID: 37738668 PMCID: PMC10653358 DOI: 10.1093/jpepsy/jsad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE Children with Down syndrome may experience more challenges in their early feeding and may be introduced to complementary foods comparatively later than typically developing (TD) children. This scoping review aimed to identify and synthesize the existing literature that describes feeding problems and early eating experiences relating to the period of complementary feeding for children with Down syndrome. METHODS Scopus, PubMed, Medline, Web of Science, and PsycInfo were searched. Journal articles published between January 1991 and June 2022 that reported on the complementary feeding period with children with Down syndrome were included. RESULTS Eighteen journal articles met the inclusion criteria. Children with Down syndrome were introduced to complementary foods later than TD children and progressed to more challenging food textures at a slower rate. Gross and fine motor skill delays and sensory difficulties contributed to secondary feeding problems such as difficulties chewing, biting, and reduced awareness of food on lips and tongue. Parents of children with Down syndrome reported exercising more caution and employing more controlling feeding practices compared to TD and had higher levels of concern regarding their child's weight. CONCLUSIONS Guidelines and early feeding support specific to children with Down syndrome should be available before the first complementary foods are introduced and throughout this period. Feeding support should aim to address parental concerns and provide assistance when feeding problems occur, to minimize delays and encourage the optimum development of eating abilities. Future research should address the development of feeding problems during this period and explore possible interventions.
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Affiliation(s)
- Laura Hielscher
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Karen Irvine
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Amanda K Ludlow
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Samantha Rogers
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Silvana E Mengoni
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
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21
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Thompson KL, Conklin JL, Thoyre S. Parental Decision-Making Around Introducing Complementary Foods: An Integrative Review. JOURNAL OF FAMILY NURSING 2023; 29:348-367. [PMID: 36899486 PMCID: PMC10629252 DOI: 10.1177/10748407231156914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
A primary role in infant parenting is feeding, and this role undergoes a significant transition when introducing complementary foods (CF), with important long-term health implications. Understanding the influences on parental decision-making around timing the introduction to CF can help health care providers provide parents with effective support for feeding; however, the factors that influence parental decision-making have not been recently reviewed in the United States. To determine influences and information sources, this integrative review examined the literature from 2012 to 2022. Results indicated that parents are confused and distrustful of inconsistent and changing guidelines around CF introduction. Instead, developmental readiness signs may be a more appropriate way for practitioners and researchers to support parents in appropriate CF introduction. Future work is needed to evaluate interpersonal and societal influences on parental decision-making, as well as to develop culturally sensitive practices to support healthful parental decisions.
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22
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Białek-Dratwa A, Kowalski O. Infant Complementary Feeding Methods and Subsequent Occurrence of Food Neophobia-A Cross-Sectional Study of Polish Children Aged 2-7 Years. Nutrients 2023; 15:4590. [PMID: 37960243 PMCID: PMC10648584 DOI: 10.3390/nu15214590] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Food neophobia is standard behaviour in child development. It is a complex process and occurs to varying degrees. The symptoms of neophobia can be variable depending on the individual. Food neophobia is a fear of new foods, whereby difficulties in eating and trying unfamiliar foods follow. It is one of the more vital determinants of the number of meals consumed at a young age. Such a process is not a disorder in itself but can lead to one. The highest severity of neophobia occurs between the ages of two and six, but in some children, it lasts beyond age 6. This study aimed to assess the prevalence of food neophobia among children aged 2-7 years, taking into account the method of complementary feeding, the length of breastfeeding, exclusive breastfeeding, the period of introduction of complementary foods, and the use of the BLW method during the period of dietary expansion. MATERIALS AND METHODS The study used an anonymous survey questionnaire consisting of five parts as the research tool. The first part of the questionnaire was a metric and concerned the socio-demographic data of the parent/guardian and their child. A standardised questionnaire assessing food neophobia among children was used to assess food neophobia: the Food Neophobia Scale-Children (FNSC). RESULTS In the study group, 171 children (29.23%) had a low risk of food neophobia according to the FNSC, 182 children (31.11%) had a medium risk of neophobia, and 232 children (39.66%) had a high risk of neophobia. A correlation was observed between the age and the risk of food neophobia (p = 0.0002). Statistically significant differences were found between children aged 2 and 4 (p = 0.003) and children aged 2 and 5 years (p = 0.049). We observed no correlation between gagging (p = 0.88557), choking (p = 0.17597), and needing medical intervention (p = 0.61427) and the risk of associated neophobia. CONCLUSION In the study group of children, the highest risk of food neophobia was characterized by children aged 4, 5, and 7 years. The length of breastfeeding and exclusive breastfeeding did not affect the risk of food neophobia. In the month in which complementary feeding (CF) was introduced, the children were fed using the baby-led weaning method (BLW method), and introducing puree and puree with lump food into the children's diet also did not affect the risk of food neophobia. It was shown, however, that children whose mothers observed difficulties during CF and whose children had a vomiting reflex and spat food out of their mouths during CF were more likely to develop food neophobia at the preschool age.
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Affiliation(s)
- Agnieszka Białek-Dratwa
- Department of Human Nutrition, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland
| | - Oskar Kowalski
- Department of Human Nutrition, Department of Dietetics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland
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23
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Duong C, Young MF, Nguyen PH, Tran L, Patel S, Ramakrishnan U. Temporal Dietary Diversity Patterns Are Associated with Linear Growth but Not Ponderal Growth in Young Children in Rural Vietnam. J Nutr 2023; 153:3083-3091. [PMID: 37364684 DOI: 10.1016/j.tjnut.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/07/2023] [Accepted: 06/22/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The first 2 y of life mark critical changes in children's diet from milk-based food to diverse food rich in taste and texture, but few studies in low-resource settings have explored the changes in diet quality during this period. OBJECTIVES We examine temporal dietary diversity patterns between 6 and 25 mo of age and their associations with child growth outcomes in rural Vietnam. METHODS We used data from a prospective cohort (PRECONCEPT) and included 781 children that had dietary diversity data for 4 age windows: 6-8, 11-13, 17-19, and 23-25 mo of age. The temporal dietary diversity patterns were constructed by tracking how minimum dietary diversity changed over the 4 age windows. Multivariate logistic and linear regressions were used to assess the associations of dietary patterns with stunting and wasting at the 23-25 mo window and with relative linear and ponderal growth between 6 and 25 mo, respectively. RESULTS Two key aspects of diet quality (the introduction and the stability of diverse diet) were used to define 5 temporal dietary diversity patterns: timely-stable (30% of the sample), timely-unstable (27%), delayed-stable (16%), delayed-unstable (15%), and super-delayed (12%). Compared with timely-stable pattern (the most optimal pattern), timely-unstable and super-delayed patterns were associated with a higher risk of stunting (odds ratio [OR]: 1.78; 95% confidence interval [CI]: 1.05, 3.04 and OR: 1.98; 95% CI: 1.02, 3.80, respectively) and slower linear growth (β: -0.24; 95% CI: -0.43, -0.06 and β: -0.25; 95% CI: -0.49, -0.02, respectively). No associations were found for wasting and relative ponderal growth. CONCLUSIONS Delayed introduction of a diverse diet and failure to maintain a diverse diet are associated with slower linear growth but not ponderal growth in the first 2 y of age. This trial was registered at clinicaltrials.gov as NCT01665378.
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Affiliation(s)
- Cam Duong
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, United States.
| | - Melissa F Young
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Phuong Hong Nguyen
- International Food Policy Research Institute, Washington, DC, United States.
| | - Lan Tran
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, United States
| | - Shivani Patel
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
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Norsa L, Goulet O, Alberti D, DeKooning B, Domellöf M, Haiden N, Hill S, Indrio F, Kӧglmeier J, Lapillonne A, Luque V, Moltu SJ, Saenz De Pipaon M, Savino F, Verduci E, Bronsky J. Nutrition and Intestinal Rehabilitation of Children With Short Bowel Syndrome: A Position Paper of the ESPGHAN Committee on Nutrition. Part 2: Long-Term Follow-Up on Home Parenteral Nutrition. J Pediatr Gastroenterol Nutr 2023; 77:298-314. [PMID: 37256821 DOI: 10.1097/mpg.0000000000003850] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) in children. The preferred treatment for IF is parenteral nutrition which may be required until adulthood. The aim of this position paper is to review the available evidence on managing SBS and to provide practical guidance to clinicians dealing with this condition. All members of the Nutrition Committee of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) contributed to this position paper. Some renowned experts in the field joined the team to guide with their expertise. A systematic literature search was performed from 2005 to May 2021 using PubMed, MEDLINE, and Cochrane Database of Systematic Reviews. In the absence of evidence, recommendations reflect the expert opinion of the authors. Literature on SBS mainly consists of retrospective single-center experience, thus most of the current papers and recommendations are based on expert opinion. All recommendations were voted on by the expert panel and reached >90% agreement. This second part of the position paper is dedicated to the long-term management of children with SBS-IF. The paper mainly focuses on how to achieve intestinal rehabilitation, treatment of complications, and on possible surgical and medical management to increase intestinal absorption.
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Affiliation(s)
- Lorenzo Norsa
- From the Department of Paediatric Hepatology, Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Olivier Goulet
- the Department of Pediatric Gastroenterology-Hepatology-Nutrition, APHP Necker-Enfants Malades Hospital, Université Paris Cité, Paris, France
| | - Daniele Alberti
- the Department of Pediatric Surgery, ASST Spedali Civili, Brescia, Italy
- the Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Barbara DeKooning
- From the Department of Paediatric Hepatology, Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Magnus Domellöf
- the Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Nadja Haiden
- the Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Susan Hill
- the Department of Paediatric Gastroenterology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Flavia Indrio
- the Department of Medical and Surgical Science, University of Foggia, Foggia, Italy
| | - Jutta Kӧglmeier
- the Department of Paediatric Gastroenterology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Alexandre Lapillonne
- the Neonatal Intensive Care Unit, APHP Necker-Enfants Malades Hospital, Paris Cité University, Paris, France
- the CNRC, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Veronica Luque
- Serra Hunter, Universitat Rovira I Virgili, IISPV, Tarragona, Spain
| | - Sissel J Moltu
- the Department of Neonatology, Oslo University Hospital, Oslo, Norway
| | - Miguel Saenz De Pipaon
- the Department of Neonatology, Instituto de Investigación Sanitaria del Hospital Universitario La Paz - IdiPAZ, Hospital Universitario La Paz - Universidad Autónoma de Madrid, Madrid, Spain
| | - Francesco Savino
- the Dipartimento di Patologia e cura del bambino "Regina Margherita", A.U.O. Città delle Salute e della Scienza di Torino, Torino, Italy
| | - Elvira Verduci
- the Department of Pediatrics, Ospedale dei Bambini Vittore Buzzi University of Milan, Milan, Italy
| | - Jiri Bronsky
- the Department of Paediatrics, University Hospital Motol, Prague, Czech Republic
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25
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Nantel A, Gingras V. Are Complementary Feeding Practices Aligned with Current Recommendations? A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:794. [PMID: 37238342 PMCID: PMC10217166 DOI: 10.3390/children10050794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023]
Abstract
The complementary feeding introduction period (introduction of solid foods alongside breastmilk or formula) is defining in children's health; however, it appears that many parents do not follow complementary feeding guidelines. Our aim was to describe current parental feeding practices during complementary feeding in relation to current recommendations and explore determinants of adherence to guidelines. We included any relevant studies published within the last decade in French or English and summarized findings by recommendation category. The timing of complementary food introduction varied widely across and within continents (earlier in North America and often delayed in Asia). The introduction of allergenic foods tended to be delayed globally. Although some parents now begin complementary feeding with solid foods (i.e., baby-led weaning), delayed introduction of lumpy textures was still prevalent in the United States and in Europe. The consumption of iron-rich foods was predominantly low in Africa. Added sugars were globally introduced early, especially in America. Evidence for the prevalence of responsive feeding practices among parents is unclear due to the small number of studies. Determinants of complementary feeding practices included parental characteristics, such as age, education, socio-economic status, and race/ethnicity. Interventions aiming to increase adherence to complementary feeding guidelines must account for parental characteristics.
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Affiliation(s)
- Audrey Nantel
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada;
- Research Center of the Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
| | - Véronique Gingras
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada;
- Research Center of the Sainte-Justine University Hospital, Montreal, QC H3T 1C5, Canada
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26
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Lemale J, Lecoufle A, Bellaiche M. Impact of diet on sensory processing in early childhood: summary of an interactive webconference / expert roundtable discussion. Postgrad Med 2023; 135:87-92. [PMID: 36408583 DOI: 10.1080/00325481.2022.2147772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pediatric feeding disorders can be seen in up to 45% of normally developing children aged under 5 years old, mainly during the first three years of life when the child has inadequate food intake and/or difficulty maintaining adequate growth, and/or lack of age-appropriate eating habit. This article describes the opinion of a group of experts on children eating patterns and how to manage pediatric feeding disorders, with the aim to improve the quality of life of children and their caregivers.
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Affiliation(s)
- Julie Lemale
- Nutrition et Gastroentérologie Pédiatriques - Hôpital Universitaire Armand Trousseau-APHP, 6 Avenue du Dr Arnold Netter, 75012 Paris, France
| | - Audrey Lecoufle
- Centre de Référence des Affections Chroniques et Malformatives de l'œsOphage (CRACMO), CHU Lille. Avenue Eugène Avinée, 59000 Lille, France
| | - Marc Bellaiche
- Nutrition et Gastroentérologie Pédiatrique - Hôpital Robert Debré-APHP, 48 Boulevard Sérurier, 75019 Paris, France
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27
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Keles MN, Ertoy Karagol HI, Serel Arslan S, Egritas Gurkan O, Sari S, Elbasan B, Dalgic B, Bakirtas A. Oropharyngeal Dysphagia in Children with Eosinophilic Esophagitis. Dysphagia 2023; 38:474-482. [PMID: 35781555 DOI: 10.1007/s00455-022-10489-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 06/20/2022] [Indexed: 01/27/2023]
Abstract
Dysphagia is the most troublesome symptom of eosinophilic esophagitis (EoE). This study aimed to investigate oropharyngeal dysphagia in children with EoE and possible related factors. Children with a definite diagnosis of EoE were included in the study. Medical and feeding histories were recorded. A disease control level was determined for each child. An oral structure examination, the Turkish version of the Mastication and Observation Evaluation (T-MOE), the Pediatric version of the Eating Assessment Tool-10 (PEDI-EAT-10) and the 3-oz water swallow test were applied in screening for oropharyngeal dysphagia. Fifty-two children participated in the study. Oropharyngeal dysphagia took the form of abnormal swallowing (PEDI-EAT-10 score ≥ 4) and increased aspiration risk (PEDI- EAT-10 score ≥ 13) in 51.9% and 25.0% of the children, respectively. Seven children failed the 3-oz water swallow test. Abnormal swallowing and aspiration risk were significantly higher in children with prolonged mealtimes, impaired chewing function, and uncontrolled disease (p < 0.05). Chewing function was the most important risk factor for abnormal swallowing and increased aspiration (R2 = 0.36, R2 = 0.52, p < 0.001, respectively). Oropharyngeal dysphagia is common in children with EoE and associated with increased aspiration risk in a subpopulation. Uncontrolled disease, prolonged mealtimes, and impaired chewing function may provide clues for oropharyngeal dysphagia in EoE.
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Affiliation(s)
- Muserrefe Nur Keles
- Department of Physiotherapy and Rehabilitation, Gazi University Faculty of Health Sciences, Cankaya, 06490, Ankara, Turkey.
| | | | - Selen Serel Arslan
- Faculty of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Odul Egritas Gurkan
- Department of Pediatric Gastroenterology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sinan Sari
- Department of Pediatric Gastroenterology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bulent Elbasan
- Department of Physiotherapy and Rehabilitation, Gazi University Faculty of Health Sciences, Cankaya, 06490, Ankara, Turkey
| | - Buket Dalgic
- Department of Pediatric Gastroenterology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Arzu Bakirtas
- Department of Pediatric Allergy, Faculty of Medicine, Gazi University, Ankara, Turkey
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28
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Soriano VX, Ciciulla D, Gell G, Wang Y, Peters RL, McWilliam V, Dharmage SC, Koplin JJ. Complementary and Allergenic Food Introduction in Infants: An Umbrella Review. Pediatrics 2023; 151:190526. [PMID: 36704902 DOI: 10.1542/peds.2022-058380] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Multiple systematic reviews examine the introduction of foods in relation to individual health outcomes, but the balance of harms and benefits has not been overviewed systematically. OBJECTIVES We aimed to perform an overview of systematic reviews on age of introduction of complementary and allergenic foods to the infant diet and long and short-term health outcomes. DATA SOURCES We searched Medline, Embase, Cochrane, and PubMed (July 25, 2022). STUDY SELECTION Included systematic reviews examining the introduction of complementary or allergenic foods before age 1. Outcomes included allergic, autoimmune, and inflammatory diseases, neurodevelopment, nutrition, and weight. DATA EXTRACTION Extraction and quality assessment were performed in duplicate (A Measurement Tool to Assess Systematic Reviews) and strength of evidence was assessed. RESULTS We screened 4015 articles and included 32 systematic reviews. There was moderate evidence that peanut and egg should be introduced from 4 to 11 months to prevent food allergy (6 of 10 reviews). Complementary food introduction was not associated with food allergy. Moderate certainty evidence suggested age of complementary food introduction was not associated with eczema. Age at introduction of gluten was not associated with celiac disease (high certainty evidence; 3 of 4 reviews). Low certainty evidence indicated that introducing solids before 4 months may increase the risk of childhood obesity, but not growth. There was insufficient evidence regarding an association between any food introduction and bone health, gastrointestinal diseases, autoimmune disorders, asthma, or allergic rhinitis. LIMITATIONS Gray literature was not included. CONCLUSIONS Current evidence supports introducing complementary foods around 6 months and allergenic foods before 11 months.
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Affiliation(s)
- Victoria X Soriano
- Centre for Food and Allergy Research.,Murdoch Children's Research Institute, Parkville, Australia
| | - Daniela Ciciulla
- Centre for Food and Allergy Research.,Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics
| | - Grace Gell
- Murdoch Children's Research Institute, Parkville, Australia
| | - Yichao Wang
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics.,School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| | - Rachel L Peters
- Centre for Food and Allergy Research.,Murdoch Children's Research Institute, Parkville, Australia
| | - Vicki McWilliam
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics.,Department of Allergy, Royal Children's Hospital, Parkville, Australia
| | - Shyamali C Dharmage
- Centre for Food and Allergy Research.,School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Jennifer J Koplin
- Centre for Food and Allergy Research.,Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics
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Vázquez-Frias R, Ladino L, Bagés-Mesa MC, Hernández-Rosiles V, Ochoa-Ortiz E, Alomía M, Bejarano R, Boggio-Marzet C, Bojórquez-Ramos MC, Colindres-Campos E, Fernández G, García-Bacallao E, González-Cerda I, Guisande A, Guzmán C, Moraga-Mardones F, Palacios-Rosales J, Ramírez-Rodríguez NE, Roda J, Sanabria MC, Sánchez-Valverde F, Santiago RJ, Sepúlveda-Valbuena N, Spolidoro J, Valdivieso-Falcón P, Villalobos-Palencia N, Koletzko B. Consensus on complementary feeding from the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition: COCO 2023. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2023; 88:57-70. [PMID: 36737343 DOI: 10.1016/j.rgmxen.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/17/2022] [Indexed: 02/04/2023]
Abstract
Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.
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Affiliation(s)
- R Vázquez-Frias
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN.
| | - L Ladino
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Facultad de Medicina, Grupo de Nutrición, Genética y Metabolismo, Universidad El Bosque, Bogotá, Colombia
| | - M C Bagés-Mesa
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Facultad de Medicina, Grupo de Nutrición, Genética y Metabolismo, Universidad El Bosque, Bogotá, Colombia
| | - V Hernández-Rosiles
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN
| | - E Ochoa-Ortiz
- Grupo de Nutrición, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica, SLAGHNP/LASPGHAN; Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Departamento de Nutrición, Mexico City, Mexico
| | - M Alomía
- Posgrado de Pediatría, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - R Bejarano
- Servicio de Gastroenterología y Nutrición, Hospital de Especialidades Pediátricas, Ciudad de Panamá, Panama
| | - C Boggio-Marzet
- Grupo de Trabajo en Gastroenterología y Nutrición Pediátrica, Hospital General de Agudos "Dr. I. Pirovano", Buenos Aires, Argentina
| | | | - E Colindres-Campos
- Departamento de Pediatría, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - G Fernández
- Departamento de Gastroenterología, Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - E García-Bacallao
- Sección de Pediatría, Instituto de Gastroenterología, Universidad de Ciencias Médicas, La Habana, Cuba
| | - I González-Cerda
- Servicio de Pediatría, Hospital Militar Escuela "Dr. Alejandro Dávila Bolaños", Managua, Nicaragua
| | - A Guisande
- Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - C Guzmán
- Hospital La Católica, San José, Costa Rica
| | - F Moraga-Mardones
- Unidad de Nutrición, Servicio de Pediatría, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - J Palacios-Rosales
- Facultad de Medicina, Universidad de San Carlos de Guatemala, Guatemala, Guatemala
| | - N E Ramírez-Rodríguez
- Facultad de Medicina, Departamento de Medicina y Salud Mental, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - J Roda
- Gastroenterología e Nutrição Pediátrica, Hospital Pediátrico - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M C Sanabria
- Cátedra y Servicio de Pediatría, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay
| | - F Sánchez-Valverde
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Universitario de Navarra, NAVARRA BIOMED, Pamplona, Navarra, Spain
| | - R J Santiago
- Departamento de Pediatría y Unidad de Gastroenterología, Hepatología y Nutrición, Hospital Universitario de Valera "Dr. Pedro Emilio Carrillo", Universidad de Los Andes, Valera, Venezuela
| | - N Sepúlveda-Valbuena
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - J Spolidoro
- Escuela de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - P Valdivieso-Falcón
- Departamento de Pediatría, Servicio subespecialidades pediátricas, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru
| | | | - B Koletzko
- Departamento de Pediatría, Medical Centre of LMU Munich, Ludwig Maximilian University of Munich, Dr. von Hauner Children's Hospital, München, Germany
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30
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Vázquez-Frias R, Ladino L, Bagés-Mesa M, Hernández-Rosiles V, Ochoa-Ortiz E, Alomía M, Bejarano R, Boggio-Marzet C, Bojórquez-Ramos M, Colindres-Campos E, Fernández G, García-Bacallao E, González-Cerda I, Guisande A, Guzmán C, Moraga-Mardones F, Palacios-Rosales J, Ramírez-Rodríguez N, Roda J, Sanabria M, Sánchez-Valverde F, Santiago R, Sepúlveda-Valbuena N, Spolidoro J, Valdivieso-Falcón P, Villalobos-Palencia N, Koletzko B. Consenso de alimentación complementaria de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica: COCO 2023. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2023. [DOI: 10.1016/j.rgmx.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Muldoon DM, Murphy TM, DeBonis DA. "Tan and Crunchy Is Where We Live": An Interpretative Phenomenological Analysis of Caregivers' Perspectives of Pediatric Feeding Disorder in Children With Developmental Disability. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2675-2687. [PMID: 36251871 DOI: 10.1044/2022_ajslp-22-00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The purpose of this study was to examine caregivers' perceptions of feeding disorders in their young child who also had a co-occurring developmental disability (DD). METHOD Using interpretative phenomenological analysis, eight caregivers of children with DD and pediatric feeding disorder (PFD) were interviewed. Interviews were recorded, transcribed, and analyzed for the lived experiences of caregivers. Thematic analysis, member checking, and an audit were completed by three researchers. RESULTS Three themes emerged: Parenting Journey, Emotions and Repercussions, and Winging It. Results indicated caregivers struggled to find appropriate professional help, referenced lack of confidence in the professionals designated to help, and were often ambivalent in approach to the PFD. Indications were that parents were frequently retelling past experiences as they presented the narrative of the feeding disorder and, as such, created narratives that became part of their present and the future experiences when feeding their child. CONCLUSIONS Implications for speech-language pathologists are considered. Particularly, interventions that go beyond the immediate environmental variables of the feeding or mealtime environment are considered, including the application of this analysis to necessary psychological flexibility for caregivers of children with PFD.
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Affiliation(s)
- Deirdre M Muldoon
- The College of Saint Rose, Albany, NY
- Albany Medical Center Hospital, NY
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32
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Duong C, Jenkins M, Pyo E, Nguyen PH, Huynh T, Nguyen‐Viet H, Young MF, Ramakrishnan U. Understanding maternal food choice for preschool children across urban-rural settings in Vietnam. MATERNAL & CHILD NUTRITION 2022; 19:e13435. [PMID: 36346156 PMCID: PMC9749606 DOI: 10.1111/mcn.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 05/27/2022] [Accepted: 09/07/2022] [Indexed: 11/10/2022]
Abstract
Improving diet quality of preschool children is challenging in countries undergoing food environment and nutrition transition. However, few studies have sought to understand how mothers in these countries decide what and how to feed their children. This study aims to explore maternal experiences, perspectives and beliefs when making food choice decisions for preschool children in urban, peri-urban and rural areas in northern Vietnam. Two focus group discussions and 24 in-depth interviews were carried out and analysed using thematic analysis. The results showed that mothers across the urban-rural spectrum shared the intention to feed children safe, nutritious food for better health and weight gain while satisfying child food preferences to improve appetite and eating enjoyment. These food choice intentions were embedded within family food traditions, whereby mothers emphasised nutritious food and adopted strict feeding styles during lunch and dinner but were flexible and accommodating of child preferences during breakfast and side meals. These intentions were also embedded within the physical food environment, which provided a mix of healthy and unhealthy food through informal food retailers. Despite these intentions, mothers faced financial constraints and difficulties in managing children's refusal to chew, changes in eating mood and strong eating temperament. These findings support policies to limit the presence of unhealthy food in informal food retail and encourage meal-specific feeding strategies to help children enjoy nutritious food, transition from soft to textured food and become more cooperative during mealtime.
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Affiliation(s)
- Cam Duong
- Nutrition and Health Sciences Program, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Mica Jenkins
- Nutrition and Health Sciences Program, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Euisun Pyo
- Nutrition and Health Sciences Program, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Phuong Hong Nguyen
- International Food Policy Research InstituteWashingtonDistrict ColumbiaUSA
| | - Tuyen Huynh
- Alliance Bioversity International and CIATAsia HubHanoiVietnam
| | - Hung Nguyen‐Viet
- Animal and Human Health ProgramInternational Livestock Research InstituteNairobiKenya
| | - Melissa F. Young
- Hubert Department of Global HealthEmory UniversityAtlantaGeorgiaUSA
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33
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Chow CY, Skouw S, Bech AC, Olsen A, Bredie WLP. A review on children's oral texture perception and preferences in foods. Crit Rev Food Sci Nutr 2022; 64:3861-3879. [PMID: 36300653 DOI: 10.1080/10408398.2022.2136619] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Texture properties of foods are particular drivers for food acceptance and rejection in children. The texture preferences follow the developmental progression of the child and these changes modulate the present and future food habits. This paper reviews the development and factors influencing texture preferences in children and the methods in food texture research with children. The child's acceptance of more complex food textures is age-dependent. The progression is indorsed by the development of oral processing skills at an early age and bolstered by repeated exposures to foods with varying textures. Children generally reject foods containing pieces or bits (i.e., geometrical textural properties); however, the impact of mechanical textural properties on food acceptance is less clear. Child characteristics such as food neophobia, picky eating, and tactile over-responsivity, negatively affect the acceptance of more diverse food textures. Depending on the child's age, the prevailing methods of characterizing food texture preferences in children include observational techniques and self-reported questionnaires. Despite knowledge of children's development of masticatory skills, learning, and cognitive abilities, the relationships of these changes to food texture acceptance and the recommended test methodology for evaluating product texture acceptance in this period of life are still limited.
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Affiliation(s)
- Ching Yue Chow
- Section for Food Design and Consumer Behavior, Department of Food Science, University of Copenhagen, Denmark
- Arla Innovation Centre, Arla Foods AMBA, Denmark
| | - Sigrid Skouw
- Section for Food Design and Consumer Behavior, Department of Food Science, University of Copenhagen, Denmark
| | - Anne C Bech
- Arla Innovation Centre, Arla Foods AMBA, Denmark
| | - Annemarie Olsen
- Section for Food Design and Consumer Behavior, Department of Food Science, University of Copenhagen, Denmark
| | - Wender L P Bredie
- Section for Food Design and Consumer Behavior, Department of Food Science, University of Copenhagen, Denmark
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34
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Commercial Complementary Food in Germany: A 2020 Market Survey. Nutrients 2022; 14:nu14183762. [PMID: 36145138 PMCID: PMC9502210 DOI: 10.3390/nu14183762] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
As consumption of commercial complementary food (CCF) during infancy and toddlerhood is common, the aim of the present study was to describe the current (2020) German market of CCF products targeted at infants and toddlers with a special focus on ingredients, macronutrients, and the practice of nutrient fortification. Information on age declarations, ingredients, energy and nutrient contents, and nutrient fortification was obtained in a market survey by contacting the producers and searching manufacturers’ websites. Each product was assigned to 1 of 13 product categories (menus, milk−cereal−meal, fruit−cereal−meal, oil, vegetables, meat, fish, fruits, cereals, snack foods, pouches, desserts, beverages). Descriptive statistics were used. We identified 1057 CF products on the German market (infants’ CCF (<12 months): n = 829; toddlers’ CCF (>12 months): n = 228)). The highest protein content (% of energy content, %E) was found in meat products. In pouches, beverages, cereal fruit meals, and fruits, more than 50% of energy came from total sugar. The highest median salt content was found in toddlers’ menus and desserts. Around one-third of infants’ CCF products and one quarter of toddlers’ products were fortified with nutrients. Vitamin B1 (thiamin) was the most frequently fortified nutrient, followed by vitamin C, iron, calcium, and vitamin D. Apple was the type of fruit listed most often in products with fruits, whereas carrot was the most frequent vegetable among CCF with vegetables. In particular, the high total sugar content of most CCFs currently available on the German market may promote unhealthy dietary habits. Parents need to be advised about the optimal selection of products.
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Spyreli E, McKinley MC, Dean M. An online survey of dietary quality during complementary feeding; associations with maternal feeding self-efficacy and adherence to dietary recommendations. BMC Nutr 2022; 8:100. [PMID: 36085052 PMCID: PMC9461111 DOI: 10.1186/s40795-022-00595-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Parents are the gatekeepers of nutrition in early life and their feeding practices form children’s dietary behaviours. Although maternal characteristics have been associated with certain feeding practices, their relationship with overall quality of complementary feeding diets has not been explored. This study aimed to: assess dietary quality in complementary feeding age; explore its association with maternal and child characteristics; and evaluate the association between complementary feeding practices and child weight. Methods An online cross-sectional survey captured data from a self-selected sample of mothers living in the UK with a healthy full-term child in complementary feeding age. A total of 466 mothers completed a questionnaire on their complementary feeding practices, demographics, anthropometrics, rates of maternal food neophobia, feeding self-efficacy, social support, postnatal depression and infant temperament. Dietary quality was assessed using the Complementary Feeding Utility Index (CFUI). Children were classified into underweight, normal weight, overweight and obese. Results Majority of participants reported high levels of dietary quality as determined by a mean CFUI score of 80%. High dietary quality was associated with reliance on the NHS recommendation on timing of complementary feeding and maternal self-efficacy in promoting a healthy diet and limiting non-recommended foods. Responsive feeding, longer breastfeeding duration, frequent exposure to fruits and to a high variety of protein-rich animal foods were significantly associated with lighter child weight status. Consumption of sweetened drinks and delayed introduction of lumpy foods were associated with heavier child weight status. Conclusions This study provided an evaluation of dietary quality in complementary feeding in a UK sample of children and explored its relationship with maternal and child attributes. Increasing understanding of the current complementary feeding recommendations and strengthening maternal feeding self-efficacy may be key for healthcare professionals and researchers to improving complementary feeding practices. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00595-8.
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Affiliation(s)
- Eleni Spyreli
- Centre for Public Health, Institute of Clinical Science Block A, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, United Kingdom. .,Institute for Global Food Security, Queen's University Belfast, Belfast, BT9 5DL, UK.
| | - Michelle C McKinley
- Centre for Public Health, Institute of Clinical Science Block A, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, United Kingdom.,Institute for Global Food Security, Queen's University Belfast, Belfast, BT9 5DL, UK
| | - Moira Dean
- Institute for Global Food Security, Queen's University Belfast, Belfast, BT9 5DL, UK
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Nutritional Assessment of Baby Food Available in Italy. Nutrients 2022; 14:nu14183722. [PMID: 36145098 PMCID: PMC9501114 DOI: 10.3390/nu14183722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
Adequate complementary feeding practices are important for short- and long-term child health. In industrialized countries, the formulation of several commercial baby foods (CBFs) and an increase in their consumption has been noticed. AIM To update and analyze the nutritional composition of CBFs available in the Italian market. METHODS Data collection carried out in two steps (July 2018-January 2019) and updated in May-September 2021. The information on CBFs was taken from the websites of the major CBF producers available in Italy. The collected information were: Suggested initial and final age of consumption; Ingredients; Energy value; Macronutrients (protein, lipids, and carbohydrates); Fiber; Micronutrients (sodium, iron, and calcium); Presence of salt and added sugars, flavorings, and other additives. RESULTS Time-space for which CBFs are recommended starts too early and ends too late; protein content is adequate and even too high in some food; Amount of fats and their quality must be improved, keeping the intake of saturated fats low; Sugar content is too high in too many CBFs and salt is unnecessarily present in some of them. Finally, the texture of too many products is purée, and its use is recommended for too long, hindering the development of infants' chewing abilities.
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Białek-Dratwa A, Soczewka M, Grajek M, Szczepańska E, Kowalski O. Use of the Baby-Led Weaning (BLW) Method in Complementary Feeding of the Infant-A Cross-Sectional Study of Mothers Using and Not Using the BLW Method. Nutrients 2022; 14:nu14122372. [PMID: 35745102 PMCID: PMC9227137 DOI: 10.3390/nu14122372] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 02/01/2023] Open
Abstract
Baby-led weaning (BLW) is an increasingly popular way of expanding a baby’s diet. It is based on the baby becoming physically ready to feed himself, effectively supplementing his diet, which until now has been based on breast milk or modified milk. The aim of the study was to assess mothers’ knowledge about the use of the BLW method to expand the diet of a young child. The essence of the study assumed the analysis of the advantages and disadvantages of using this method indicated by mothers. Materials and Methods: A total of 320 mothers participated in the study. Data for the study were collected anonymously using the CAWI method. The research tool was the original questionnaire relating to the knowledge about the BLW method and the application of the BLW method in practice. Results: The BLW method was used by 240 (75%) women. The reasons for not using the BLW method were: the child did not cooperate n = 30 (37.5%) and was not ready to use the BLW method n = 20 (25%). In total, 182 (75.8%) mothers using BLW and 63 (78.8%) mothers not using BLW started extending the diet before the child was 6 months old. According to 270 (84.4%) mothers, including 205 (85.4%) using BLW, stable sitting in a highchair/on the lap is a decisive factor for starting the dietary expansion with the BLW method. Conclusions: Mothers’ knowledge of the BLW method as a way of expanding a young child’s diet was insufficient. It seems important to implement appropriate educational activities on the methods of expanding children’s diets to broaden parents’ knowledge of the influence of nutrition on infant development.
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Affiliation(s)
- Agnieszka Białek-Dratwa
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland; (E.S.); (O.K.)
- Correspondence: ; Tel.: +48-(0-32)-275-51-95
| | - Monika Soczewka
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, 60-512 Poznan, Poland;
- Doctoral School, Poznan University of Medical Sciences, Fredry St. 10, 61-701 Poznan, Poland
| | - Mateusz Grajek
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, ul. Piekarska 18, 41-902 Bytom, Poland;
| | - Elżbieta Szczepańska
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland; (E.S.); (O.K.)
| | - Oskar Kowalski
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, ul. Jordana 19, 41-808 Zabrze, Poland; (E.S.); (O.K.)
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San Mauro Martín I, Garicano Vilar E, Porro Guerra G, Camina Martín MA. Knowledge and attitudes towards baby-led-weaning by health professionals and parents: A cross-sectional study. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32 Suppl 1:S64-S72. [PMID: 35688568 DOI: 10.1016/j.enfcle.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 04/14/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain. METHODS This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test. RESULTS 92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest. CONCLUSION Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.
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Affiliation(s)
- Ismael San Mauro Martín
- Research Centers in Nutrition and Health (CINUSA Group), Paseo de la Habana, 43, 28036 Madrid, Spain; Escuela Baby Lead Weaning, https://www.escuelablw.es/, Spain.
| | - Elena Garicano Vilar
- Research Centers in Nutrition and Health (CINUSA Group), Paseo de la Habana, 43, 28036 Madrid, Spain
| | - Gema Porro Guerra
- Escuela Universitaria de Enfermería Dr. Dacio Crespo, Universidad de Valladolid, Av. San Telmo, s/n, 34004 Palencia, Spain
| | - María Alicia Camina Martín
- Escuela Universitaria de Enfermería Dr. Dacio Crespo, Universidad de Valladolid, Av. San Telmo, s/n, 34004 Palencia, Spain; Facultad de Ciencias de la Salud, Universidad Isabel I de Castilla, C/ Fernán González, 76, 09003 Burgos, Spain
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Thompson HR, Borger C, Paolicelli C, Whaley SE, Reat A, Ritchie L. The Relationship between Breastfeeding and Initial Vegetable Introduction with Vegetable Consumption in a National Cohort of Children Ages 1–5 Years from Low-Income Households. Nutrients 2022; 14:nu14091740. [PMID: 35565708 PMCID: PMC9101240 DOI: 10.3390/nu14091740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022] Open
Abstract
Compared to other food groups, vegetable intakes are lowest relative to recommendations. Breastfeeding and initial introduction to vegetables may help infants establish long-lasting taste preferences. We examined the relationship between breastfeeding and initial vegetable introduction and vegetable intake in early childhood (ages 13–60 months). This repeated cross-sectional study used data from the national WIC Infant and Toddler Feeding Practices Study-2 collected from low-income mother/caregivers about infants from around birth through age 5 (60 months; n = 3773). Survey-weighted adjusted regression models assessed associations between breastfeeding and vegetable introduction measures with vegetable consumption at child ages 13, 24, 36, 48, and 60 months. Longer breastfeeding duration was associated with a slightly, but significantly, greater variety of vegetables consumed/day in early childhood. There was also a small but positive statistically significant association between the number of different types of vegetables consumed on a given day at 9 months and the amount and variety of vegetables consumed/day in early childhood. Age of initial vegetables introduction and whether vegetables were the first/second food introduced were not consistently related to the amount or variety of vegetables consumed later in childhood. Longer breastfeeding and introduction to a greater variety of vegetables at 9 months may be behaviors to target to increase consumption of a greater variety of vegetables by young children.
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Affiliation(s)
- Hannah R. Thompson
- Community Health Sciences, School of Public Health, University of California, 2121 Berkeley Way, 6120, Berkeley, CA 94720, USA
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, 1111 Franklin Street, Fifth Floor, Oakland, CA 94706, USA;
- Correspondence:
| | | | - Courtney Paolicelli
- USDA Food and Nutrition Service, 1320 Braddock Place, Alexandria, VA 22314, USA; (C.P.); (A.R.)
| | - Shannon E. Whaley
- Public Health Foundation Enterprises WIC, Division of Research and Evaluation, 12781 Schabarum Avenue, Irwindale, CA 91706, USA;
| | - Amanda Reat
- USDA Food and Nutrition Service, 1320 Braddock Place, Alexandria, VA 22314, USA; (C.P.); (A.R.)
| | - Lorrene Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, 1111 Franklin Street, Fifth Floor, Oakland, CA 94706, USA;
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Chang MC, Liu HY, Huang ST, Chen HL. Study of Orofacial Function in Preschool Children Born Prematurely. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030360. [PMID: 35327731 PMCID: PMC8947379 DOI: 10.3390/children9030360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 11/16/2022]
Abstract
Children born prematurely often exhibit orofacial dysfunction. We conducted Nordic Orofacial Test Screening and analyzed chewing and swallowing functions of 243 children aged 3−5 years, consisting of 142 and 101 children born full-term and preterm, respectively, to evaluate the orofacial function of preschool premature children. Categorical variables were analyzed using chi-square test for a comparison. The univariate analysis of variance was used to analyze the effects of birth weight, gestational age, intubation at birth, use of nasal continuous positive airway pressure support after birth, and use of nasogastric tube on the chewing and swallowing functions of children born prematurely. In this survey, term-born children had a higher incidence of bad oral habits, grinding teeth while sleeping, and abnormal gulping compared to preterm-born children. Preterm-born children had a higher incidence of choking, decreased mouth opening (<30 mm), abnormal dental arch form, abnormal palatal vault, and dysarthria compared to term-born children.
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Affiliation(s)
- Mei-Chen Chang
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung City 813414, Taiwan;
| | - Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City 807378, Taiwan; (H.-Y.L.); (S.-T.H.)
| | - Shun-Te Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung City 807378, Taiwan; (H.-Y.L.); (S.-T.H.)
- Division of Pediatric Dentistry and Special Care Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung City 807378, Taiwan
| | - Hsiu-Lin Chen
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung City 807378, Taiwan
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung City 807378, Taiwan
- Correspondence: ; Tel.: +886-7312-1101 (ext. 6529)
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Rendall S, Harvey K, Tavassoli T, Dodd H. Associations between emotionality, sensory reactivity and food fussiness in young children. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nekitsing C, Hetherington MM. Implementing a 'Vegetables First' Approach to Complementary Feeding. Curr Nutr Rep 2022; 11:301-310. [PMID: 35152358 PMCID: PMC9174121 DOI: 10.1007/s13668-022-00399-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/30/2022]
Abstract
Purpose of Review To provide a rationale for promoting a vegetables first approach to complementary feeding (CF), building on prior exposure to vegetable flavours experienced in utero and via breastfeeding (chemosensory continuity). Recent Findings Vegetables confer selective health benefits but population intakes are below recommendations globally; maternal intake of vegetables during both pregnancy and lactation promotes familiarity with some vegetable flavours. Building on this exposure, vegetables as a first food during CF further promote acceptance. However, experiments testing efficacy of a vegetables first approach to CF demonstrate increased liking and intake, some evidence of generalisability but little evidence of sustained effects beyond infancy. Summary The aim to increase the quantity and variety of vegetables eaten by children is both desirable, to improve nutrient quality of the diet, and achievable. However, longer, larger, randomised control trials are needed to evidence any longer term, sustainable benefits to liking and intake of vegetables.
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Graf MD, Lutenbacher M, Wasser H, Dietrich MS, Karp SM. Choking, allergic reactions, and pickiness: A qualitative study of maternal perceived threats and risk avoidance strategies during complementary feeding. Appetite 2022; 171:105914. [PMID: 35007666 PMCID: PMC8842507 DOI: 10.1016/j.appet.2022.105914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 12/31/2021] [Accepted: 01/05/2022] [Indexed: 11/17/2022]
Abstract
An infant's early eating experiences influence later growth and health. However, motivators for mothers' complementary feeding decisions for their infants, such as the process of introducing solid foods, remains unclear. This qualitative study identified maternal perceived threats surrounding complementary feeding and strategies mothers use to mitigate perceived threats of adverse feeding-related health outcomes for their infants. Twenty-seven mothers participated in private, semi-structured interviews. Inductive and deductive qualitative content analysis revealed three primary themes of maternal perceived threats: a) choking, b) allergic reaction, and c) pickiness. Within each primary theme were sub-themes that further delineated the perceived threats and outlined specific and focused complementary feeding practices (CFPs) mothers used for each type of perceived threat. Findings suggest mothers have difficulty with estimating the likelihood and severity of risks and rely on elevated threat perception to guide their feeding decisions. CFPs used to prevent perceived threats were disproportionate to risks, and, at times, actually introduced additional, alternative risks.
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Affiliation(s)
| | - Melanie Lutenbacher
- School of Nursing, Vanderbilt University, Nashville, TN, 37235, United States
| | - Heather Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, United States
| | - Mary S Dietrich
- School of Nursing, Vanderbilt University, Nashville, TN, 37235, United States; Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, TN, 37235, United States
| | - Sharon M Karp
- School of Nursing, Vanderbilt University, Nashville, TN, 37235, United States
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Timing of Introduction to Solid Food, Growth, and Nutrition Risk in Later Childhood. J Pediatr 2022; 240:102-109.e3. [PMID: 34481809 DOI: 10.1016/j.jpeds.2021.08.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/22/2021] [Accepted: 08/26/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the relationship between the timing of infant cereal introduction between 4 and 6 months of age and growth and dietary intake in later childhood. STUDY DESIGN A longitudinal cohort study was conducted among healthy children 0-10 years of age participating in The Applied Research Group for Kids cohort study between June 2008 and August 2019 in Toronto, Canada. RESULTS Of 8943 children included, the mean (SD) age of infant cereal introduction was 5.7 (2.1) months. In the primary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.17 greater body mass index z score (95% CI 0.06-0.28; P = .002) and greater odds of obesity (OR 1.82; 95% CI 1.18-2.80; P = .006) at 10 years of age. In the secondary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.09 greater height-for-age z score (95% CI 0.04-0.15; P = .002) at 1 year of age, an association that was not observed at 5 or 10 years of age. Children who were introduced to infant cereal at 4 vs 6 months had greater nutrition risk which was primarily determined by a less-favorable eating behavior score at 18 months to 5 years of age (0.18 units higher; 95% CI 0.07-0.29; P = .001). CONCLUSIONS Introduction of infant cereal at 4 vs 6 months was associated with greater body mass index z score, greater odds of obesity, similar height-for-age z score, and less favorable eating behavior. These findings support recommendations for introducing solid food around 6 months of age.
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Czarnik M, Hamner HC, Moore LV. Food Preparation Practices for Infants Aged From 7 to 13 Months. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:28-35. [PMID: 34598893 PMCID: PMC10898497 DOI: 10.1016/j.jneb.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/10/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To examine infant food preparation practices at age 7, 9, 11, and 13 months overall and by sociodemographic characteristics. DESIGN Data from a longitudinal study from the US Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2) were used. PARTICIPANTS A sample of 1,904 infants (970 males and 934 females) enrolled in WIC who had been introduced to solid foods and were consuming food prepared at home. MAIN OUTCOME MEASURES Food preparation practices included pureeing, mashing, chopping/dicing, and prechewing. Estimates were provided overall and by sociodemographics. ANALYSIS Prevalence estimates were calculated for each survey month overall and by sociodemographics. Chi-square tests for independence were used to test for differences. RESULTS Food preparation practices changed as infants aged. Pureeing and mashing were common in month 7 (57.8% and 59.6%, respectively), but chopping/dicing were the most prevalent by month 13 (85.4%). Food preparation practices did not vary by education status, but statistical differences were consistently observed by race and ethnicity and inconsistently observed by maternal age at birth. CONCLUSIONS AND IMPLICATIONS Exposing children to a range of food textures at an appropriate age is important for developmental progress. Continued culturally relevant efforts by WIC educators and health care providers can emphasize the importance of early experiences with food textures.
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Affiliation(s)
- Michaila Czarnik
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Moumin NA, Golley RK, Mauch CE, Makrides M, Green TJ, Netting MJ. The Australian Feeding Infants and Toddlers Study (OzFITS) 2021: Study Design, Methods and Sample Description. Nutrients 2021; 13:4524. [PMID: 34960074 PMCID: PMC8708463 DOI: 10.3390/nu13124524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 12/04/2022] Open
Abstract
(1) Background: Caregiver feeding practices during the first two years of a child's life influence nutrition, growth, and development, as well as long term taste preferences and dietary patterns. Suboptimal feeding practices lead to poorer health outcomes, such as obesity, that persist into adulthood. Although the importance of early life nutrition is well-established, there are no Australia-wide surveys of dietary intakes of children under two years of age. The 2021 Australian Feeding Infants and Toddlers Study (OzFITS) aims to fill this gap. This paper describes the methods and study sample of OzFITS 2021. (2) Methods: OzFITS 2021 is a cross-sectional study of children aged 0 to 23.9 months of age and their caregiver across Australia. Data were collected between April 2020 and April 2021. A telephone-based survey was completed with a caregiver to obtain information on child and caregiver characteristics and feeding practices. For exclusively breastfed infants, the number of breastfeeds in a 24 h period was reported. Dietary intakes for mixed fed children were estimated using a one-day food record, with 30% of caregivers completing a second food record on a non-consecutive day. (3) Results: We enrolled 1140 caregiver and child dyads. Of those eligible to complete a food record, 853 (87%) completed the food record. Compared to the Australian population, caregivers were more likely to be university-educated (>75%), married or in a de facto relationship (94%), and have a household income >$100,000/y (60%). (4) Conclusions: OzFITS 2021 is the first national study to examine food and nutrient intake in Australian children aged under 2 years. The study will provide information on breastfeeding rates and duration, use of breast milk substitutes, and timing of solid food introduction. Dietary intake data will allow the comparison of core food groups and discretionary food intake to Australian guidelines and estimate the prevalence of inadequate intake of key nutrients, like iron. Healthcare practitioners and policymakers can use the study findings as a source of evidence to inform the next iteration of infant feeding guidelines.
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Affiliation(s)
- Najma A. Moumin
- Discipline of Pediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.M.); (M.M.); (T.J.G.)
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Rebecca K. Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia; (R.K.G.); (C.E.M.)
| | - Chelsea E. Mauch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia; (R.K.G.); (C.E.M.)
| | - Maria Makrides
- Discipline of Pediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.M.); (M.M.); (T.J.G.)
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Tim J. Green
- Discipline of Pediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.M.); (M.M.); (T.J.G.)
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Merryn J. Netting
- Discipline of Pediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.M.); (M.M.); (T.J.G.)
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Nutrition Department, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
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Roberts AP, Cross L, Hale A, Houston-Price C. VeggieSense: A non-taste multisensory exposure technique for increasing vegetable acceptance in young children. Appetite 2021; 168:105784. [PMID: 34748876 DOI: 10.1016/j.appet.2021.105784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022]
Abstract
Vegetable consumption falls well below recommended levels for children in the UK. Previous research has found that repeated non-taste sensory exposure over the course of several days increases young children's willingness to touch and taste vegetables. The current study examined the impact of a one-off multisensory non-taste exposure intervention that took place on a single day on children's willingness to taste and intake of the exposed vegetables. Children (N = 110) aged 3- to 4-years-old were assigned to one of three intervention groups or to a control group. Children in all groups participated individually in a single activity session delivered in their nursery. Children in the intervention conditions took part in fun activities that provided either (a) visual exposure, (b) smell and visual exposure, or (c) smell, touch and visual exposure to six raw and prepared vegetables. Children in the control group engaged in a visual exposure activity with non-food items. After the exposure activities, all children were offered the prepared vegetables to eat; their willingness to taste and intake of the vegetables were measured. Results confirmed previous findings of sensory exposure activities increasing children's willingness to taste and intake of vegetables and revealed linear trends in both measures of acceptance with the number of senses engaged; children who took part in smell, touch and visual activities showed the highest level of acceptance. Findings suggest that multisensory exposures are effective in increasing consumption of vegetables in young children and that the effect of sensory exposure to healthy foods may be cumulative, with the more senses engaged prior to offering a food, the better.
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Affiliation(s)
- Alan Parry Roberts
- School of Psychology and Clinical Language Sciences, University of Reading, Earley, Reading, RG6 6BZ, UK.
| | - Lara Cross
- School of Psychology and Clinical Language Sciences, University of Reading, Earley, Reading, RG6 6BZ, UK
| | - Amy Hale
- School of Psychology and Clinical Language Sciences, University of Reading, Earley, Reading, RG6 6BZ, UK
| | - Carmel Houston-Price
- School of Psychology and Clinical Language Sciences, University of Reading, Earley, Reading, RG6 6BZ, UK
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48
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Delaney AL, Van Hoorn M, Staskiewicz S, Feuling MB, Pladies S, Bansal NK, Goday PS. Texture Consumption Patterns of 8- to 12-Month-Old Infants: A Reflection of Typical Feeding Development. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2643-2652. [PMID: 34723644 DOI: 10.1044/2021_ajslp-21-00048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose The lack of age-appropriate expectations for the acquisition of feeding skills and consumption of textured food in early childhood inhibits early and accurate identification of developmental delay in feeding and pediatric feeding disorder. The objective of this study was to describe texture intake patterns in a cohort of typically developing infants between 8 and 12 months of age, with the aim of informing future research to establish targets for feeding skill acquisition. Method Using cross-sectional methodology, we studied the presence of liquid and solid textures and drinking methods in the diet, consumption patterns by texture and drinking methods, and caloric intake by texture via caregiver questionnaire and 3-day dietary intake record in 63 healthy infants between 8 and 12 months of age. Descriptive statistics and a one-way analysis of variance were conducted to compare the effect of age on texture intake patterns. Results Findings reveal rapid advancement of intake patterns for texture overall and for energy intake by texture between 8 and 12 months of age. Whereas liquids continue to provide a large proportion of total energy through this time, solids contribute an equal proportion of energy by 12 months of age. Conclusions This study describes texture intake patterns in a cohort of typically developing infants between 8 and 12 months of age by examining the presence of texture and drinking methods, liquid and solid consumption patterns, and energy intake by texture. When applied to data from a future population sample, findings will provide a threshold for age expectations for typical and disordered feeding development to aid in the detection of developmental delay in feeding and pediatric feeding disorder. What Is Known: Expectations regarding early feeding development have been focused on nutrition parameters. Lack of standardized, age-appropriate expectations for texture progression in infancy and early childhood inhibits early and accurate identification and treatment of pediatric feeding disorder. What Is New: We have described changes in dietary composition by texture and drinking method in healthy infants. Together with nutritional composition, this study describes a more comprehensive assessment of infant feeding, particularly to clinicians who need to diagnose feeding skill deficits. Supplemental Material https://doi.org/10.23641/asha.16879615.
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Affiliation(s)
- Amy L Delaney
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI
| | - Megan Van Hoorn
- Department of Clinical Nutrition, Children's Wisconsin, Milwaukee
| | | | | | | | - Naveen K Bansal
- Department of Mathematics, Statistics and Computer Science, Marquette University, Milwaukee, WI
| | - Praveen S Goday
- Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, Milwaukee
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Cappellotto M, Olsen A. Food Texture Acceptance, Sensory Sensitivity, and Food Neophobia in Children and Their Parents. Foods 2021; 10:2327. [PMID: 34681376 PMCID: PMC8535628 DOI: 10.3390/foods10102327] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 01/26/2023] Open
Abstract
This study aims to explore whether children's food texture preferences are associated with different levels of sensory sensitivity and food neophobia, as well as with other variables, such as parental texture preferences. An online questionnaire was completed by 70 children aged 6-13 years old, alongside one of their parents. Generic texture preferences of children and parents were investigated with the Child Food Texture Preference Questionnaire (CFTPQ). Parents provided background information about their children by completing the Food Neophobia Scale (FNS), the Short Sensory Profile (SSP) and a Food Frequency Questionnaire (FFQ). The results showed that children who differed in their texture-liker status also differed in their levels of food neophobia and sensory information processing: children who preferred softer and non-particulate versions of foods were found to be more neophobic and sensory sensitive across all sensory domains. No relationship was found between parental and children's texture preferences.
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Affiliation(s)
| | - Annemarie Olsen
- Section for Food Design and Consumer Behaviour, Department of Food Science, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark;
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50
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Boctor DL, Jutteau WH, Fenton TR, Shourounis J, Galante GJ, Eicher I, Goulet O, Lambe C. The prevalence of feeding difficulties and potential risk factors in pediatric intestinal failure: Time to consider promoting oral feeds? Clin Nutr 2021; 40:5399-5406. [PMID: 34571239 DOI: 10.1016/j.clnu.2021.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/14/2021] [Accepted: 08/20/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Although nutritional care is a cornerstone in the management of pediatric intestinal failure (IF), little is known about feeding difficulty (FD) prevalence. The aim of this study was to determine the frequency of FD and associated factors and to characterize eating behaviours in two pediatric IF rehabilitation centres (Hôpital-Necker Enfants Malades (NEM), France and Alberta Children's Hospital (ACH), Canada). METHODS Parents of children (aged 1-18 years) on home parenteral nutrition (PN) for >3 months followed at NEM and ACH completed two validated tools: Montreal Children's Feeding scale for severity of FD, Child Eating Behaviour Questionnaire and a pediatric IF-specific questionnaire for FD associated risk factors. RESULTS In the entire cohort (n = 59, median 5.2 years), 15% had mild, 19% had moderate and 25% had severe FD. No FD was seen in 53% vs 11% and severe FD was seen in 20% vs. 39% of the NEM and ACH cohorts respectively (p = 0.003). Current ETF was less common at NEM vs. ACH (3% vs. 50%, p < 0.001). The FD score was associated with current enteral tube feed (ETF) use (p = 0.04). Compared to healthy reference children, the NEM cohort did not differ for the enjoyment of food, whereas the ACH cohort's enjoyment was lower (p < 0.0001). The ACH cohort scored higher for food avoidance behaviours: food fussiness (p < 0.02), satiety responsiveness (p < 0.0001), and slowness in eating (p < 0.0001) while the NEM cohort was not different from healthy reference children. In the entire cohort, according to parental recall, 60% were reported to be NPO for >12 weeks in the first 6 months of life, and late introduction of purees (>9 months) and lumpy textures (>1 year) were found in 40% and 58%, respectively. Parent-recalled ETF differed between NEM and ACH in the first 6 months of life (45% vs 76%, p = 0.03). CONCLUSIONS Feeding difficulty and associated risk factors, including early ETF, prolonged NPO and delays in achieving feeding milestones were frequently reported in pediatric IF. Feeding medicalization with the use of ETF may inadvertently contribute to FD and eating disorder behavioural characteristics. This study highlights the need for FD prevention and an increased focus on establishing healthy eating. Future prospective study of FD, associated risk factors and clinical outcomes are merited.
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Affiliation(s)
- Dana Liza Boctor
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta Children's Hospital Calgary, 28 Oki Drive NW, Calgary, AB, T3B-6A8, Canada.
| | - Wiem Hassen Jutteau
- Department of Pediatric Gastroenterology-Hepatology-Nutrition, National Reference Center for Rare Digestive Diseases, Pediatric Intestinal Failure Rehabilitation Center, Hôpital Necker-Enfants Malades, University of Paris Medical School, 149 Rue de Sèvres, 75015 Paris, France
| | - Tanis R Fenton
- Nutrition Services, Alberta Health Services, Department of Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Jasmine Shourounis
- Alberta Children's Hospital, Nutrition Services, Alberta Health Services, 28 Oki Drive NW, Calgary, AB, T3B-6A8, Canada
| | - Gary Joshua Galante
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta Children's Hospital Calgary, 28 Oki Drive NW, Calgary, AB, T3B-6A8, Canada
| | - Isabelle Eicher
- Department of Pediatric Gastroenterology-Hepatology-Nutrition, National Reference Center for Rare Digestive Diseases, Pediatric Intestinal Failure Rehabilitation Center, Hôpital Necker-Enfants Malades, University of Paris Medical School, 149 Rue de Sèvres, 75015 Paris, France
| | - Olivier Goulet
- Department of Pediatric Gastroenterology-Hepatology-Nutrition, National Reference Center for Rare Digestive Diseases, Pediatric Intestinal Failure Rehabilitation Center, Hôpital Necker-Enfants Malades, University of Paris Medical School, 149 Rue de Sèvres, 75015 Paris, France
| | - Cecile Lambe
- Department of Pediatric Gastroenterology-Hepatology-Nutrition, National Reference Center for Rare Digestive Diseases, Pediatric Intestinal Failure Rehabilitation Center, Hôpital Necker-Enfants Malades, University of Paris Medical School, 149 Rue de Sèvres, 75015 Paris, France
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