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Capra ME, Decarolis NM, Monopoli D, Laudisio SR, Giudice A, Stanyevic B, Esposito S, Biasucci G. Complementary Feeding: Tradition, Innovation and Pitfalls. Nutrients 2024; 16:737. [PMID: 38474864 DOI: 10.3390/nu16050737] [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: 02/03/2024] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
According to WHO, "complementary feeding (CF) is the process starting when breast milk alone or infant formula alone is no longer sufficient to meet the nutritional requirements of infants, and therefore, other foods and liquids are needed, along with breast human milk or a breastmilk substitute". CF is one of the most important "critical and sensitive periods" in human life: indeed, timing and approaches to solid foods introduction in an infant's nutrition are of utmost importance as potential epigenetic factors from infancy to adulthood. CF is also deeply influenced by each country and single-family traditions, culture, and beliefs. The aim of our narrative review is to analyze traditional CF practices, including innovative and alternative ones that emerged in the last decades, such as baby-led weaning or plant-based weaning, and to evaluate their effects on the risk of developing non-communicable diseases. Moreover, we will discuss pitfalls and misunderstandings that pediatricians frequently have to face when dealing with complementary feeding. Health care professionals must not have prejudices against parents' wishes or traditions about CF; rather, they should support and educate them in case of any alternative CF choice, always pursuing the infant's adequate growth, neuro- and taste development, and the achievement of correct eating behavior as the primary goal.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Serena Rosa Laudisio
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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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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Neves RO, Nunes LM, Silveira LDO, Lima MR, Moreira PR, Bernardi JR. Functional constipation symptoms and complementary feeding methods: A randomized clinical trial. An Pediatr (Barc) 2023; 98:267-275. [PMID: 36922244 DOI: 10.1016/j.anpede.2023.01.011] [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: 04/06/2022] [Revised: 09/14/2022] [Accepted: 09/18/2022] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION The aim of the study was to investigate the impact of different complementary feeding methods on the prevalence of functional constipation symptoms in infants at 12 months of age. MATERIAL AND METHODS Randomized clinical trial in mother-infant dyads that underwent the intervention at 5.5 months post birth, randomly allocated to one of three complementary food introduction methods: PLW (parent-led weaning), Baby-led Introduction to SolidS (BLISS) and a mixed approach. The symptoms of constipation were assessed at 12 months with an online questionnaire based on the Rome IV diagnostic criteria and adapted to our sample. The data were summarised as absolute frequencies and percentages and compared by means of the χ2 test. The project was approved by the ethics committee of the Hospital de Clínicas de Porto Alegre under number 2019-0230. RESULTS We analysed data corresponding to 135 infants, 45 allocated to PLW, 48 to BLISS and 42 to the mixed approach. The prevalence of constipation symptoms was 49.6% in the overall sample (n = 67), 60% (n = 27) in the PLW group, 47.9% (n = 23) in the BLISS group and 40.5% (n = 17) in the mixed approach group. We found no association between functional constipation symptoms and the method used to introduce complementary foods (P = .183). CONCLUSIONS The prevalence of functional constipation symptoms was high in the study population. The presence of constipation symptoms was not associated with the complementary feeding approach.
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Affiliation(s)
- Renata Oliveira Neves
- Programa de Postgrado en Salud Infantil y Adolescente, Facultad de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Río Grande del Sur, Brazil
| | - Leandro Meirelles Nunes
- Departamento de Pediatría, Programa de Postgrado en Salud Infantil y Adolescente, Facultad de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Río Grande del Sur, Brazil
| | | | - Marcela Reckziegel Lima
- Facultad de Nutrición, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Río Grande del Sur, Brazil
| | - Paula Ruffoni Moreira
- Programa de Postgrado en Alimentación, Nutrición y Salud, Facultad de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Río Grande del Sur, Brazil
| | - Juliana Rombaldi Bernardi
- Programa de Postgrado en Salud Infantil y Adolescente, Programa de Postgrado en Alimentación, Nutrición y Salud, Departamento de Nutrición, Facultad de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Río Grande del Sur, Brazil
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Síntomas de estreñimiento funcional y métodos de alimentación complementaria: ensayo clínico aleatorizado. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Yuan M, Lu M, Guo Y, Lam KBH, Lu J, He J, Shen S, Wei D, Thomas GN, Cheng KK, Qiu X. Timing of infant formula introduction in relation to BMI and overweight at ages 1 and 3 years: the Born in Guangzhou Cohort Study (BIGCS). Br J Nutr 2023; 129:166-174. [PMID: 35264258 DOI: 10.1017/s000711452200071x] [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: 11/07/2022]
Abstract
Mounting evidence suggests that the first few months of life are critical for the development of obesity. The relationships between the timing of solid food introduction and the risk of childhood obesity have been examined previously; however, evidence for the association of timing of infant formula introduction remains scarce. This study aimed to examine whether the timing of infant formula introduction is associated with growth z-scores and overweight at ages 1 and 3 years. This study included 5733 full-term (≥ 37 gestational weeks) and normal birth weight (≥ 2500 and < 4000 g) children in the Born in Guangzhou Cohort Study, a prospective cohort study with data collected at 6 weeks, 6, 12 and 36 months. Compared with infant formula introduction at 0-3 months, introduction at 4-6 months was associated with the lower BMI, weight-for-age and weight-for-length z-scores at 1 and 3 years old. Also, introduction at 4-6 months was associated with the lower odds of at-risk of overweight at age 1 (adjusted OR 0·72, 95 % CI 0·55, 0·94) and 3 years (adjusted OR 0·50, 95 % CI 0·30, 0·85). Introduction at 4-6 months also decreased the odds of overweight at age 1 year (adjusted OR 0·42, 95 % CI 0·21, 0·84) but not at age 3 years. Based on our findings, compared with introduction within the first 3 months, introduction at 4-6 months has a reduction on later high BMI risk and at-risk of overweight. However, these results need to be replicated in other well-designed studies before more firm recommendations can be made.
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Affiliation(s)
- Mingyang Yuan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Minshan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Yixin Guo
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | | | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Jianrong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - Dongmei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
- Provincial Clinical Research Center for Child Health, Guangzhou, China
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Moreira PR, Nunes LM, Neves RO, Belin CHS, Fuhr J, Gomes E, Mariath A, Bernardi JR. Adherence to different methods for introducing complementary food to 7-month-old babies: a randomized clinical trial. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021235. [PMID: 36102400 PMCID: PMC9462408 DOI: 10.1590/1984-0462/2023/41/2021235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/03/2021] [Indexed: 11/21/2022]
Abstract
Objective: To assess the adherence to three methods of food introduction for 7-month-old babies. Methods: This is a randomized clinical trial conducted with mother-infant pairs, submitted to the intervention with five and a half months of age and three different methods for food introduction according to randomization: Parent-Led Weaning (PLW), Baby-Led Introduction to SolidS (BLISS), or mixed (specially developed for this study). Adherence to the method was assessed at the seventh month of age, via telephone call to the caregiver by a researcher blinded to the method. The analyses were performed using the Chi-Square test and data are presented in absolute numbers and percentages. Results: A total of 139 mother-infant pairs were evaluated; 46 of them were allocated to the PLW method; 47, to the BLISS; and 46, to the mixed. At seven months of age, 60 (43.2%) mothers reported that the infants were following the proposed feeding method. When analyzing each approach, the mixed method showed a higher likelihood of adherence (71.7%, n=33), followed by the PLW method (39.1%, n=18) and by the BLISS (19.2%, n=9) (p<0.001). Among the sample that did not follow the proposed method, those that had been randomized to the PLW and BLISS methods mostly migrated to the mixed method (92.9%; n=26 and 92.1%; n=35, respectively) (p<0.001). Conclusions: Complementary feeding in a mixed approach obtained greater adherence in 7-month-old babies.
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Affiliation(s)
| | | | | | | | - Jordana Fuhr
- Universidade Federal do Rio Grande do Sul, Brazil
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Pearce J, Rundle R. Baby-led weaning: A thematic analysis of comments made by parents using online parenting forums. J Hum Nutr Diet 2022; 36:772-786. [PMID: 35996924 DOI: 10.1111/jhn.13078] [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: 01/05/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Baby-led weaning (BLW) centres on making the baby an active partner, rather than a passive recipient of complementary feeding. Key features of BLW include self-feeding foods in their natural form, eating with the rest of the family and consuming family foods. This differs from traditional weaning (TW) where parents initially spoon feed purees, alongside finger foods, before graduating to more textured food. Previous research, however, has suggested parents may not fully adhere to one weaning style. This study aimed to explore how the meaning and interpretation of BLW may contribute to the weaning style used. METHODS Messages and responses posted on three UK parenting forums, and relating to complementary feeding, were analysed using an interpretive thematic approach. RESULTS The characterisation of BLW by parents was varied but they described BLW having an ethos which included trusting the baby, role modelling, developing confidence with food and sharing the social aspects of mealtimes. BLW also offered an alternative to those actively seeking something different or a default for those whose baby refused purees or spoon feeding. BLW felt like a natural progression, with low parental effort for some, and a source of anxiety, stress, choking risk and mess for others. Many parents struggled to find a process (what to eat and when) within BLW, that they could follow. Finger foods were used synonymously with BLW but many mixed/blurred aspects of both TW and BLW. CONCLUSIONS The interpretation of BLW varies considerably between parents and a broader definition of BLW may be required, along with guidance on the process and purpose of BLW. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jo Pearce
- Food & Nutrition Subject Group, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB
| | - Rachel Rundle
- Food & Nutrition Subject Group, Sheffield Hallam University, Howard Street, Sheffield, S1 1WB
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Białek-Dratwa A, Szczepańska E, Trzop P, Grot M, Grajek M, Kowalski O. Practical Implementation of the BLW Method During the Expansion of the Infant Diet—A Study Among Polish Children. Front Nutr 2022; 9:890843. [PMID: 35685886 PMCID: PMC9171390 DOI: 10.3389/fnut.2022.890843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/02/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to verify the knowledge of mothers of children under 3 years of age about the Baby Led Weaning (BLW) feeding model and their practical implementation of this method. The study involved 761 mothers and their children. After analysis of the inclusion and exclusion criterion, the information provided by women 699 aged 21–48 years was included in the final data analysis. In the study group, most children were breastfed for 6 months to 1 year (n = 256, 36.7%), 1 year to 2 years (n = 179, 25.6%) and over 2 years (n = 71, 10.2%). Starting dietary expansion before 17 weeks of age was implemented in 47 (6.7%) children, between and 17–26 weeks of age in 328 (46.9%) children, and after 26 weeks of age in 324 (46.3%) children. Feeding food and dishes from the family table was practiced by 518 (74.1%) mothers. Spoon-feeding was practiced by 529 (75.6%) children, 157 (22.4%) children were fed this way sometimes. Taking into account the above data, feeding with the BLW method was used in 170 children (24.2%). In the examined group of mothers the use of the BLW method in feeding their children, especially during diet expansion, was declared by 408 women (74.8%). The child's independent decision concerning what the child will eat and what is according to the BLW method is accepted by 434 (62.1%) mothers. Among the positive aspects of using the BLW method, the women surveyed indicated the child's independence, while among the disadvantages, the omnipresent mess and chaos when eating meals.
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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, Bytom, Poland
- Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
- *Correspondence: Agnieszka Białek-Dratwa
| | - Elżbieta Szczepańska
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
- Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Paulina Trzop
- Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Martina Grot
- Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
- Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Oskar Kowalski
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
- Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
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Martinón-Torres N, Carreira N, Picáns-Leis R, Pérez-Ferreirós A, Kalén A, Leis R. Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years? A Systematic Review. Nutrients 2021; 13:nu13031009. [PMID: 33800994 PMCID: PMC8003981 DOI: 10.3390/nu13031009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/13/2021] [Accepted: 03/17/2021] [Indexed: 12/12/2022] Open
Abstract
Childhood is a window of opportunity for the prevention of the obesity pandemic. Since “the first 1000 days of life” is a period in which healthy eating habits must be acquired, it should be the target for preventive strategies. Baby-led weaning (BLW) is an emergent way of weaning that could influence children’s health. The nutrition committees of the main pediatric societies affirm there is not enough evidence to support which is the best method of weaning. The aim was to determinate the influence of BLW on the infant’s weight gain compared to the traditional spoon-feeding, and to assess if it could decrease the risk of obesity in children. A systematic review was conducted, following the PRISMA method. Pubmed, Web of Science, Embase, and Cochrane Library were searched. Out of 747 articles, eight studies (2875 total infants) were included (two randomized control trials, 6 observational studies). Results were indecisive, while some studies seem to demonstrate lower weight gain in infants that apply BLW, others show inconclusive results. The risk of bias in all included studies was moderate or high. In conclusion, more clinical trials and prospective studies should be done prior to providing a general recommendation about the best method of weaning to reduce the risk of obesity.
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Affiliation(s)
- Nazareth Martinón-Torres
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, University Clinical Hospital of Santiago (CHUS), 15706 Santiago de Compostela, Spain; (N.M.-T.); (N.C.)
- Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS), CHUS-USC, 15706 Santiago de Compostela, Spain
| | - Nathalie Carreira
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, University Clinical Hospital of Santiago (CHUS), 15706 Santiago de Compostela, Spain; (N.M.-T.); (N.C.)
- Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS), CHUS-USC, 15706 Santiago de Compostela, Spain
| | - Rosaura Picáns-Leis
- Department of Pediatrics, University Clinical Hospital of Santiago (CHUS), 15706 Santiago de Compostela, Spain;
| | - Alexandra Pérez-Ferreirós
- Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), 15701 Santiago de Compostela, Spain; (A.P.-F.); (A.K.)
| | - Anton Kalén
- Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), 15701 Santiago de Compostela, Spain; (A.P.-F.); (A.K.)
| | - Rosaura Leis
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, University Clinical Hospital of Santiago (CHUS), 15706 Santiago de Compostela, Spain; (N.M.-T.); (N.C.)
- Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS), CHUS-USC, 15706 Santiago de Compostela, Spain
- Department of Pediatrics, University Clinical Hospital of Santiago (CHUS), 15706 Santiago de Compostela, Spain;
- Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), 15701 Santiago de Compostela, Spain; (A.P.-F.); (A.K.)
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-981-951-116
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Jones SW, Lee M, Brown A. Spoonfeeding is associated with increased infant weight but only amongst formula-fed infants. MATERNAL AND CHILD NUTRITION 2020; 16:e12941. [PMID: 31943799 PMCID: PMC7296821 DOI: 10.1111/mcn.12941] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/13/2019] [Accepted: 12/15/2019] [Indexed: 11/30/2022]
Abstract
Infant feeding experiences are important for the development of healthy weight gain trajectories. Evidence surrounding milk feeding and timing of introduction to solids is extensive; however, the impact of the method of introducing solids on infant growth has been relatively underexplored. Baby‐led weaning (where infants self‐feed family foods) is proposed to improve appetite regulation, leading to healthier weight gain and a reduced risk of obesity. However, the evidence is mixed and has methodological inconsistencies. Furthermore, despite milk being a large part of the infant diet during the period infants are introduced to solid foods, its influence and interaction with introductory style have not been considered. The aim of this study was to explore growth among infants aged 3–12 months according to both style of introduction to solid foods and milk feeding; 269 infants were weighed and measured, and body mass index (BMI) computed. The results showed that overall, infants who were spoon‐fed (compared with self‐fed) at introduction to complementary feeding (CF) had greater length (but not weight or BMI). However, when milk feeding was accounted for, we found that infants who were both spoon‐fed and fully formula fed had greater weight compared with spoon‐fed, breastfed infants. There was no significant difference in weight among self‐fed infants who were breastfed or formula fed. The results highlight the importance of considering infant feeding as a multicomponent experience in relation to growth, combining both milk feeding and method of CF. This relationship may be explained by differences in maternal feeding style or diet consumed.
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Affiliation(s)
- Sara Wyn Jones
- Department of Public Health, Policy and Social Sciences, Swansea University, Swansea, UK.,Centre for Lactation, Infant Feeding and Translation (LIFT), Swansea University, Swansea, UK
| | - Michelle Lee
- Department of Psychology, Swansea University, Swansea, UK.,Centre for Lactation, Infant Feeding and Translation (LIFT), Swansea University, Swansea, UK
| | - Amy Brown
- Department of Public Health, Policy and Social Sciences, Swansea University, Swansea, UK.,Centre for Lactation, Infant Feeding and Translation (LIFT), Swansea University, Swansea, UK
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