1
|
Frizzo J, Rodrigues VCC, Speridião PGL, Morais MB. Evaluation of the complementary feeding practices, dietary intake, and nutritional status of infants on a cow's milk protein elimination diet. J Pediatr (Rio J) 2022; 98:256-263. [PMID: 34303657 PMCID: PMC9432029 DOI: 10.1016/j.jped.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To evaluate the complementary feeding practices, food intake, and nutritional status of infants on a cow's milk protein elimination diet. METHODS A cross-sectional and observational study was conducted to compare infants aged 4-18 months who were on a cow's milk protein elimination diet with a control group of healthy infants without any dietary restrictions. General information on the child's health, demographic data, and food consumption were collected. RESULTS The study included 96 infants in the elimination diet group and 99 in the control group. In the elimination diet group, the median age (in months) of introduction of solid foods (5.0 × 4.0; p < 0.001) and water (5.5 × 4.0; p < 0.05) was later, consumption of soft drinks and industrialized cookies was less frequent (p < 0.05), and a lower index of complementary feeding inadequacies (2.75 × 3.50; p < 0.001) was observed. The elimination diet group presented lower individual values of Z scores for weight/age, weight/height, and body mass index/age, although they were fed with higher amounts of energy (117.4 × 81.3 kcal/kg of weight; p < 0.001) and macro-and micronutrients, except for vitamin A. In the elimination diet group, breast milk and its substitutes contributed to more than 67% of energy intake. Although calcium consumption was a deficit in 31.5% of the infants, none received supplementation. CONCLUSION Infants on an elimination diet presented more adequate complementary feeding practices and higher nutritional intake, despite lower body weight values.
Collapse
Affiliation(s)
- Juliana Frizzo
- Universidade Federal de São Paulo, Departamento de Pediatra, Divisão de Gastroenterologia Pediátrica, Programa de Pós-Graduação em Nutrição, São Paulo, SP, Brazil
| | - Vanessa C C Rodrigues
- Universidade Federal de São Paulo, Departamento de Pediatra, Divisão de Gastroenterologia Pediátrica, Programa de Pós-Graduação em Nutrição, São Paulo, SP, Brazil
| | - Patrícia G L Speridião
- Universidade Federal de São Paulo, Departamento de Pediatra, Divisão de Gastroenterologia Pediátrica, São Paulo, SP, Brazil; Universidade Federal de São Paulo, Curso de Nutrição, Departamento de Saúde, Educação e Sociedade, Santos, SP, Brazil
| | - Mauro B Morais
- Universidade Federal de São Paulo, Departamento de Pediatra, Divisão de Gastroenterologia Pediátrica, São Paulo, SP, Brazil; Escola Paulista de Medicina, Gastroenterologia Pediátrica, São Paulo, SP, Brazil.
| |
Collapse
|
2
|
Maternal awareness to the timing of allergenic food introduction in Saudi infants: A cross-sectional study. Int J Pediatr Adolesc Med 2021; 8:239-245. [PMID: 34401449 PMCID: PMC8356115 DOI: 10.1016/j.ijpam.2021.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/15/2020] [Accepted: 01/31/2021] [Indexed: 11/28/2022]
Abstract
Background Current guidelines recommend the introduction of allergenic foods as early as 4–6 months of age to decrease the risk of food allergy. However, caregivers’ knowledge about such practices and adherence to them is ambiguous. Objectives The purpose of this study was to evaluate the timing of introduction of potentially allergenic foods into children’s diet and the level of maternal awareness about and degree of compliance with current recommendations. Materials and methods We conducted a cross-sectional study from May 2019 to January 2020 at Imam Mohammad Ibn Saud Islamic University Medical Center, Riyadh, Saudi Arabia. Data were collected through questionnaire-based surveys, and a total of 405 mothers were enrolled in the study. The eligibility criteria included mothers of children between the ages of 12 and 36 months. Results Most mothers in this study had initiated allergenic foods, and the average time of introduction was 9.84 ± 3.16 months for eggs, 14.6 ± 5.78 months for peanuts, and 13.6 ± 5.37 months for fish. Around one-quarter (n = 102, 25.2%) of the children were identified as being in the high-risk group. Most mothers did not know or disagreed that the timing of introducing allergenic foods might help in preventing food allergy, but there was no difference between the risk groups (33.8% and 26.2%, respectively). Moreover, only 18.6% and 13.2% of the high- and low-risk groups, respectively, received correct information from their health care providers (P = .004). Mothers with only one child were less likely to start eggs at an early age (odds ratio [OR] = 0.5 and P = .005). Furthermore, children at a high risk of food allergy were two times more likely to start eggs at an earlier age (OR = 2.12 and P = .003). Conclusion In this study, the allergenic food feeding practices being followed for infants and young children were found to be suboptimal. Parental education level and the number of siblings were identified as potential barriers to the implementation of and adherence to recent guidelines. There is a need for corrective measures to ensure safe and appropriate feeding practices in the Saudi community.
Collapse
|
3
|
Vieira SCF, Santos VS, Franco JM, Nascimento-Filho HM, Barbosa KDOESS, Lyra-Junior DPD, Bastos KDA, Cipolotti R, Wayhs MLC, Vieira MC, Solé D, de Morais MB, Gurgel RQ. Brazilian pediatricians' adherence to food allergy guidelines-A cross-sectional study. PLoS One 2020; 15:e0229356. [PMID: 32092100 PMCID: PMC7039437 DOI: 10.1371/journal.pone.0229356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/04/2020] [Indexed: 12/20/2022] Open
Abstract
Food allergy is an emerging clinical condition in pediatrics, so recommendations on its management have been widely published. Studying pediatricians' adherence to these clinical practice guidelines (CPG) and understanding the reasons for their non-compliance can help to promote better management of this condition. A cross-sectional study was conducted by a survey among Brazilian pediatricians, randomly selected during the 38th Brazilian Congress of Pediatrics, which took place in October, 2017. A validated questionnaire with 16 questions addressing knowledge and practice on food allergy, as well as self-reported adherence to international guidelines was applied. Of the total of 415 pediatricians from all regions of the country who were surveyed, only 69 (16.7%) had a satisfactory adherence rate (≥80%). Adequate adherence to the guidelines was associated with the variables: 'evaluating more than 10 children with suspected cow's milk allergy (CMA) per month'; 'having read the Brazilian consensus'; or 'being aware of any international food allergy guideline'. In 8 of the 10 questions that assessed conscious adherence, a minority of those surveyed (20.3-42.3% variation) stated that they knew that their response was in line with the guidelines. This finding was statistically significant (p<0.05) in 7 of these 8 questions. The self-reported adherence of Brazilian pediatricians to international food allergy guidelines was low. Pediatricians who evaluated a higher number of children with suspected CMA or who were aware of the recommendations, had a higher rate of adherence. The results of the survey found that lack of resource was the major reported barrier to guideline adherence but lack of awareness must be a relevant non perceived barrier. This study shows the pediatricians´ self-reported adherence to food allergy guidelines in a widely overview for the first time in Brazil. More studies are necessary to investigate adherence to guidelines by pediatricians in other countries and to develop strategies to improve adherence.
Collapse
Affiliation(s)
- Sarah Cristina Fontes Vieira
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Reference Center for Food Allergy of Sergipe, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Jackeline Motta Franco
- Reference Center for Food Allergy of Sergipe, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | | | | | - Kleyton de Andrade Bastos
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Rosana Cipolotti
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Mônica Lisboa Chang Wayhs
- Department of Pediatrics, Federal University of Santa Catarina, Florianópolis-Santa Catarina, Brazil
| | - Mário César Vieira
- Center for Pediatric Gastroenterology, Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil.,Department of Pediatrics, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Dirceu Solé
- Department of Pediatrics, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Ricardo Queiroz Gurgel
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| |
Collapse
|