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Martín-Adrados A, Fernández-Leal A, Martínez-Pérez J, Delgado-Ojeda J, Santamaría-Orleans A. Clinically Relevant Topics and New Tendencies in Childhood Nutrition during the First 2 Years of Life: A Survey among Primary Care Spanish Paediatricians. Nutrients 2024; 16:2146. [PMID: 38999893 PMCID: PMC11243411 DOI: 10.3390/nu16132146] [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: 05/29/2024] [Revised: 06/25/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
A multicenter cross-sectional study was conducted among 245 experienced Spanish paediatricians, who completed an online survey based on clinically relevant topics in nutrition during the first two years of life and their recommendations to parents in daily clinical practice. Most participants advise about the choking risk associated with baby-led weaning (BLW) and more than 60% consider that infants can receive an insufficient variety and quantity of nutrients with this practice. The general opinion is that there is a lack of evidence for delaying the introduction of gluten and other allergenic foods in the complementary feeding of healthy infants. Most participants agree/strongly agree that two servings of dairy products are the adequate daily amount in a diversified diet and 93.4% disagree/strongly disagree with the use of vegetal beverages under 1 year of life. There is a general agreement to avoid added salt and sugar before 12 months of life, the consideration that organic foods do not have a better nutritional profile than non-organic ones, and the limitations of vegetarian diets especially for adequate provision of micronutrients. Overall, there is an adequate knowledge of the new trends by paediatricians and younger ones seemed more in favor of them and interested in receiving more information on most topics.
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Affiliation(s)
- Ana Martín-Adrados
- Gastroenterology and Nutrition Service, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain (A.F.-L.); (J.M.-P.)
| | - Amalio Fernández-Leal
- Gastroenterology and Nutrition Service, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain (A.F.-L.); (J.M.-P.)
| | - Jorge Martínez-Pérez
- Gastroenterology and Nutrition Service, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain (A.F.-L.); (J.M.-P.)
| | - Jesús Delgado-Ojeda
- Medical Department, Laboratorios Ordesa S.L., 08830 Sant Boi de Llobregat, Spain
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Jha PK, Shukla S, Acharya S. Trends and practices of weaning in infants across India: A comprehensive review. J Family Med Prim Care 2024; 13:2568-2575. [PMID: 39070991 PMCID: PMC11271987 DOI: 10.4103/jfmpc.jfmpc_1744_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/14/2024] [Accepted: 02/08/2024] [Indexed: 07/30/2024] Open
Abstract
Weaning is a critical phase in an infant's life, during which there is a transition from exclusive breastfeeding or formula feeding to consuming solid foods. Weaning is a critical step in determining a child's nutritional status, growth, and general health. India is a multiethnic and culturally diverse nation and has a variety of weaning practices that are affected by local customs, religious beliefs, and socioeconomic concerns. Malnutrition brought on by inadequate weaning methods used in infancy and early childhood may have an impact on cognitive, motor and social, development and productivity of the child, more importantly manifesting in later ages. Weaning customs in India have a long history of being ingrained in both family and cultural traditions. The variety of Indian cuisine is reflected in the meals that are offered to the infant during weaning. Homemade food commonly prepared like mashed fruits and vegetables, lentil soups, and rice porridge are the most popular. However, the inclination by parents toward professionally produced infant foods and formulas has increased because of urbanization and globalization; there have been observable changes in weaning practices over the past few decades because of changing lifestyles and easier access. These foods are frequently thought of as more convenient but may not be as nutrient-dense as homemade alternatives. Not following the medically recommended mandate of an exclusive diet of mother's breast milk to the infant, many parents often begin introducing complementary foods as early as four months. Still most concerningly also the timing of weaning commencement varies significantly across areas and communities. Overall, this review offers valuable insights into the current trends and practices of weaning in infants across India, underscoring the importance of culturally sensitive and informed strategies to ensure the well-being of the nation's youngest population.
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Affiliation(s)
- Piyush K. Jha
- Department of Pathology, JNMC, DMIHER, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Samarth Shukla
- Department of Pathology, JNMC, DMIHER, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Sourya Acharya
- Department of Medicine, JNMC, DMIHER, Sawangi (Meghe), Wardha, Maharashtra, India
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Guevara D, Marcos A, Ruiz FI, Gómez-Martínez S, Del Pozo S. A Descriptive Study of Spanish and Ecuadorian Commercial Infant Cereals: Are They in Line with Current Recommendations? Nutrients 2024; 16:1992. [PMID: 38999740 PMCID: PMC11243726 DOI: 10.3390/nu16131992] [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: 05/28/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
Cereals are an important source of nutrients, especially used in complementary feeding. The objective of this study is to review the nutritional composition of cereal-based foods for infants from 4 months and toddlers that are offered in Spain and Ecuador, countries selected because of the opportunity to work in them, and due to their socio-economic differences (industrialized and developing countries, respectively). The number of these products was 105 cereals in Spain and 22 in Ecuador. The products were classified as gluten-free cereals, five cereals, eight cereals, multigrain cereals, and cookies. A 25 g serving was used to determine the percentage in which the samples analyzed can cover the Reference Nutrient Intake (RNI) for micronutrients in infants from 7 months and toddlers according to the European Food Safety Authority (EFSA). Nutritional information per 100 g of dry product was collected according to medium, minimum, and maximum units, and nutrient density was calculated. The age range in which these products are recommended is different in both countries. The nutritional composition presents some differences; Spanish cereals show a lower content of sodium, added sugars, hydrolyzed cereals, and maltodextrin than Ecuadorian cereals. Commercialized cereals could contribute to satisfying the nutritional needs of infants and toddlers; however, they can also be a source of non-recommended components.
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Affiliation(s)
- Debby Guevara
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Ascensión Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN)-CSIC, 28040 Madrid, Spain
| | | | - Sonia Gómez-Martínez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN)-CSIC, 28040 Madrid, Spain
| | - Susana Del Pozo
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
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Ortega-Ramírez AD, Maneschy IR, Miguel-Berges ML, Pastor-Villaescusa B, Leis R, Babio N, Navas-Carretero S, Portoles O, Moreira A, Jurado-Castro JM, Flores-Rojas K, Vázquez-Cobela R, Mimbreros G, Flores-Barrantes P, Martínez JA, Castro-Collado C, Ferré-Pallás N, Gimenez-Legarre N, Gil-Campos M, Salas-Salvadó J, de Miguel-Etayo P, Moreno Aznar LA. Early feeding practices and eating behaviour in preschool children: The CORALS cohort. MATERNAL & CHILD NUTRITION 2024:e13672. [PMID: 38853145 DOI: 10.1111/mcn.13672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024]
Abstract
This study aimed to investigate if the duration of breastfeeding and the method at initiation of complementary feeding affect eating behaviour in children aged 3-6 years. This is a cross-sectional analysis from the Childhood Obesity Risk Assessment Longitudinal Study project, an ongoing longitudinal cohort study that aims to identify childhood obesity risk factors in Spanish children. A total of 1215 children aged 3-6 years were included. Breastfeeding duration and the method of initiation of complementary feeding [baby-led weaning (BLW), traditional/spoon or mixed method] were evaluated. Eating behaviour at 3-6 years was assessed with the Child Eating Behaviour Questionnaire. Generalized linear models were fitted to assess the association between the aforementioned exposures and eating behaviour. Children breastfed for ≥4 months were less likely to be fussy eaters at 3-6 years compared to those breastfed for <1 month (OR: 0.86 95% CI: 0.76-0.98; p = 0.031). Compared to those children using the traditional/spoon-feeding method, those initiating complementary feeding through BLW or through a mixed approach were more likely to have higher scores on the enjoyment of food (EF) (OR, 95% CI: 1.33, 1.13-1.57; p = 0.001 and 1.17, 1.05-1.30; p = 0.002, respectively) and lower scores on food fussiness (FF) at 3-6 years (0.76, 0.62-0.91; p = 0.004 and 0.87, 0.78-0.98; p = 0.033, respectively). Breastfeeding for ≥4 months and initiation of complementary feeding with the BLW and a mixed approach were associated with greater EF and lower FF, which should endure practice.
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Affiliation(s)
- Ana Daniela Ortega-Ramírez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Faculty of Medicine, University of Colima, Colima, Mexico
| | - Ivie Reis Maneschy
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - María L Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Belen Pastor-Villaescusa
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), RD21/0012/0008, Instituto de Salud Carlos III, Madrid, Spain
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Rosaura Leis
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
- Pediatric Nutrition Research Group, Health Research Institute of Santiago de Compostela (IDIS), Unit of Investigation in Nutrition, Growth and Human Development of Galicia-USC, Santiago de Compostela, Spain
| | - Nancy Babio
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Universitat Rovira i Virgili Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Grup ANUT-DSM, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Santiago Navas-Carretero
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Center for Nutrition Research, University of Navarra, Pamplona, Spain
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy & Nutrition, University of Navarra, Pamplona, Spain
- IdisNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Olga Portoles
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
| | - Ana Moreira
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - José Manuel Jurado-Castro
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Katherine Flores-Rojas
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Rocío Vázquez-Cobela
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
- Pediatric Nutrition Research Group, Health Research Institute of Santiago de Compostela (IDIS), Unit of Investigation in Nutrition, Growth and Human Development of Galicia-USC, Santiago de Compostela, Spain
| | - Gisela Mimbreros
- Universitat Rovira i Virgili Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Grup ANUT-DSM, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - José Alfredo Martínez
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Center for Nutrition Research, University of Navarra, Pamplona, Spain
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy & Nutrition, University of Navarra, Pamplona, Spain
| | - Cristina Castro-Collado
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Natalia Ferré-Pallás
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Universitat Rovira i Virgili Departament de Medicina i Cirurgia, Unitat de Recerca en Pediatria, Nutrició i Desenvolupament Humà, Tarragona, Spain
| | - Natalia Gimenez-Legarre
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Mercedes Gil-Campos
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Metabolism and Investigation Unit, Reina Sofia University Hospital, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, Córdoba, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Universitat Rovira i Virgili Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Grup ANUT-DSM, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Pilar de Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Luis A Moreno Aznar
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Consorcio CIBER, M. P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department Physiatry and Nursing, Universidad de Zaragoza, Zaragoza, Spain
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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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Wilschanski M, Munck A, Carrion E, Cipolli M, Collins S, Colombo C, Declercq D, Hatziagorou E, Hulst J, Kalnins D, Katsagoni CN, Mainz JG, Ribes-Koninckx C, Smith C, Smith T, Van Biervliet S, Chourdakis M. ESPEN-ESPGHAN-ECFS guideline on nutrition care for cystic fibrosis. Clin Nutr 2024; 43:413-445. [PMID: 38169175 DOI: 10.1016/j.clnu.2023.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Nutritional status is paramount in Cystic Fibrosis (CF) and is directly correlated with morbidity and mortality. The first ESPEN-ESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with CF were published in 2016. An update to these guidelines is presented. METHODS The study was developed by an international multidisciplinary working group in accordance with officially accepted standards. Literature since 2016 was reviewed, PICO questions were discussed and the GRADE system was utilized. Statements were discussed and submitted for on-line voting by the Working Group and by all ESPEN members. RESULTS The Working Group updated the nutritional guidelines including assessment and management at all ages. Supplementation of vitamins and pancreatic enzymes remains largely the same. There are expanded chapters on pregnancy, CF-related liver disease, and CF-related diabetes, bone disease, nutritional and mineral supplements, and probiotics. There are new chapters on nutrition with highly effective modulator therapies and nutrition after organ transplantation.
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Affiliation(s)
- Michael Wilschanski
- Pediatric Gastroenterology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Anne Munck
- Cystic Fibrosis Centre, Hopital Necker-Enfants Malades, AP-HP, Paris, France
| | - Estefania Carrion
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Canada
| | - Marco Cipolli
- Cystic Fibrosis Center, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Sarah Collins
- CF Therapies Team, Royal Brompton & Harefield Hospital, London, UK
| | - Carla Colombo
- University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Dimitri Declercq
- Cystic Fibrosis Reference Centre, Ghent University Hospital and Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Elpis Hatziagorou
- Cystic Fibrosis Unit, 3rd Pediatric Dept, Hippokration Hospital, Aristotle University of Thessaloniki, Greece
| | - Jessie Hulst
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Canada; Department of Pediatrics and Department of Nutritional Sciences, The University of Toronto, Toronto, Canada
| | - Daina Kalnins
- Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Canada
| | - Christina N Katsagoni
- Department of Clinical Nutrition, Agia Sofia Children's Hospital, Athens, Greece; EFAD, European Specialist Dietetic Networks (ESDN) for Gastroenterology, Denmark
| | - Jochen G Mainz
- Brandenburg Medical School, University Hospital. Klinikum Westbrandenburg, Brandenburg an der Havel, Germany
| | - Carmen Ribes-Koninckx
- Pediatric Gastroenterology and Paediatric Cystic Fibrosis Unit. La Fe Hospital & La Fe Research Institute, Valencia, Spain
| | - Chris Smith
- Department of Dietetics, Royal Alexandra Children's Hospital, Brighton, UK
| | - Thomas Smith
- Independent Patient Consultant Working at Above-disease Level, UK
| | | | - Michael Chourdakis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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Vassilopoulou E, Feketea G, Pagkalos I, Rallis D, Milani GP, Agostoni C, Douladiris N, Lakoumentas J, Stefanaki E, Efthymiou Z, Tsabouri S. Complementary Feeding Practices: Recommendations of Pediatricians for Infants with and without Allergy Risk. Nutrients 2024; 16:239. [PMID: 38257132 PMCID: PMC10819658 DOI: 10.3390/nu16020239] [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: 11/30/2023] [Revised: 12/30/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
AIM To investigate the routine guidance provided by pediatricians concerning the timing of complementary feeding (CF) for both healthy infants and those at a heightened risk of allergies. METHODS A total of 233 pediatricians participated in an anonymous online survey that included questions about demographics and recommendations for CF. Specifically, they provided guidance on the types of foods, preparation methods, supplements, time intervals for introducing new foods to infants at low and high allergy risk, and delayed food introductions for high-risk cases. RESULTS The respondents advised introducing certain foods at specific ages: fruits, starchy non-gluten grains, vegetables, olive oil, and meat were appropriate at 6 months; gluten-rich grains at 7 months; yogurt, hard-boiled eggs, and legumes at 8 months; fish at 8.5 months; and nuts at 9 months. Pediatricians, especially those with less than 15 years of practice, often introduced egg, seafood, gluten-rich grains, legumes, and nuts earlier for high-risk infants. Parenthood and male gender were associated with the earlier introduction of eggs and grains. CONCLUSIONS Greek pediatricians follow a structured food introduction schedule for CF in infants. Interestingly, they tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants. Key Notes: Despite recent evidence-based indications on healthy complementary feeding strategies for infants, discrepancies persist among pediatricians regarding food choices and the order and timing of food introduction, both for healthy infants and those at risk of allergy. Guidance on complementary feeding by pediatricians is influenced by their individual characteristics. Pediatricians tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants.
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Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
| | - Gavriela Feketea
- Department of Pediatrics, “Karamandaneio” Children’s Hospital of Patra, 26331 Patras, Greece
- Department of Pharmacology, “luliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Dimitrios Rallis
- School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (D.R.); (S.T.)
| | - Gregorio Paolo Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20157 Milan, Italy
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.P.M.); (C.A.)
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20157 Milan, Italy
| | - Nikolaos Douladiris
- Allergy Unit, 2nd Pediatric Clinic, University of Athens, 11527 Athens, Greece;
| | - John Lakoumentas
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Evangelia Stefanaki
- Department of Pediatrics, General Hospital of Heraklion, Venizeleio and Pananio, 71409 Heraklion, Greece;
| | - Zenon Efthymiou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (E.V.); (I.P.); (J.L.); (Z.E.)
| | - Sophia Tsabouri
- School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (D.R.); (S.T.)
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Białek-Dratwa A, Kowalski O. Complementary Feeding Methods, Feeding Problems, Food Neophobia, and Picky Eating among Polish Children. CHILDREN (BASEL, SWITZERLAND) 2023; 11:45. [PMID: 38255359 PMCID: PMC10814245 DOI: 10.3390/children11010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
Proper nutrition during the first period of life is primarily related to meeting energy needs and providing essential nutrients that ensure the infant's normal physical and psychomotor development. Improper nutrition during this period, inadequate amounts of nutrients, inappropriate timing and manner of introduction of individual foods, can permanently alter metabolism and the course of physiological processes, increasing the risk of diseases such as obesity, allergic diseases, and cardiovascular diseases. This study aimed to verify how the method of complementary feeding influences the occurrence of food neophobia between 2 and 7 years of age, as well as to assess the different nutritional aspects resulting from the process of starting feeding other than breast milk and milk formula. In this study, 490 mothers and their children aged 2-7 years participated. The research tool was a questionnaire consisting of a child's dietary assessment and standardized questionnaires assessing food neophobia among children: Food Neophobia Scale for Children (FNSC) and the Montreal Children's Hospital-Pediatric Feeding (MCH-FS). In the study group of children, 238 (48.57%) had no Baby-Led Weaning Method (no BLW) method used during complementary feeding (CF), and 252 (51.42%) children used Baby-Led Weaning Method (BLW). According to the FNSC questionnaire, a high risk of food neophobia was found in 32.65% of the children studied and a medium risk in 39.80%. The medium risk of feeding problem occured in 11.63% of children, the high risk in 6.73% of children, and the highest risk in 6.94% (MCH-FS). No statistically significant differences were observed between the BLW and NoBLW groups. High risk of food neophobia occured in 1/3 of the children studied, but there was no relationship in the study group between the mode of CF (BLW/NoBLW) and the risk of food neophobia.
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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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9
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Sanini Belin CH, Nunes LM, Ficagna CR, Neves RO, Moreira PR, Bernardi JR. Adherence to different complementary feeding methods in the first year of life: A randomized clinical trial. PLoS One 2023; 18:e0289696. [PMID: 37917730 PMCID: PMC10621984 DOI: 10.1371/journal.pone.0289696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 07/25/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Infant-guided methods, such as Baby-Led Introduction to SolidS (BLISS), encourage children to feed themselves from the same food consumed by their family since the beginning of the introduction of complementary foods, in opposition to the Parent-Led Weaning (PLW) method, which proposes foods mashed with a fork and given by parents. Adherence to child-guided methods is low due to a lack of confidence in the children's ability to feed themselves. This study aimed to assess adherence to three methods of food introduction: PLW, BLISS, or mixed (PLW and BLISS) at seven, nine, and 12 months of age. METHODS A randomized clinical trial was conducted with mother-infant pairs undergoing intervention at 5.5 months of age. Data were presented in absolute numbers and percentages and analyzed using the Chi-Square test. RESULTS The sample was constituted of 139 mother-infant pairs: 45 (32%) used PLW, 48 (35%) used BLISS, and 46 (33%) used the mixed method. Adherence to the method at seven, nine, and 12 months of age children was 34.1% (n = 45), 28.5% (n = 37), and 34.1% (n = 46), respectively. The mixed method presented significantly higher adherence results: 69.0% (n = 29) at seven months, 55.8% (n = 24) at nine months, and 78.6% (n = 33) at 12 months (p<0.001). Among the sample that unfollowed the proposed method, those who used PLW and BLISS migrated mostly to the mixed method at 12 months, 60.0% (n = 27) and 72.9% (n = 35) of them, respectively, because of the feeding mode and 97.8% (n = 44) and 100.0% (n = 48) because of food consistency. CONCLUSION Complementary feeding in a mixed method presented higher adherence at seven, nine, and 12 months of age of children, which shows the feasibility of this approach to guide families in the introduction of complementary feeding.
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Affiliation(s)
- Christy Hannah Sanini Belin
- The Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Leandro Meirelles Nunes
- The Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Cátia Regina Ficagna
- The Graduate Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Renata Oliveira Neves
- The Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | | - Juliana Rombaldi Bernardi
- The Graduate Program in Child and Adolescent Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- The Graduate Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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10
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Fernández-Medina IM, Márquez-Díaz RR, Arcas-Rueda M, Ruíz-Fernández MD, Ortíz-Amo R, Ventura-Miranda MI. Experiences and opinions towards baby-led weaning by healthcare professionals. A qualitative study. Pediatr Res 2023; 94:1784-1788. [PMID: 37340099 DOI: 10.1038/s41390-023-02694-z] [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] [Received: 01/05/2023] [Revised: 04/20/2023] [Accepted: 05/07/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Baby-led weaning (BLW) is an alternative method to spoon-feeding to introduce solid foods. This study aimed to describe and understand the experiences and opinions of pediatricians and pediatric nurse specialists of the implementation of the BLW approach. METHODS An interpretive descriptive qualitative research was carried out. A focus group with 7 participants and 13 face-to-face interviews were conducted between February and May 2022 (17 females and 3 males). All were audio-recorded, transcribed, and analyzed with the supported by Atlas.Ti qualitative data analysis software. RESULTS From the data, two themes developed: (1) BLW as an ideal method of introducing solid food, with the subthemes: "a natural method of introducing complementary feeding" and "BLW is a safe method"; (2) Perceived barriers to the uptake of the BLW method, with the subthemes: "a lack of BLW training prevents the best practice" and "the influence of family and social context on parents." CONCLUSIONS Healthcare professionals perceive BLW to be a safe and natural weaning approach. The lack of training of healthcare professionals and the influence of family social context on parents may limit the implementation of BLW. IMPACT Baby-led weaning is perceived by healthcare professionals as a safe complementary feeding method that promotes chewing, improves growth, and the development of fine motor skills. However, lack of training of healthcare professionals and the family social context of the parents hinders the uptake of baby-led weaning. The views of the family and parents' social context about baby-led weaning may restrict their willingness to use the method. Family education delivered by healthcare professionals may avoid risks and allay parental anxieties about safety.
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Affiliation(s)
| | | | - Marina Arcas-Rueda
- Torrecárdenas Maternity and Infant Hospital, Andalusian Health Service, Almería, Spain
| | - María Dolores Ruíz-Fernández
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Chile.
| | - Rocío Ortíz-Amo
- Department of Psychology, University of Almería, Almería, Spain
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11
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Di Prete A, Del Grosso D, Focaroli V, Paoletti M, Pecora G, Hodges EA, Galloway AT, Farrow C, Chiarotti F, Caravale B, Gasparini C, Gastaldi S, Bellagamba F, Addessi E. Complementary feeding approach and maternal responsiveness in 8- and 12-month-old Italian infants: A longitudinal study. Appetite 2023; 190:107028. [PMID: 37678586 DOI: 10.1016/j.appet.2023.107028] [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: 05/16/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
In Western countries, infants are usually introduced to solids through spoon-fed puréed foods (parent-led weaning, PLW). However, an alternative approach known as "baby-led weaning" (BLW), in which infants usually participate in family meals and eat independently, is becoming increasingly popular. We investigated the relationship between the type of complementary feeding approach and maternal responsiveness to infant feeding cues in a longitudinal sample of 178 infants observed at 8 and 12 months. Mothers reported the complementary feeding method used and, from video-recorded meals, we coded the proportion of time infants self-fed and rated maternal responsiveness by means of the Responsiveness to Child Feeding Cues Scale (Hodges et al., 2013). Responsiveness to infant receptiveness and fullness cues were significantly correlated at 8 months, but not at 12 months, when unresponsiveness decreased for receptiveness but remained stable for fullness cues. Thus, as infants got older, mothers were increasingly tuned in to their receptiveness cues. However, we did not observe the same pattern for fullness cues, perhaps because mothers were concerned that their infants did not eat enough. Moreover, at both time points, mothers were more responsive to infants' receptiveness than fullness cues, possibly due to an evolutionary drive to protect infants from starvation. Finally, responsiveness to fullness, but not responsiveness to receptiveness, was positively related to the proportion of infant self-feeding, but there were no significant differences in responsiveness depending on the self-reported complementary feeding approach. Thus, a weaning style that emphasizes independent feeding, regardless of whether this is labeled as BLW, may promote more infant-centered maternal responses at the end of the meal, with potential implications for promoting infant self-regulation not only at mealtimes, but also in other domains.
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Affiliation(s)
| | | | | | | | - Giulia Pecora
- CNR, Istituto di Scienze e Tecnologie della Cognizione, Rome, Italy
| | - Eric A Hodges
- The University of North Carolina at Chapel Hill, School of Nursing, USA
| | - Amy T Galloway
- Appalachian State University, Department of Psychology, USA
| | | | | | | | | | - Serena Gastaldi
- CNR, Istituto di Scienze e Tecnologie della Cognizione, Rome, Italy
| | | | - Elsa Addessi
- CNR, Istituto di Scienze e Tecnologie della Cognizione, Rome, Italy.
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12
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Studer-Perez E, Musher-Eizenman D. Relationship of baby led weaning to other parenting and feeding constructs. J Pediatr Nurs 2023; 73:e639-e645. [PMID: 37968195 DOI: 10.1016/j.pedn.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Baby-led weaning (BLW), a popular complementary feeding style, prioritizes exploration of foods, independence of children in eating, and eating with family. Though BLW has received popular attention, empirical evidence is limited. This study measured parents' reports of BLW, parenting style, and feeding practices; analyzed BLW's relation to children's dietary intake; examined how demographic variables such as age, parent sex, education, and marital status related to the prevalence of using BLW. METHODS This cross sectional study recruited 313 parents with children ages 6-30 months via Cloud Research, an online survey platform where individuals complete surveys for compensation. Hierarchical regressions examined how feeding style, dietary intake, and parenting style related to independence, exploration, and family subscales of BLW after controlling for relevant demographics. FINDINGS The majority (69.3%) of participants identified as female, white (76.6%), middle-class (52.4%), married (69%), and a third had a bachelor's degree (37.4%). Restrictive feeding practices, Ellyn Satter's division of responsibility, and the parents' sex were significant predictors of all subscales of BLW. DISCUSSION Parents who use BLW allowed for an autonomous food experience and were less likely to restrict or control the child's eating. BLW appears to be related to, but distinct from, well-researched parent feeding practices such as restriction and division of responsibility. APPLICATION TO PRACTICE These findings might be useful in education and interventions for healthcare professionals. Future research on BLW should examine how child behavior and nutrition outcomes compare to other feeding practices.
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Affiliation(s)
- Emma Studer-Perez
- Bowling Green State University, 822 E. Merry St., Bowling Green, OH 43403, USA.
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13
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Shaw MA, Liu A. Nutritional Considerations for the First Year of Life. Pediatr Ann 2023; 52:e316-e321. [PMID: 37695279 DOI: 10.3928/19382359-20230720-08] [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: 09/12/2023]
Abstract
Feeding during the first year of life is a dynamic process with unique questions, concerns, and milestones emerging at every step. This article will review a small selection of specific questions and concerns related to feeding in the first 12 months of infancy. The aim of this article is to inform and support pediatric providers and parents during this crucial developmental period. [Pediatr Ann. 2023;52(9):e316-e321.].
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14
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Complementary Feeding Methods: Associations with Feeding and Emotional Responsiveness. CHILDREN 2023; 10:children10030464. [PMID: 36980022 PMCID: PMC10047322 DOI: 10.3390/children10030464] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023]
Abstract
Learning to eat complementary foods is a crucial milestone for infants, having implications across development. The most used method for introducing complementary foods is Traditional Spoon-Feeding (TSF). However, the alternative method Baby-Led Weaning (BLW) is increasingly becoming used as it has been associated with positive outcomes. Research analyzing associations between complementary feeding methods and responsive parenting is practically non-existent. Therefore, the objective of this study was to analyze differences in emotional and feeding responsiveness between caregivers who previously implemented traditional vs. non-traditional feeding approaches. Caregivers (mostly mothers) of 179 children between 3 and 5 years were asked about the complementary feeding method that they had followed previously (70.4% reported using the TSF, 16.8% said they used the BLW and 12.8% used both methods simultaneously). In addition, they reported on their feeding practices using the Comprehensive Feeding Practices Questionnaire and on their responses to children’s distress using the Coping with Children’s Negative Emotions Scale. The results showed that parents who reported using a non-traditional (BLW or both) complementary feeding method reported less pressure to eat and minimization of reactions to children’s negative emotions, compared to parents who used a traditional method (although these reported using more problem-focused reactions). The findings suggest that complementary feeding methods and responsive parenting may be linked, leaving the question of which one sets the stage for the other.
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15
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B M, Solanki Pujaben V, N S, KJ S. Awareness on weaning diet among mothers of under five children in North Gujarat. Bioinformation 2023; 19:32-34. [PMID: 37720277 PMCID: PMC10504508 DOI: 10.6026/97320630019032] [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: 01/01/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 09/19/2023] Open
Abstract
Malnutrition caused by ineffective weaning techniques used during infancy and early childhood might affect cognitive and social development, school performance, and productivity in later life. The aim of the study was to evaluate the efficacy of education program in enhancing the awareness of mothers of under 5 children regarding weaning diet. The data was collected from 60 mothers of under 5 year's children. The existing awareness was assessed using a self-structured questionnaire. After pre intervention test, the mothers were provided with educational pamphlets and teaching programme with the help of pictures and charts. Benefits of complementary feeding, types of diet and its importance were included in the teaching program. The effectiveness of the teaching programme was assessed seven days after the start of the education programme. The mean score on the pre-test was 6.98, and the mean score on the post-test was 15.46. The average disparity was 8.48. The pre-test knowledge score's standard deviation was 3.85 and the post-test knowledge score's standard deviation was 4.23. The DF value was 59, the p value was 1.671, and the calculated "t" value is 24.98. At the 0.05 level of significance, the estimated "t" value (24.98) was higher than the table value (1.67) indicating that the education programme was successful in improving mothers' knowledge of weaning food.
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Affiliation(s)
- Mahalakshmi B
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat -384315, India
| | | | - Sivasubramanian N
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat -384315, India
| | - Shaijo KJ
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat -384315, India
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16
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Moreira PR, Nunes LM, Giugliani ERJ, Gomes E, Führ J, Neves RO, Belin CHS, Bernardi JR. Complementary feeding methods and introduction of ultra-processed foods: A randomized clinical trial. Front Nutr 2022; 9:1043400. [PMID: 36570172 PMCID: PMC9767977 DOI: 10.3389/fnut.2022.1043400] [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: 09/13/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Complementary feeding (CF) is defined as a period when foods, other than milk, are introduced to the infant's diet. Unfortunately, frequent consumption of ultra-processed foods (UPF) has become highly prevalent early in an infant's life. The aim was to verify the association of CF methods with the introduction of UPF in early childhood. Methods This randomized clinical trial involved pairs of mother-infants, allocated in groups receiving different CF interventions: strict Parent-Led Weaning (PLW); strict Baby-Led Introduction to SolidS (BLISS), or mixed-method. The intervention consisted of a counseling session on healthy eating at the child's 5.5 months of age. A structured questionnaire was created based on the NOVA classification for the definition of UPF and applied at 9 and 12 months. The effect of the CF method intervention was measured by a survival curve for UPF offered for the first time in early childhood between groups. Cox regression was used to estimate its magnitude. The primary analysis was done in three groups (PLW, BLISS, and Mixed) and the secondary analysis was done in two groups (PLW, and BLISS + Mixed). Results A total of 139 mother-infant pairs were eligible and 129 followed the study. The prevalence of infants who were exposed to UPF in early childhood was 58.9% (n = 76), being 71.4% in the PLW group, 53.3% in the BLISS group, and 52.4% in the Mixed group, without differences between them (p = 0.133). The PLW group intervention had a greater chance of exposure to ice cream or popsicles (p = 0.032) and sweet crackers (p = 0.009), compared with the other two CF groups. The Cox regression did not find significant differences between the three groups. However, the regression with two groups estimated a 38% reduction in the offer of UPF in the BLISS + Mixed group intervention (p = 0.049). Discussion The CF intervention promoting greater infant autonomy (BLISS and Mixed) was associated with a reduction in the offer of UPF in early childhood. This knowledge may contribute to supporting strategies aimed at reducing UPF consumption by the young infant. Brazilian registry of clinical trials ReBEC [https://ensaiosclinicos.gov.br/rg/RBR-229scm], identifier [RBR-229scm U1111-1226-9516].
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Affiliation(s)
- Paula Ruffoni Moreira
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil,Graduate Program in Food, Nutrition, and Health, Department of Nutrition, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil,Graduate Program in Child and Adolescent Health, Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Leandro Meirelles Nunes
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil,Graduate Program in Child and Adolescent Health, Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Elsa Regina Justo Giugliani
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil,Graduate Program in Child and Adolescent Health, Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Erissandra Gomes
- School of Dentistry, Department of Surgery and Orthopedics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Jordana Führ
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil,Graduate Program in Child and Adolescent Health, Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Renata Oliveira Neves
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil,Graduate Program in Child and Adolescent Health, Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Christy Hannah Sanini Belin
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil,Graduate Program in Child and Adolescent Health, Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Juliana Rombaldi Bernardi
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil,Graduate Program in Food, Nutrition, and Health, Department of Nutrition, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil,Graduate Program in Child and Adolescent Health, Department of Pediatrics, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil,*Correspondence: Juliana Rombaldi Bernardi,
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17
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Gasparre N, Mefleh M, Boukid F. Nutritional Facts and Health/Nutrition Claims of Commercial Plant-Based Infant Foods: Where Do We Stand? PLANTS 2022; 11:plants11192531. [PMID: 36235397 PMCID: PMC9572996 DOI: 10.3390/plants11192531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/08/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022]
Abstract
One of the current drivers of the infant food market is the rising demand for vegan products, and thus accurate knowledge of their nutritional composition is required to guide parents and health professionals. Thus, this study aimed to assess the nutritional composition of commercial plant-based infant foods, in addition to analyzing their health/nutrition claims. A selection of infant products launched in the global market (2017–2021) were classified into eight types and each type was divided into vegan and vegetarian products. Based on the ingredients list, cereals, seeds, pseudocereals and/or pulses were the most used ingredients in the retrieved products. The nutritional composition of six out eight types varied significantly among vegan and vegetarian products. When protein, calcium and iron contents differed significantly, vegan products had the highest protein content in all categories, compared to those that were vegetarian. When significant differences were found in sugar content, vegan products have lower amounts in all categories, compared to vegetarian products. Health and nutrition claims were found mostly used in vegetarian products. Strategies to reduce added sodium and sugar, and saturated fatty acids is required to ensure a healthy diet for infants. This study also implies the importance of a complete labelling of infants’ foods, especially vegan products to help parents making a reasonable choice.
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Affiliation(s)
- Nicola Gasparre
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Marina Mefleh
- Department of Soil, Plant and Food Science (DISSPA), University of Bari Aldo Moro, I-70126 Bari, Italy
| | - Fatma Boukid
- ClonBio Group Ltd., 6 Fitzwilliam Pl, D02 XE61 Dublin, Ireland
- Correspondence:
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18
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Bocquet A, Brancato S, Turck D, Chalumeau M, Darmaun D, De Luca A, Feillet F, Frelut ML, Guimber D, Lapillonne A, Linglart A, Peretti N, Rozé JC, Simeoni U, Briend A, Dupont C, Chouraqui JP. "Baby-led weaning" - Progress in infant feeding or risky trend? Arch Pediatr 2022; 29:516-525. [PMID: 36109286 DOI: 10.1016/j.arcped.2022.08.012] [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: 01/19/2022] [Revised: 04/12/2022] [Accepted: 08/04/2022] [Indexed: 11/29/2022]
Abstract
Baby-led weaning (BLW), proposed as a new form of complementary feeding, has emerged as a real trend phenomenon in the media. Infants are seated at the family table from the age of 6 months, facing the foods they grab and bring to their mouth: they decide which foods they want to eat and what amount. The consumption of mashed foods and the use of a spoon are totally discouraged. BLW is increasingly used in nurseries and centers of young children. A bibliographic search carried out between 2000 and 2021 found 423 articles, of which 38 were selected. The clinical studies selected are 11 cross-sectional observational studies and two randomized controlled studies. BLW promotes breastfeeding, the early introduction of morsels, the respect of the child's appetite, the use of unprocessed foods, and the choice of "homemade" and friendliness. These benefits can nonetheless be reached with usual complementary feeding (SCF), according to current recommendations. Other benefits are claimed without scientific evidence such as easier achievement of dietary complementary feeding and an optimal growth with prevention of excess weight gain. BLW has some obvious downsides. The infant may not get enough energy, iron, zinc, vitamins, and other nutrients, or too much protein, saturated fat, salt, or sugar. The risk of choking, which must be distinguished from the physiological gagging reflex, has not been ruled out by scientific studies. Currently, the Nutrition Committee of the French Pediatric Society considers that the data published to date in terms of benefits and risks of BLW do not lend themselves to advice for this practice in preference over SCF carried out according to current recommendations.
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Affiliation(s)
- A Bocquet
- Université de Franche-Comté, 25000 Besançon, France; Association française de pédiatrie ambulatoire, 30, rue Émile-Zola, 45000 Orléans, France.
| | - S Brancato
- Cabinet de pédiatrie, 4, rue du puits Descarsses, 30190 Brignon, France; Association française de pédiatrie ambulatoire, 30, rue Émile-Zola, 45000 Orléans, France
| | - D Turck
- Université de Lille, INFINITE-Inserm U1286, 59000 Lille, France
| | - M Chalumeau
- Department of General Pediatrics and Pediatric Infectious Diseases, Hôpital Necker - Enfants malades, AP HP, France; Centre of Research in Epidemiology and Statistics (CRESS), Obstetrical, Perinatal and Pediatric Epidemiology Research Team, INSERM; Université de Paris, Paris, France
| | - D Darmaun
- Inra UMR1280, Université Nantes-Atlantique, 44300 Nantes, France
| | - A De Luca
- Université de Tours, 37000 Tours, France
| | - F Feillet
- Université de Lorraine, 54000 Nancy, France
| | - M-L Frelut
- Cabinet de pédiatrie, 16, rue Septfonds, 81000 Albi, France; Association française de pédiatrie ambulatoire, 30, rue Émile-Zola, 45000 Orléans, France
| | - D Guimber
- Université de Lille, 59000 Lille, France
| | - A Lapillonne
- Université de Paris,EA7328,AP-HP, hôpital Necker-Enfants-Malades, 75015 Paris, France
| | - A Linglart
- AP-HP, Université Paris Saclay, endocrinologie et diabète de l'enfant, Hôpital Bicêtre, le Kremlin Bicêtre, France
| | - N Peretti
- Université de Lyon, Hospices Civils de Lyon, CaRMEN, 69000 Lyon, France
| | - J-C Rozé
- Inra UMR1280, Université Nantes-Atlantique, 44300 Nantes, France
| | - U Simeoni
- Université of Lausanne, CHUV, 1011 Lausanne, Switzerland
| | - A Briend
- Institut de Recherche Pour le Développement, 13002 Marseille, France
| | - C Dupont
- Université de Paris 75015 Paris, France; Clinique Marcel-Sembat, 92100 Boulogne-Billancourt, France
| | - J-P Chouraqui
- Gastro-entérologie et nutrition pédiatriques DMCP, CHUV, rue du Bugnon, 46, 1011 Lausanne, Switzerland
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- Hôpital Necker - Enfants-Malades (NEM), 149, rue de Sèvres, 75015 Paris, France
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19
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Bergamini M, Simeone G, Verga MC, Doria M, Cuomo B, D’Antonio G, Dello Iacono I, Di Mauro G, Leonardi L, Miniello VL, Palma F, Scotese I, Tezza G, Caroli M, Vania A. Complementary Feeding Caregivers’ Practices and Growth, Risk of Overweight/Obesity, and Other Non-Communicable Diseases: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14132646. [PMID: 35807827 PMCID: PMC9268062 DOI: 10.3390/nu14132646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 12/07/2022] Open
Abstract
Several institutions propose responsive feeding (RF) as the caregivers’ relational standard when nurturing a child, from breast/formula feeding onwards. Previous systematic reviews (SRs) on caregivers’ feeding practices (CFPs) have included studies on populations from countries with different cultures, rates of malnutrition, and incomes, whereas this SR compares different CFPs only in healthy children (4–24 months) from industrialized countries. Clinical questions were about the influence of different CFPs on several important outcomes, namely growth, overweight/obesity, risk of choking, dental caries, type 2 diabetes (DM2), and hypertension. The literature review does not support any Baby Led Weaning’s or Baby-Led Introduction to SolidS’ (BLISS) positive influence on children’s weight–length gain, nor their preventive effect on future overweight/obesity. RF-CFPs can result in adequate weight gain and a lower incidence of overweight/obesity during the first two years of life, whereas restrictive styles and coercive styles, two kinds of non-RF in CF, can have a negative effect, favoring excess weight and lower weight, respectively. Choking risk: failure to supervise a child’s meals by an adult represents the most important risk factor; no cause–effect relation between BLW/BLISS/RF/NRCF and choking could be found. Risks of DM2, hypertension, and caries: different CFPs cannot be considered as a risky or preventive factor for developing these conditions later in life.
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Affiliation(s)
- Marcello Bergamini
- AUSL Ferrara, 44121 Ferrara, Italy
- Correspondence: ; Tel.: +39-338-929-0865
| | | | | | - Mattia Doria
- AULSS 3 Serenissima, 30015 Chioggia, Venice, Italy;
| | - Barbara Cuomo
- Department of Pediatrics, Belcolle Hospital, 01010 Viterbo, Italy;
| | | | | | | | - Lucia Leonardi
- Maternal Infantile and Urological Sciences Department, Sapienza University, 00161 Rome, Italy;
| | - Vito Leonardo Miniello
- Nutrition Unit, Department of Pediatrics, “Giovanni XXIII” Children Hospital, “Aldo Moro” University of Bari, 70126 Bari, Italy;
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20
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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: 8] [Impact Index Per Article: 4.0] [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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21
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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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22
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Knowledge, Attitude, and Practice of Weaning among Mothers in Najran Region, Saudi Arabia, 2021. J Nutr Metab 2022; 2022:6073878. [PMID: 35284142 PMCID: PMC8906984 DOI: 10.1155/2022/6073878] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background Weaning is a complex process of a gradual introduction of complementary foods to the infant's diet. It is recommended that solid food is introduced between 6 and 12 months of age. Weaning is difficult and potentially dangerous time for infants' growth and mother's education is an established determinant of its success. Little is known about weaning attitudes or practice among mothers in Najran Region of Saudi Arabia. Method The study is a cross-sectional questionnaire-based observational investigation using random sampling scheme. We utilized ordinal logistic regression modelling to evaluate the relationship between demographic variables and knowledge level among mothers. Results The total number included was n = 385 mothers who agreed to take part in the study. Good satisfactory knowledge rate was n = 135, 35.1%. Knowledge was mostly sought from other mothers (n = 102, 26.5%), followed by reliance on their own experience (n = 82, 21.3%). Seeking doctors' advice was associated with better knowledge levels. Worse adjusted knowledge scores were associated with bottle feeding (OR = 0.5383, p=0.0137), using cerelac preparations (OR = 0.0316, p=0.0092), development of weaning symptoms (OR = 0.5869, p=0.0260), seeking other mothers' advice (OR = 0.4750, p=0.0226), and feeding babies under 4 times daily (OR = 0.2742, p=0.0008). Mother education did not have significant impact on knowledge scores. Discussion. We confirmed, in this work, that knowledge levels were alarmingly unsatisfactory about weaning among our participants. Women were likely following local customs in terms of their choice of weaning methods even among the well-educated. The association between seeking doctors' advice and better knowledge should be utilized in future educational interventions. Underfeeding babies of below 4 times daily was correlated substantially with poorer knowledge score. This could be viewed as reverse causality, as clearly more knowledgeable mothers are expected to stick to optimum feeding frequency. Recommendations. Communication channels between physicians and mothers need to be opened and widened through focused educational programmes. Poor knowledge is clearly associated with infant underfeeding and difficulties in recognizing weaning symptoms. Such points need to be emphasized in design of health education packages to nursing mothers. Research on knowledge about weaning should focus on its association with traditional weaning methods and bottle feeding.
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23
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Białek-Dratwa A, Kowalski O, Szczepańska E. Traditional complementary feeding or BLW (Baby Led Weaning) method? - A cross-sectional study of Polish infants during complementary feeding. Front Pediatr 2022; 10:992244. [PMID: 36340726 PMCID: PMC9634407 DOI: 10.3389/fped.2022.992244] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Baby-led weaning (BLW) is an increasingly well-known method of complementary feeding for infants. The BLW method is based on the fact that the baby becomes physically ready to eat on its own and can henceforth effectively supplement its diet, which was previously based on breast milk or formula milk. The aim of the study was to compare complementary feeding among mothers using and not using the BLW method. The study took into account, among other things, the frequency of spoon feeding, eating from the family table, and eating meals with a pulpy consistency. The study also determined the frequency of the risk of choking/gagging, food regurgitation or the occurrence of vomiting during a meal in the study groups. Material and method: a cross-sectional survey was conducted among mothers of children from 6 months to 36 months of age residing throughout Poland. RESULTS The study group was divided into three subgroups: mothers using BLW (M-BLW), mothers not familiar with the BLW method (M-NoBLW)), mothers not using the BLW method - mothers using the spoon-feeding method) (M-TS). Among the mothers surveyed, 413 women (63.93%) used the BLW method, 222 mothers (34.36%) did not use the BLW method of which 50 (7.73%) of these were unfamiliar with the method, and 172 (26.62%) simply did not use it. Among M-TS mothers, the child was most often entirely or mostly spoon-fed by an adult (73.84%), and the same was true for the M-NoBLW group (70.0%). In the M-BLW group, 58.60% of children were half-fed by an adult with a spoon. half ate independently. CONCLUSIONS Infants fed by the BLW method were more likely to have their diets expanded after 6 months of age, they were also more likely to be given products from the family table than children fed traditionally with a spoon. Full BLW was implemented by only 29% of children in the BLW group. The vomiting reflex, spitting food out of the mouth, and gagging, were more common among children fed by the BLW method. In contrast, choking occurred comparably often in both groups - in 5.4% of spoon-fed children and 6.9% of BLW-fed children.
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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, Zabrze, Poland
| | - Oskar Kowalski
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Elżbieta Szczepańska
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Zabrze, Poland
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24
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Nuzzi G, Gerini C, Comberiati P, Peroni DG. The weaning practices: A new challenge for pediatricians? Pediatr Allergy Immunol 2022; 33 Suppl 27:44-46. [PMID: 35080314 PMCID: PMC9303897 DOI: 10.1111/pai.13627] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/27/2021] [Accepted: 08/06/2021] [Indexed: 01/04/2023]
Abstract
Introduction of complementary feeding, or weaning, is the period where infants are gradually introduced to solid foods, with a progressive reduction of breastfeeding or bottle-feeding. Weaning represents a crucial nutritional moment in the growth and development of infants, and it can also affect future health. Throughout the years, various weaning strategies have been proposed, ranging from classic to baby-led weaning. Recently, vegetarian-/vegan-based approaches are also being increasingly adopted by young parents. This rostrum aims to critically address the safety profiles of current weaning practices for infants and to highlight the important role of pediatricians in choosing the most advisable weaning approach for their patients.
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Affiliation(s)
- Giulia Nuzzi
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Carlotta Gerini
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.,Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Diego G Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
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25
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Neves FS, Romano BM, Campos AAL, Pavam CA, Oliveira RMS, Cândido APC, Pereira Netto M. Brazilian health professionals' perception about the Baby-Led Weaning (BLW) method for complementary feeding: an exploratory study. REVISTA PAULISTA DE PEDIATRIA 2021; 40:e2020321. [PMID: 34614129 PMCID: PMC8543847 DOI: 10.1590/1984-0462/2022/40/2020321] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/29/2020] [Indexed: 12/31/2022]
Abstract
Objective: To describe Brazilian health professionals’ perception about the Baby-Led Weaning (BLW) method use for complementary feeding. Methods: Cross-sectional, descriptive study including 458 health professionals graduated in Nursing, Speech Therapy, Medicine, Nutrition or Dentistry and working in Pediatrics, being directly or indirectly involved with pediatric nutrition. We used a convenience non-probability sampling. The questionnaire applied to participants addressed demographic characteristics, academic degree, workplace, knowledge about clinical practice and perceptions about the possible advantages of the BLW method. Results: Participants had a mean age of 34.5±8.5 years, 64.6% of them working in Southeast Brazil and 65.3% being nutritionists. Most participants reported being acquainted with the BLW method (82.0%). Regarding clinical practice, 38.3% mentioned having recommended the BLW some times, 37.5% often and 20.5% always. Most participants fully agreed that the BLW method could have advantages for babies, for example, having them more likely to share family meals, facilitating adaptation to food flavors and consistencies, enhancing chewing and favoring the development of motor skills. On the other hand, important disagreements were also expressed regarding the BLW convenience and the possibility to create less concerns or anxiety in parents. Conclusions: The BLW method reported as advantageous, but disagreements were also raised, probably because scientific evidences on the suject are scarse. Further investigation is needed so we can better understand the risks and benefits and health care professionals can feel effectively assisted to offer support and advice to parents and caretakers.
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26
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Pearce J, Langley-Evans SC. Comparison of food and nutrient intake in infants aged 6-12 months, following baby-led or traditional weaning: A cross-sectional study. J Hum Nutr Diet 2021; 35:310-324. [PMID: 34476858 DOI: 10.1111/jhn.12947] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/11/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND A baby-led approach to weaning (BLW) encompasses self-feeding and self-selecting graspable foods, offering an alternative to traditional weaning (TW). This cross-sectional study explored adherence to characteristics of BLW and differences in food group exposure and nutrient intake between babies following either TW or BLW. METHODS Nutritional data were collected via multiple-pass 24-h recall, following parental completion of an online survey. RESULTS Infants were grouped according to age (6-8 months; TW [n = 36] and BLW [n = 24]) and (9-12 months; TW [n = 24] and BLW [n = 12]). BLW babies were more likely to be breast fed (p = 0.002), consumed a higher percentage of foods also consumed by their mother (p = 0.008) and were fed less purees (p < 0.001) at 6-8 months. TW babies were spoon fed more (p ≤ 0.001) at all ages. Amongst babies aged 6-8 months, total intake (from complementary food plus milk) of iron (p = 0.021), zinc (p = 0.048), iodine (p = 0.031), vitamin B12 (p = 0.002) and vitamin D (p = 0.042) and both vitamin B12 (p = 0.027) and vitamin D (p = 0.035) from complementary food alone was higher in babies following TW. Compared to TW, BLW babies aged 6-8 months had a higher percentage energy intake from fat (p = 0.043) and saturated fat (p = 0.026) from their milk. No differences in nutrient intake were observed amongst infants aged 9-12 months. Few differences were observed between groups in their number of exposures to specific food groups. CONCLUSIONS TW infants had higher intakes of key micronutrients at 6-8 months, although there were few differences in nutritional intake at 9-12 months or food group exposure between babies following TW or BLW. BLW appears to be socially desirable. Guidance for parents is required, along with larger, longer-term studies, which explore the potential impact of BLW in later childhood.
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Affiliation(s)
- Jo Pearce
- Food & Nutrition Subject Group, Sheffield Hallam University, Sheffield, UK
| | - Simon C Langley-Evans
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Leicestershire, UK
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27
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Complementary Feeding Methods-A Review of the Benefits and Risks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137165. [PMID: 34281101 PMCID: PMC8297117 DOI: 10.3390/ijerph18137165] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022]
Abstract
Complementary feeding methods have the potential to not only ensure a diet of nutritional adequacy but also promote optimal food-related behaviours and skills. While the complementary feeding practice known as baby-led weaning (BLW) has gained popularity, evidence supporting the potential benefits and/or risks for infant growth, development, and health warrants consideration. A review of 29 studies was conducted with findings indicating that parents who implement BLW typically have higher levels of education, breastfeed for longer, and differ in other personality traits. Fear of choking was an important factor in parents’ decision not to implement BLW; however, this fear was not supported by the literature. Benefits of BLW included lower food fussiness, higher food enjoyment, lower food responsiveness, and higher satiety responsiveness. While this profile of eating behaviours confers a reduced obesity risk, few studies have examined the relationship between BLW and infant growth robustly. BLW does not seem to increase the risk of inadequate zinc or iron intake; however, emphasis needs to be given to ensuring adequate intake of these micronutrients among all infants. A better understanding of the impacts of BLW is needed to inform evidence-based recommendations to support and guide parents in complementary feeding methods.
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28
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Spyreli E, McKinley MC, Dean M. Comparing Maternal and Paternal Complementary Feeding Practices: Findings From an Online Survey. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:531-539. [PMID: 33468410 DOI: 10.1016/j.jneb.2020.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore differences between mothers' and fathers' complementary feeding practices. METHODS An online survey of UK parents with a healthy child in complementary feeding age. Timing of introducing solid foods and adherence to feeding guidelines were assessed. Dietary quality was measured using the Complementary Feeding Utility Index. RESULTS In a sample of 60 mothers and fathers (nondyads), there were no differences between fathers and mothers in the timing of introduction of solid foods, compliance with complementary feeding guidelines, or dietary quality. Most fathers who participated had a male child, whereas mothers had an equal number of male and female children (P < 0.001). The proportion of mothers who followed baby-led weaning was higher compared with fathers (P = 0.02). CONCLUSIONS AND IMPLICATIONS Study findings reveal no gender differences in parental complementary feeding practices apart from the use of baby-led weaning. Future studies with bigger male samples are warranted to explore the paternal role during complementary feeding.
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Affiliation(s)
- Eleni Spyreli
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, United Kingdom; Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom
| | - Michelle C McKinley
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, United Kingdom; Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, United Kingdom
| | - Moira Dean
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, United Kingdom.
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29
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Urkia-Susin I, Rada-Fernandez de Jauregui D, Orruño E, Maiz E, Martinez O. A quasi-experimental intervention protocol to characterize the factors that influence the acceptance of new foods by infants: mothers' diet and weaning method. Dastatuz project. BMC Public Health 2021; 21:918. [PMID: 33985471 PMCID: PMC8120711 DOI: 10.1186/s12889-021-10967-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Children usually refuse to eat and taste fruits and vegetables; and turning unhealthy eating habits around is an important social challenge in industrialized countries. The Dastatuz project aims to study children food neophobia and to enhance fruit and vegetable acceptance. METHODS A quasi-experimental, multicentre, controlled and prospective intervention study is proposed, in which early factors influencing new food acceptance will be studied. Mothers in the third trimester of pregnancy (n = 144) and their infants will be the study population. Experimental groups will be established based on mothers´ fruit and vegetable intake (standard or high intake) and weaning method (baby lead weaning vs spoon feeding). The project will assess the possible impact of maternal diet and complementary feeding on infants eating behaviour until 18 months of age. Outcome measures will comprise maternal diet and psychological features during pregnancy and breast-feeding (validated questionnaires). Compositional and physicochemical analysis of milk during breastfeeding will also be carried out. During weaning, until 18 months of age, children's diet will be assessed with 24 h recalls and acceptance of new fruits and vegetables will be studied using video recording. DISCUSSION If the intervention is effective, this research work would have a high potential to be transferred to future public health programs or nutrition guidelines, as a feasible solution to achieve a higher intake of fruits and vegetables among children. TRIAL REGISTRATION This study is registered at ClinicalTrials.gov. Identifier: NCT04262102 . Registration date: February 10, 2020 - Retrospectively registered.
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Affiliation(s)
- Iratxe Urkia-Susin
- Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
- Department of Clinical and Health Psychology and Research Methodology, Faculty of Psychology, University of the Basque Country EHU/UPV, Donostia-San Sebastián, Gipuzkoa, Basque Country, Spain
- Biodonostia Health Research Institute, Mental Health group, Donostia-San Sebastián, Basque Country, Spain
| | - Diego Rada-Fernandez de Jauregui
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
- Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
| | - Estibaliz Orruño
- Bioaraba Health Research Institute, Araba University Hospital, Vitoria-Gasteiz, Araba, Basque Country, Spain
| | - Edurne Maiz
- Department of Clinical and Health Psychology and Research Methodology, Faculty of Psychology, University of the Basque Country EHU/UPV, Donostia-San Sebastián, Gipuzkoa, Basque Country, Spain.
- Biodonostia Health Research Institute, Mental Health group, Donostia-San Sebastián, Basque Country, Spain.
| | - Olaia Martinez
- Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain
- Bioaraba Health Research Institute, Nutrition and Food Safety group, Vitoria-Gasteiz, Araba, Basque Country, Spain
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30
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Addessi E, Galloway AT, Wingrove T, Brochu H, Pierantozzi A, Bellagamba F, Farrow CV. Baby-led weaning in Italy and potential implications for infant development. Appetite 2021; 164:105286. [PMID: 33961935 DOI: 10.1016/j.appet.2021.105286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/17/2022]
Abstract
Baby-led weaning is an approach to complementary feeding that emphasizes an infant's ability to self-feed rather than being spoon fed, and to eat minimally-processed foods rather than puréed foods. This study aimed to investigate the variability in infant feeding practices and the possible association with developmental milestones in an Italian population. A sample of 1245 mothers of 6-12 month-old infants completed an online survey about complementary feeding and their infant's attainment of developmental milestones. Infants' eating of family food was positively related to self-feeding and to a lower consumption of puréed foods. As in previous studies in the UK and New Zealand, a baby-led weaning style was positively associated with breastfeeding, exposure to complementary foods around six months of age, earlier exposure to both finger and family foods, and higher interest in family food and shared family meals. Infants who were introduced to solid foods using a baby-led weaning approach were more likely to have met important developmental milestones; when controlling for covariates, percentage of family feeding was positively associated with sitting unsupported at an earlier age and a low spoon-feeding style was associated with crawling at an earlier age. These data suggest that baby-led weaning should be defined more comprehensively. Moreover, its potential influence on developmental domains beyond diet and eating behavior warrants future targeted exploration.
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Affiliation(s)
- Elsa Addessi
- CNR, Istituto di Scienze e Tecnologie della Cognizione, Via Ulisse Aldrovandi, 16/b, Rome, Italy.
| | - Amy T Galloway
- Department of Psychology, Appalachian State University, Boone, NC, USA.
| | - Twila Wingrove
- Department of Psychology, Appalachian State University, Boone, NC, USA.
| | - Hadley Brochu
- Department of Psychology, Appalachian State University, Boone, NC, USA.
| | - Arianna Pierantozzi
- CNR, Istituto di Scienze e Tecnologie della Cognizione, Via Ulisse Aldrovandi, 16/b, Rome, Italy.
| | - Francesca Bellagamba
- Dipartimento di Psicologia Dinamica, Clinica e Salute, Sapienza Università di Roma, Via degli Apuli 1, 00185, Rome, Italy.
| | - Claire V Farrow
- Deparment of Psychology, College of Health and Life Sciences, Aston University, Aston Triangle, B4 7ET Birmingham, UK.
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31
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Hojsak I, Chourdakis M, Gerasimidis K, Hulst J, Huysentruyt K, Moreno-Villares JM, Joosten K. What are the new guidelines and position papers in pediatric nutrition: A 2015-2020 overview. Clin Nutr ESPEN 2021; 43:49-63. [PMID: 34024560 DOI: 10.1016/j.clnesp.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/01/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Nutrition related publications in pediatric population cover wide range of topics and therefore it is usually difficult for clinicians to get an overview of recent nutrition related guidelines or recommendations. METHODS The Special Interest Group (SIG) of Pediatrics of European Society for Clinical Nutrition and Metabolism (ESPEN) performed a literature search to capture publications in the last five years aiming to provide the latest information concerning nutritional issues in children in general and in specific diseases and to discuss progression in the field of pediatric nutrition evidence-based practice. RESULTS Eight major topics were identified as the most frequently reported including allergy, critical illness, neonatal nutrition, parenteral and enteral nutrition, micronutrients, probiotics and malnutrition. Furthermore, it was noted that many reports were disease focused or included micronutrients and were, therefore, represented as tables. CONCLUSION Overall, it has been shown that most reports on nutrition topics in pediatrics were systematic reviews or guidelines/position papers of relevant societies, but many of them basing the conclusion on a limited number of high-quality randomized controlled trials or large observational cohort studies.
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Affiliation(s)
- Iva Hojsak
- Children's Hospital Zagreb, University of Zagreb Medical School, Zagreb, Croatia; University J.J. Strossmayer Medical School, Osijek, Croatia.
| | - Michael Chourdakis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
| | - Konstantinos Gerasimidis
- Human Nutrition, School of Medicine, College of Medicine, Veterinary and Life Sciences, Royal Hospital for Sick Children, University of Glasgow, Glasgow, United Kingdom.
| | - Jessie Hulst
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Koen Huysentruyt
- Department of Pediatric Gastroenterology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | | | - Koen Joosten
- Department of Pediatric Intensive Care, Sophia Children's Hospital - Erasmus Medical Center, Rotterdam, the Netherlands.
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Lutter CK, Grummer-Strawn L, Rogers L. Complementary feeding of infants and young children 6 to 23 months of age. Nutr Rev 2021; 79:825-846. [PMID: 33684940 DOI: 10.1093/nutrit/nuaa143] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Complementary feeding, when foods are introduced to complement a milk-based diet, generally occurs between 6 and 23 months of age. It is a critical period for both physical and cognitive development. During this period, the growth rate of the brain is one of the fastest during the life span and, consequently, the timing, dose, and duration of exposure to specific nutrients can result in both positive and negative effects. Complementary feeding is more than ensuring an adequate intake of nutrients; it also is about avoiding excess intakes of calories, salt, sugars, and unhealthy fats. Meals are cultural and social events where young children observe, imitate, learn about foods to like or dislike, and form lifelong eating habits and practices. Meals are also when a child learns to touch foods and connect food tastes to how foods look and feel. Ideally, complementary feeding is responsive and promotes child autonomy, but it can also be used to manage behavior problems or overly indulge a child, resulting in long-term consequences for nutrition and health. Therefore, in addition to what a child is fed, attention to how a child is fed is also important. In this review, 12 topics relevant for updating global guidance on complementary feeding were identified: age of introduction of complementary foods; continued breastfeeding; responsive feeding; safe preparation and storage of complementary foods; food textures, flavors, and acceptance; energy and meal and snack frequency; fats, protein, and carbohydrates; dietary diversity; milks other than breast milk; fluid needs; unhealthy foods and beverages; and use of vitamin and mineral supplements or supplementary foods.
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Affiliation(s)
- Chessa K Lutter
- Division of Food Security and Agriculture, RTI International, Washington, DC, USA
| | | | - Lisa Rogers
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
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Bąbik K, Patro-Gołąb B, Zalewski BM, Wojtyniak K, Ostaszewski P, Horvath A. Infant feeding practices and later parent-reported feeding difficulties: a systematic review. Nutr Rev 2021; 79:1236-1258. [PMID: 33486523 DOI: 10.1093/nutrit/nuaa135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Early feeding practices may influence the acceptance of new foods and contribute to the development of feeding difficulties later in childhood. OBJECTIVE The aim of this systematic review was to evaluate the association of breastfeeding duration, timing of complementary feeding introduction, and feeding techniques with feeding difficulties or their subtypes, namely picky or fussy eating, food refusal, and food neophobia, in children older than 1 year of age. DATA SOURCES Guidance from the Cochrane Collaboration and the Centre for Reviews and Dissemination was followed. MEDLINE, Embase, and PsycINFO databases were searched up to December 2019. Additionally, references from included articles were screened. STUDY SELECTION Interventional and observational studies were eligible. Of the 3653 records obtained after the search strategy was applied, 21 observational studies (cohort, case-control, cross-sectional), many with important methodological limitations, and 1 randomized controlled trial were included. DATA EXTRACTION Three authors extracted data independently. RESULTS Results were synthesized narratively. Twelve observational studies assessed the association of breastfeeding duration with parent-reported feeding difficulties. Longer duration of breastfeeding tended to be associated with fewer childhood feeding problems in the majority of studies, but the differences were often small and not significant. Eight observational studies that examined the timing of complementary feeding introduction in relation to parent-reported feeding difficulties showed inconsistent results. Baby-led weaning, as compared with spoon-feeding, was significantly associated with less fussiness at age 12 to 36 months in 1 of 5 studies. CONCLUSIONS This review showed no strong evidence to support the hypothesis that early feeding practices contribute significantly to specific parent-reported feeding difficulties in children older than 1 year of age. Additional methodologically rigorous studies are needed to confirm these findings. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42018115792.
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Affiliation(s)
- Katarzyna Bąbik
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | | | | | - Katarzyna Wojtyniak
- Department of Pediatrics, Pediatric Teaching Clinical Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Ostaszewski
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Andrea Horvath
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
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Martí-Solsona E, González-Chordá VM, Andreu-Pejo L, Cervera-Gasch Á, Valero-Chillerón MJ, Mena-Tudela D. Parents' Perception of the Complementary Baby-Led Weaning Feeding Method: A Validation Study. NURSING REPORTS (PAVIA, ITALY) 2020; 10:115-123. [PMID: 34968356 PMCID: PMC8608133 DOI: 10.3390/nursrep10020015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/12/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022]
Abstract
This study aims to construct and validate a questionnaire that allows Parents’ Perceptions of the complementary Baby-Led Weaning feeding method (PaPerc-BLW questionnaire) to be evaluated. An instrumental design was used. Five child nutrition experts took part in the development and content validity. The questionnaire was administered to a sample of 216 Spanish parents of infants aged 0–6 months to determine psychometric properties (construct validity and internal consistency). The factor analysis explained 65.12% of variance with three factors (Promoting infant autonomy and development; Infant’s health; Parents’ fear to apply BLW), and internal consistency was α = 0.67. The mean score of the PaPerc-BLW questionnaire for the total sample was 4.14 (DS = 0.64, 95% CI = 4.06–4.23). Significant differences were found in the parents’ perception of baby-led weaning feeding method based on variables as previous children (p ≤ 0.001). Otherwise, the sample included in the study could bias the results, since 98.6% indicated that they were familiar with the BLW method and 62% had previous experience Despite this limitation, the PaPerc-BLW questionnaire offers adequate validity for evaluating parents’ perception of the baby-led weaning method.
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35
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Cook EJ, Powell FC, Ali N, Penn-Jones C, Ochieng B, Randhawa G. Parents' experiences of complementary feeding among a United Kingdom culturally diverse and deprived community. MATERNAL AND CHILD NUTRITION 2020; 17:e13108. [PMID: 33169518 PMCID: PMC7988868 DOI: 10.1111/mcn.13108] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 01/08/2023]
Abstract
Complementary feeding practices and adherence to health recommendations are influenced by a range of different and often interrelating factors such as socio‐economic and cultural factors. However, the factors underlying these associations are often complex with less awareness of how complementary feeding approaches vary across the UK’s diverse population. This paper describes a qualitative investigation undertaken in a deprived and culturally diverse community in the UK which aimed to explore parents’ knowledge, beliefs and practices of complementary feeding. One hundred and ten mothers and fathers, self‐identified as being White British, Pakistani, Bangladeshi, Black African/Caribbean or Polish took part in twenty‐four focus group discussions, organised by age group, sex and ethnicity. The findings revealed that most parents initiated complementary feeding before the World Health Organisation (WHO) recommendation of 6 months. Early initiation was strongly influenced by breast feeding practices alongside the extent to which parents believed that their usual milk; that is, breastmilk or formula was fulfilling their infants' nutritional needs. The composition of diet and parents' approach to complementary feeding was closely aligned to traditional cultural practices; however, some contradictions were noted. The findings also acknowledge the pertinent role of the father in influencing the dietary practices of the wider household. Learning about both the common and unique cultural feeding attitudes and practices held by parents may help us to tailor healthy complementary feeding advice in the context of increasing diversity in the United Kingdom.
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Affiliation(s)
| | | | - Nasreen Ali
- Institute for Health Research, University of Bedfordshire, Luton, UK
| | - Catrin Penn-Jones
- Institute for Health Research, University of Bedfordshire, Luton, UK
| | - Bertha Ochieng
- Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Luton, UK
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36
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D’Auria E, Borsani B, Pendezza E, Bosetti A, Paradiso L, Zuccotti GV, Verduci E. Complementary Feeding: Pitfalls for Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7931. [PMID: 33137971 PMCID: PMC7662522 DOI: 10.3390/ijerph17217931] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/19/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022]
Abstract
The term complementary feeding is defined as the period in which a progressive reduction of breastfeeding or infant-formula feeding takes place, while the infant is gradually introduced to solid foods. It is a crucial time in the infant's life, not only because of the rapid changes in nutritional requirements and the consequent impact on infant growth and development, but also for a generation of lifelong flavor preferences and dietary habits that will influence mid and long-term health. There is an increasing body of evidence addressing the pivotal role of nutrition, especially during the early stages of life, and its link to the onset of chronic non-communicable diseases, such as obesity, hypertension, diabetes, and allergic diseases. It is clear that the way in which a child is introduced to complementary foods may have effects on the individual's entire life. The aim of this review is to discuss the effects of complementary feeding timing, composition, and mode on mid and long-term health outcomes, in the light of the current evidence. Furthermore, we suggest practical tips for a healthy approach to complementary feeding, aiming at a healthy future, and highlight gaps to be filled.
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Affiliation(s)
- Enza D’Auria
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20122 Milan, Italy; (B.B.); (E.P.); (A.B.); (L.P.); (G.V.Z.); (E.V.)
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37
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Balantekin KN, Anzman-Frasca S, Francis LA, Ventura AK, Fisher JO, Johnson SL. Positive parenting approaches and their association with child eating and weight: A narrative review from infancy to adolescence. Pediatr Obes 2020; 15:e12722. [PMID: 32881344 PMCID: PMC8018716 DOI: 10.1111/ijpo.12722] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/07/2020] [Indexed: 12/13/2022]
Abstract
Parents play a critical role in the development of children's eating behaviours and weight status, serving as providers, models and regulators of the food environment. Many research reviews have focused on the robust body of evidence on coercive control in feeding: how parenting practices such as restriction and pressure to eat increase children's risk for developing undesirable eating behaviours and unhealthy weight outcomes. Fewer reviews adopt a strengths-based perspective focusing on the ways that parents can actively support the development of healthy eating behaviours and weight trajectories. Emerging research on such positive parenting styles and practices offers solutions beyond the avoidance of coercive control, as well as opportunities to highlight parallels between research on food parenting and the broader, well-established developmental literature on positive parenting. The focus of this review is to summarize what is known regarding benefits of positive parenting styles and practices for child eating and weight outcomes and discuss recommendations for future research. Current evidence supports starting with responsive feeding and parenting during infancy and incorporating structure and limit setting in early childhood, with monitoring and mealtime structure remaining important during middle childhood and adolescence. Areas for future research include: (1) further examination of the implications of identified food parenting practices and styles among diverse groups and caregivers; (2) increased consideration of child factors (eg, temperament) as moderators or mediators; and (3) further clarification of the relationship between general parenting and food parenting.
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Affiliation(s)
- Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
| | - Stephanie Anzman-Frasca
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
- Department of Pediatrics, Jacobs School of Medicine, University at Buffalo, Buffalo, New York, USA
| | - Lori A Francis
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Alison K Ventura
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, California, USA
| | - Jennifer O Fisher
- Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA
| | - Susan L Johnson
- Department of Pediatrics, University at Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Mancabelli L, Tarracchini C, Milani C, Lugli GA, Fontana F, Turroni F, van Sinderen D, Ventura M. Multi-population cohort meta-analysis of human intestinal microbiota in early life reveals the existence of infant community state types (ICSTs). Comput Struct Biotechnol J 2020; 18:2480-2493. [PMID: 33005310 PMCID: PMC7516180 DOI: 10.1016/j.csbj.2020.08.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022] Open
Abstract
Appropriate development of the intestinal microbiota during infancy is known to be important for human health. In fact, aberrant alterations of the microbial composition during childhood may cause short- and/or long-term negative health effects. Many factors influence the initial assembly and subsequent progression of the gut microbiota of a neonate, such as feeding type, delivery mode, gestational age, maternal metabolic status and antibiotic exposure. In the current study, the composition of the infant gut core-microbiota was explored, revealing particular variations of this core-microbiota during the first three years as influenced by delivery mode and feeding type. A multi-population cohort meta-analysis was performed by selecting 15 publicly available datasets pertaining to taxonomic profiles of 1035 fecal samples of healthy infants, as obtained by means of a 16S rRNA gene-based profiling approach. Interestingly, this multi-population cohort meta-analysis revealed great microbial complexity and specific taxonomic shifts in children older than six months, suggesting a major impact by the introduction of solid foods which prompts progression of infant gut microbiota towards that typical of adults. The taxonomic data sets employed in this multi-population cohort meta-analysis possess the statistical robustness to allow the identification of infant community state types (ICSTs). Our analysis therefore reveals the existence of specific taxonomic patterns that correspond to particular nutritional and developmental stages of early life, and that had previously been obscured by the high variability typical of such infant gut microbiota.
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Affiliation(s)
- Leonardo Mancabelli
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Chiara Tarracchini
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Christian Milani
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Gabriele Andrea Lugli
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Federico Fontana
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Francesca Turroni
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Douwe van Sinderen
- APC Microbiome Institute and School of Microbiology, Bioscience Institute, National University of Ireland, Cork, Ireland
| | - Marco Ventura
- Laboratory of Probiogenomics, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
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Pérez-Ríos M, Santiago-Pérez MI, Butler H, Mourino N, Malvar A, Hervada X. Baby-led weaning: prevalence and associated factors in Spain. Eur J Pediatr 2020; 179:849-853. [PMID: 31960148 DOI: 10.1007/s00431-020-03579-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/04/2019] [Accepted: 01/10/2020] [Indexed: 02/06/2023]
Abstract
The main goals of this study are to estimate the percentage of mothers who declared feeding their children with baby-led weaning (BLW) and to characterize them. A cross-sectional survey was carried out in 2016 targeting women who had given birth in 2016 (sample size 6777) in Galicia (Spain). The questionnaire included questions regarding the mother's characteristics and behaviors, attitudes, and practices related to BLW. Prevalence of exclusive and non-exclusive BLW was estimated. Different maternal characteristics were evaluated for their possible association with BLW using a logistic regression model. The percentages and ORs were presented with a 95% confidence interval. The study included 6355 women, of which 38.6% (37.4-39.9) had heard of BLW and the overall prevalence of BLW was estimated at 14.0% (13.1-14.9). Prevalence of exclusive BLW was estimated at 2.1% (2.4-3.3). No differences were observed when age was taken into consideration. Children fed with BLW were more likely among mothers who continue with exclusive breastfeeding (OR, 4.1 (95% CI, 3.3-5.0)); live in an urban setting (OR, 1.6 (1.2-2.2)); or have a higher level of education (OR, 1.3 (1.1-1.5)).Conclusion: Full adherence to BLW seems low among mothers who claimed to have fed their children following this method.What is Known:• Baby-led weaning (BLW) has been present in our society for almost two decades, but it remains unclear how many mothers choose BLW for their children.What is New:• BLW is not a common choice for weaning in Spain, and more than half of the mothers had not heard about it.• Full adherence to BLW seems low among mothers who claimed to have fed their children following this method.
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Affiliation(s)
- Mónica Pérez-Ríos
- Epidemiology Unit, Galician Directorate for Public Health. Consellería de Sanidade, Santiago de Compostela, Spain. .,Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Maria Isolina Santiago-Pérez
- Epidemiology Unit, Galician Directorate for Public Health. Consellería de Sanidade, Santiago de Compostela, Spain
| | - Haylie Butler
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Nerea Mourino
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Malvar
- Epidemiology Unit, Galician Directorate for Public Health. Consellería de Sanidade, Santiago de Compostela, Spain
| | - Xurxo Hervada
- Epidemiology Unit, Galician Directorate for Public Health. Consellería de Sanidade, Santiago de Compostela, Spain
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40
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Mastrorilli C, Santoro A, Caffarelli C. Primary Prevention of Allergic Diseases: The Role of Early Exposure to Cow's Milk Formula. Front Pediatr 2020; 8:420. [PMID: 32850536 PMCID: PMC7399633 DOI: 10.3389/fped.2020.00420] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/18/2020] [Indexed: 12/13/2022] Open
Abstract
The burden of atopic disorders is continuously worsening worldwide, especially in childhood. Therefore, risk factors and preventive measures have been called into question. The age when infants introduce complementary foods, varies greatly according to traditional habits, clinical practice recommendations, and breastfeeding duration. It is still debated the impact of early exposure to cow's milk on the increase of allergic diseases, mainly food allergy, and atopic dermatitis. Many factors may play a role in this potential link, such as genetic variation, parental atopy, infant feeding regimens. Recent evidences suggest that the early introduction of complementary foods (up to 6 months of age), including cow's milk, could prevent the development of food allergies. So, several countries included this new approach into feeding guidelines. Our review will focus on the influence of early exposure to cow's milk formula on the development of allergic diseases. Some trials found that cow's milk supplementation in the first days of life could even increase the development of IgE sensitization and food allergies. Other trials did not show any efficacy on prevention of allergic disorders. Further studies are needed to understand the prospective for allergy prevention related to optimal timing of cow's milk formula introduction.
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Affiliation(s)
- Carla Mastrorilli
- UO Pediatria e Pronto Soccorso, Azienda Ospedaliero-Universitaria Consorziale Policlinico, Ospedale Pediatrico Giovanni XXIII, Bari, Italy
| | - Angelica Santoro
- Clinica Pediatrica, Dipartimento Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Carlo Caffarelli
- Clinica Pediatrica, Dipartimento Medicina e Chirurgia, Università di Parma, Parma, Italy
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41
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D'Auria E, Peroni DG, Sartorio MUA, Verduci E, Zuccotti GV, Venter C. The Role of Diet Diversity and Diet Indices on Allergy Outcomes. Front Pediatr 2020; 8:545. [PMID: 33042906 PMCID: PMC7522364 DOI: 10.3389/fped.2020.00545] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022] Open
Abstract
Nutrients in foods are not eaten in isolation and food intake interacts in a complex manner, affecting health and disease outcomes. For this reason, focusing on the whole "pattern" of dietary intake instead of the single nutrients or groups of nutrients when studying diseases outcomes is increasingly appealing and growing. Diet diversity refers to the variety of foods being eaten, and the terms, diversity or variety, are often used interchangeably. When the overall diet is characterized by healthy foods, diet diversity will reflect a diversity/variety of healthy foods eaten over a period of time. The introduction of solid foods in the 1st year of life is considered a measure of increased diet diversity. Consuming a diverse range of foods and food allergens in the first year of life may increase intake of important nutrients and positively affect the gut microbiome structure and function. Intake of omega-3 fatty acids and fibers/prebiotics may be particularly important but more information is required about dose and which individuals are most likely to benefit. Increased diet diversity in the first year of life is also associated with reduced food allergy outcomes. In addition to diet diversity, diet indices are considered measures of overall diet quality and can be used as a simple assessment of dietary intake. The focus of this paper is to review and critically address the current knowledge of the association between diet diversity and diet indices and allergy outcomes. Based on the current evidence, we recommend the introduction of solid foods, including common allergenic solids, during the 1st year of life, according to the infant's neuro-developmental abilities and familial or cultural habits. For infants with severe AD and/or FA, medical assessment may be advisable before introducing common food allergens into the diet. Limited evidence exist about the role of diet indices in pregnancy and allergic disease in the offspring, and the most promising results indicate a reduction in childhood wheeze and/or asthma intake.
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Affiliation(s)
- Enza D'Auria
- Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy
| | - Diego G Peroni
- Clinical and Experimental Medicine Department, Section of Pediatrics, University of Pisa, Pisa, Italy
| | - Marco Ugo Andrea Sartorio
- Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy
| | - Elvira Verduci
- Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy
| | - Gian Vincenzo Zuccotti
- Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy
| | - Carina Venter
- Section of Allergy and Immunology, Children Hospital Colorado, University of Colorado, Denver, CO, United States
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Sestito S, D'Auria E, Baldassarre ME, Salvatore S, Tallarico V, Stefanelli E, Tarsitano F, Concolino D, Pensabene L. The Role of Prebiotics and Probiotics in Prevention of Allergic Diseases in Infants. Front Pediatr 2020; 8:583946. [PMID: 33415087 PMCID: PMC7783417 DOI: 10.3389/fped.2020.583946] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022] Open
Abstract
Allergic diseases have been linked to genetic and/or environmental factors, such as antibiotic use, westernized high fat and low fiber diet, which lead to early intestinal dysbiosis, and account for the rise in allergy prevalence, especially in western countries. Allergic diseases have shown reduced microbial diversity, including fewer lactobacilli and bifidobacteria, within the neonatal microbiota, before the onset of atopic diseases. Raised interest in microbiota manipulating strategies to restore the microbial balance for atopic disease prevention, through prebiotics, probiotics, or synbiotics supplementation, has been reported. We reviewed and discussed the role of prebiotics and/or probiotics supplementation for allergy prevention in infants. We searched PubMed and the Cochrane Database using keywords relating to "allergy" OR "allergic disorders," "prevention" AND "prebiotics" OR "probiotics" OR "synbiotics." We limited our evaluation to papers of English language including children aged 0-2 years old. Different products or strains used, different period of intervention, duration of supplementation, has hampered the draw of definitive conclusions on the clinical impact of probiotics and/or prebiotics for prevention of allergic diseases in infants, except for atopic dermatitis in infants at high-risk. This preventive effect on eczema in high-risk infants is supported by clear evidence for probiotics but only moderate evidence for prebiotic supplementation. However, the optimal prebiotic or strain of probiotic, dose, duration, and timing of intervention remains uncertain. Particularly, a combined pre- and post-natal intervention appeared of stronger benefit, although the definition of the optimal intervention starting time during gestation, the timing, and duration in the post-natal period, as well as the best target population, are still an unmet need.
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Affiliation(s)
- Simona Sestito
- Pediatric Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Enza D'Auria
- Department of Pediatrics, Vittore Buzzi Children's Hospital-University of Milan, Milan, Italy
| | - Maria Elisabetta Baldassarre
- Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Silvia Salvatore
- Department of Pediatrics, Ospedale "F. Del Ponte", University of Insubria, Varese, Italy
| | - Valeria Tallarico
- Pediatric Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Ettore Stefanelli
- Pediatric Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Flora Tarsitano
- Pediatric Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Daniela Concolino
- Pediatric Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,Department of Health Sciences, School of Medicine and Surgery, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Licia Pensabene
- Pediatric Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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Caffarelli C, Santamaria F, Mastrorilli C, Santoro A, Iovane B, Petraroli M, Gaeta V, Di Pinto R, Borrelli M, Bernasconi S, Corsello G. Report on advances for pediatricians in 2018: allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery. Ital J Pediatr 2019; 45:126. [PMID: 31619283 PMCID: PMC6796402 DOI: 10.1186/s13052-019-0727-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/30/2019] [Indexed: 12/11/2022] Open
Abstract
This review reported notable advances in pediatrics that have been published in 2018. We have highlighted progresses in allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery. Many studies have informed on epidemiologic observations. Promising outcomes in prevention, diagnosis and treatment have been reported. We think that advances realized in 2018 can now be utilized to ameliorate patient care.
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Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy.
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Carla Mastrorilli
- UO Pediatria e Pronto Soccorso, Azienda Ospedaliero-Universitaria Consorziale Policlinico Pediatric Hospital Giovanni XXIII, Bari, Italy
| | - Angelica Santoro
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy
| | - Brunella Iovane
- UOC Pediatria Generale e d'Urgenza, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Maddalena Petraroli
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy
| | - Valeria Gaeta
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Rosita Di Pinto
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Melissa Borrelli
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Sergio Bernasconi
- Pediatrics Honorary Member University Faculty, G D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
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Utami AF, Wanda D. Is the baby-led weaning approach an effective choice for introducing first foods? A literature review. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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45
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Anderson LN, van den Heuvel M, Omand JA, Wong PD. Practical tips for paediatricians: Baby-led weaning. Paediatr Child Health 2019; 25:77-78. [PMID: 32189974 DOI: 10.1093/pch/pxz069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 04/08/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario.,Child Health Evaluative Sciences, SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario
| | - Meta van den Heuvel
- Child Health Evaluative Sciences, SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario.,Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Jessica A Omand
- Child Health Evaluative Sciences, SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario
| | - Peter D Wong
- Child Health Evaluative Sciences, SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario.,Division of Paediatric Medicine, Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario
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46
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Bovbjerg ML. Current Resources for Evidence-Based Practice, March 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:230-248. [PMID: 30735623 DOI: 10.1016/j.jogn.2019.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
A review of new resources to support the provision of evidence-based care for women and infants.
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47
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Baroni L, Goggi S, Battino M. Planning Well-Balanced Vegetarian Diets in Infants, Children, and Adolescents: The VegPlate Junior. J Acad Nutr Diet 2018; 119:1067-1074. [PMID: 30174286 DOI: 10.1016/j.jand.2018.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Indexed: 12/30/2022]
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