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Daniel IC, Siqueira MSM, Romaneli GU, Rocha Orsi JS, Werneck RI. Food-Based Dietary Guidelines for Infants in Latin America and the Caribbean: A Systematic Review. Nutrients 2024; 16:1233. [PMID: 38674923 PMCID: PMC11053862 DOI: 10.3390/nu16081233] [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: 02/20/2024] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.
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Affiliation(s)
| | | | | | | | - Renata Iani Werneck
- Graduate Program in Dentistry, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80242 980, Brazil; (I.C.D.); (G.U.R.); (J.S.R.O.)
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Sdravou K, Printza A, Emmanouilidou-Fotoulaki E, Michou E, Sotiriadou F, Fotoulaki M. Developmental Feeding Stages and Their Impact on Child Feeding Behavior. J Pediatr Gastroenterol Nutr 2023; 77:769-778. [PMID: 37490588 DOI: 10.1097/mpg.0000000000003892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
OBJECTIVES Previous research has shown that critical periods of feeding skills development exist and feeding problems can arise in children due to delays in attaining feeding developmental milestones. This study aims to delineate the transitional process of feeding development in healthy children and children with gastrointestinal diseases (GIDs) and to examine the relationship between feeding milestones and the appearance of later feeding problems. METHODS A cross-sectional case-control study among 711 healthy Greek children and 119 children with GID, aged 2-7 years. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale and "self-reported" questionnaires assessing child's feeding history. RESULTS Differences in feeding behavior of preschoolers between the 2 groups were found concerning the time of introduction of complementary (pureed), lumpy, and table foods as well as finger feeding and regular cup-drinking. Age-specific milestones as proposed by guidelines were not reached. Late introduction of complementary and lumpy foods (>6 months and >9 months, respectively) as well as finger feeding (>9 months) were predictive of more problematic feeding behaviors later on. CONCLUSIONS The trajectory of feeding development, including less studied feeding milestones, both in healthy children and children with GIDs, indicates that there are discrepancies between current feeding practices and infant feeding guidelines, and a tendency to delay the acquisition of all assessed feeding milestones.
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Affiliation(s)
| | - Athanasia Printza
- the 1st Otolaryngology Department, School of Medicine, Aristotle University of Thessaloniki, University Hospital AXEPA, Thessaloniki, Greece
| | - Elpida Emmanouilidou-Fotoulaki
- the 1st Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General Hospital "Ippokrateio", Thessaloniki, Greece
| | - Emilia Michou
- the Speech and Language Therapy Department, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
- the Centre for Gastrointestinal Sciences, The University of Manchester, Manchester, UK
| | - Fotini Sotiriadou
- the 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Maria Fotoulaki
- the 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General "Papageorgiou" Hospital, Thessaloniki, Greece
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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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de Paiva CSS, Nunes LM, Bernardi JR, Moreira PR, Mariath AAS, Gomes E. Choking, gagging and complementary feeding methods in the first year of life: a randomized clinical trial. J Pediatr (Rio J) 2023; 99:574-581. [PMID: 37400061 PMCID: PMC10594018 DOI: 10.1016/j.jped.2023.05.011] [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: 12/14/2022] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVE Compare the occurrence of choking and gagging in infants subjected to three complementary feeding (CF) methods. METHODS Randomized clinical trial with mother-infant pairs, allocated according to the following methods of CF: a) Parent-Led Weaning (PLW) - group control, b) Baby-Led Introduction to SolidS (BLISS), and c) mixed (initially BLISS and if the infant presents a lack of interest or dissatisfaction, PLW), with the last two methods guided by the infant. Mothers received nutritional intervention on CF and prevention of choking and gagging according to the method at 5.5 months of age and remained in follow-up until 12 months. Frequencies of choking and gagging were collected by questionnaire at nine and 12 months. The comparison between groups was performed using the analysis of variance test (p < 0.05). RESULTS 130 infants were followed, and 34 (26.2%) children presented choking between six and 12 months of age, 13 (30.2%) in PLW, 10 (22.2%) BLISS, and 11 (26.2%) mixed method, no significative difference between methods (p > 0.05). The choking was caused mainly by the semi-solid/solid consistency. Moreover, 100 (80%) infants aged from six to 12 months presented gagging and their characteristics were not statistically different among groups (p > 0.05). CONCLUSION Infants following a baby-led feeding method that includes advice on minimizing choking risk do not seem more likely to choke than infants following traditional feeding practice that includes advice on minimizing choking risk.
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Affiliation(s)
| | - Leandro Meirelles Nunes
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Seção de Neonatologia, Porto Alegre, RS, Brazil
| | - Juliana Rombaldi Bernardi
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Departamento de Nutrição, Porto Alegre, RS, Brazil
| | - Paula Ruffoni Moreira
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Porto Alegre, RS, Brazil
| | - Adriela Azevedo Souza Mariath
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Odontologia, Departamento de Cirurgia e Ortopedia, Porto Alegre, RS, Brazil
| | - Erissandra Gomes
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Odontologia, Departamento de Cirurgia e Ortopedia, Porto Alegre, RS, Brazil.
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Moreira PR, Nunes LM, Neves RO, Belin CHS, Fuhr J, Gomes E, Mariath A, Bernardi JR. Adherence to different methods for introducing complementary food to 7-month-old babies: a randomized clinical trial. REVISTA PAULISTA DE PEDIATRIA 2023; 41:e2021235. [PMID: 36102400 PMCID: PMC9462408 DOI: 10.1590/1984-0462/2023/41/2021235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/03/2021] [Indexed: 11/21/2022]
Abstract
Objective: To assess the adherence to three methods of food introduction for 7-month-old babies. Methods: This is a randomized clinical trial conducted with mother-infant pairs, submitted to the intervention with five and a half months of age and three different methods for food introduction according to randomization: Parent-Led Weaning (PLW), Baby-Led Introduction to SolidS (BLISS), or mixed (specially developed for this study). Adherence to the method was assessed at the seventh month of age, via telephone call to the caregiver by a researcher blinded to the method. The analyses were performed using the Chi-Square test and data are presented in absolute numbers and percentages. Results: A total of 139 mother-infant pairs were evaluated; 46 of them were allocated to the PLW method; 47, to the BLISS; and 46, to the mixed. At seven months of age, 60 (43.2%) mothers reported that the infants were following the proposed feeding method. When analyzing each approach, the mixed method showed a higher likelihood of adherence (71.7%, n=33), followed by the PLW method (39.1%, n=18) and by the BLISS (19.2%, n=9) (p<0.001). Among the sample that did not follow the proposed method, those that had been randomized to the PLW and BLISS methods mostly migrated to the mixed method (92.9%; n=26 and 92.1%; n=35, respectively) (p<0.001). Conclusions: Complementary feeding in a mixed approach obtained greater adherence in 7-month-old babies.
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Affiliation(s)
| | | | | | | | - Jordana Fuhr
- Universidade Federal do Rio Grande do Sul, Brazil
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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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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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Nunes LM, Führ J, Belin CHS, Moreira PR, Neves RO, de Brito ML, Morando LA, Mariath AAS, Gomes E, Bernardi JR. Complementary feeding methods in the first year of life: a study protocol for a randomized clinical trial. Trials 2021; 22:687. [PMID: 34627344 PMCID: PMC8501700 DOI: 10.1186/s13063-021-05647-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/20/2021] [Indexed: 12/01/2022] Open
Abstract
Background The traditional spoon-feeding approach to introduction of solid foods during the complementary feeding period is supported by consensus in the scientific literature. However, a method called Baby-Led Introduction to SolidS (BLISS) has been proposed as an alternative, allowing infants to self-feed with no adult interference. To date, there have been no trials in the Brazilian population to evaluate the effectiveness of BLISS in comparison to the traditional approach. Methods/design To evaluate and compare three different complementary feeding methods. Data on 144 mother-child pairs will be randomized into intervention groups by methods: (A) strict Parent-Led Weaning; (B) strict Baby-Led Introduction to SolidS; and (C) a mixed method. Prospective participants from Porto Alegre, Brazil, and nearby cities will be recruited through the Internet. The interventions will be performed by nutritionists and speech therapists, at 5.5 months of age of the child, at a private nutrition office equipped with a test kitchen where meals will be prepared according to the randomized method. The pairs will be followed up at 7, 9, and 12 months of age. Data will be collected through questionnaires designed especially for this study, which will include a 24h child food recall, questionnaires on the child’s and parents’ eating behavior, oral habits, eating difficulties, and choking prevalence. At 12 months of age, children will undergo blood collection to measure hemoglobin, ferritin, and C-reactive protein, saliva collection for analysis of genetic polymorphisms, and oral examination. Anthropometric parameters (child and maternal) will be measured at the baseline intervention, at a 9 month home visit, and at the end-of-study visit at the hospital. The primary outcome will be child growth and nutritional status z-scores at 12 months; secondary outcomes will include iron status, feeding behavior, acceptability of the methods, dietary variety, choking, eating behaviors, food preferences, acceptance of bitter and sweet flavors, suction, oral habits, oral hygiene behavior, dental caries, gingival health status, and functional constipation. Discussion The trial intends to ascertain whether there are potential advantages to the BLISS complementary feeding method in this specific population, generating data to support families and healthcare providers. Trial registration Brazilian Clinical Trials Registry (ReBEC): RBR- 229scm number U1111-1226-9516. Registered on September 24, 2019.
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Affiliation(s)
- Leandro Meirelles Nunes
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil.,Neonatology Section, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Jordana Führ
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil
| | - Christy Hannah Sanini Belin
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil
| | - Paula Ruffoni Moreira
- Graduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul (UFRGS) Nutrition Department, Medical School, Porto Alegre, Brazil
| | - Renata Oliveira Neves
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil.
| | - Mariana Lopes de Brito
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil
| | - Lorenzo Andreazza Morando
- Department of Surgery and Orthopedics, Universidade Federal do Rio Grande do Sul (UFRGS) Dentistry School, Porto Alegre, Brazil
| | - Adriela Azevedo Souza Mariath
- Department of Surgery and Orthopedics, Universidade Federal do Rio Grande do Sul (UFRGS) Dentistry School, Porto Alegre, Brazil
| | - Erissandra Gomes
- Department of Surgery and Orthopedics, Universidade Federal do Rio Grande do Sul (UFRGS) Dentistry School, Porto Alegre, Brazil
| | - Juliana Rombaldi Bernardi
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil.,Graduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul (UFRGS) Nutrition Department, Medical School, Porto Alegre, Brazil.,Nutrition Department, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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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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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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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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