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Karagoz I, Bayram S, Caliskan H, Yilmaz CS. Differences in eating behaviours and mothers attitudes between baby-led weaning vs. traditional spoon-feeding approaches in Turkiye. Appetite 2024; 203:107720. [PMID: 39426733 DOI: 10.1016/j.appet.2024.107720] [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: 05/02/2024] [Revised: 10/08/2024] [Accepted: 10/16/2024] [Indexed: 10/21/2024]
Abstract
This study was aimed to examine the differences in eating behaviours and mothers attitudes between baby-led vs. traditional spoon-feeding approaches and its effect on eating behaviours in preschool children. The study was conducted with 150 mothers of children aged 2-6, who applied to the Pediatrics Polyclinic of Başkent University Ankara Hospital, between December 2022 and February 2023. Sociodemographics, biochemical parameters were recorded to form. Maternal attitudes and eating behaviours of children were evaluated with Mother's Attitudes Towards the Feeding Process Scale (MATFP) and Early Childhood Adaptive Eating Behaviour Scale (ECAEB), respectively. The mean age of the children was 43.80 ± 11.04 months and 51.3% of them were girls. A weak negative correlation was found between the ECAEB total scores and the child age (r = -0.196, p < 0.05). A moderate positive correlation was found between the total scores of the MATFP and ECAEB (r = 0.699, p < 0.001). There wasn't significant difference between the MATFP total scores who chose baby-led weaning or traditional feeding (p > 0.05). According to the ECAEB; aggression and reaction to main meal order subgroup scores of children who consumed pureed vegetables until the ninth month were higher than those who didn't consume them (p < 0.05). Mothers who prefer the TSF offer their babies more blenderized and pureed foods, while those who prefer the BLW serve fork-mashed, steamed and sliced foods (p < 0,05). As the mothers' subscale scores for negative affect during meals, attitudes about insufficient/unbalanced feeding, negative feeding strategies, forced feeding, reaction to viewpoint of others increase, so did their subscale scores for child reluctance, eating refusal associated with sensory causes, aggression, reaction to main meal order increase. Consequently, it's believed that maternal attitudes and actions should be taken into account while evaluating the eating habits of toddlers.
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Affiliation(s)
- Incilay Karagoz
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkiye, Baglica Campus, Fatih Sultan District, Eskişehir Road 18.km, TR 06790, Etimesgut, Ankara.
| | - Sinem Bayram
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkiye, Baglica Campus, Fatih Sultan District, Eskişehir Road 18.km, TR 06790, Etimesgut, Ankara.
| | - Hilal Caliskan
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkiye, Baglica Campus, Fatih Sultan District, Eskişehir Road 18.km, TR 06790, Etimesgut, Ankara.
| | - Can Selim Yilmaz
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkiye, Baglica Campus, Fatih Sultan District, Eskişehir Road 18.km, TR 06790, Etimesgut, Ankara.
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Correia L, Sousa AR, Capitão C, Pedro AR. Complementary feeding approaches and risk of choking: A systematic review. J Pediatr Gastroenterol Nutr 2024; 79:934-942. [PMID: 38937992 DOI: 10.1002/jpn3.12298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/24/2024] [Accepted: 06/12/2024] [Indexed: 06/29/2024]
Abstract
There are two main complementary feeding (CF) approaches: traditional spoon-feeding (TSF) and baby-led weaning (BLW). Many parents and healthcare professionals have concerns about the risk of choking associated with BLW. Since asphyxia is one of infants' main causes of death, this study aims to understand the influence of the CF approach adopted by caregivers on infants' risk of choking. A systematic review was performed. The search was conducted through PubMed, Scopus, and Web of Science databases. We included randomized controlled trials or observational studies published between January 2010 and November 2023, with a clear definition of the intervention and directly assessing the risk of choking. After the selection procedure, 7 of the 165 studies initially identified were included. No study reported statistically significant differences in the risk of choking between babies following BLW, baby-led introduction to solids (BLISS), and TSF. In five studies, although not statistically significant, infants in the TSF group had more choking episodes than those in the BLW or BLISS groups. The risk of choking does not seem to be associated with the CF approach. Instead, it may be related to the familiarity of the baby with each texture and the parent's understanding of the information about how to minimize the risk of choking. Recall bias may be present in all included studies. Advice on how to modify foods to make them safer needs to be clearer and reinforced to all parents.
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Affiliation(s)
- Lia Correia
- NOVA National School of Public Health, NOVA University Lisbon, Lisboa, Portugal
| | - Ana R Sousa
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Carolina Capitão
- EnviHeB Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Ana R Pedro
- NOVA National School of Public Health, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, Lisboa, Portugal
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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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Song G, Chang J, Guan H, Zhang Y, Zhang T, Zhang Z. Professional Feeding Guidance Improved Infants' Self-Feeding Proportion during Complementary Foods Introduction in Beijing, China: An Exploratory Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1740. [PMID: 38002831 PMCID: PMC10670357 DOI: 10.3390/children10111740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023]
Abstract
An exploratory study was undertaken to examine the prevalence of infants' feeding patterns in Beijing, China, as well as the factors linked to infants' self-feeding proportion during the introduction of complementary foods, and the impact of professional feeding guidance on this proportion. A total of 122 families with infants aged 6-11 months from Beijing were included in the study. A descriptive analysis was employed to assess the prevalence of infants' feeding patterns, while generalized linear model analysis was utilized to investigate the factors associated with these patterns. All families were provided with comprehensive and personalized professional guidance regarding the introduction of complementary foods for infants. However, 64 families were lost to follow-up, leaving 58 families who were re-evaluated and queried after one month. To exclude the influence of infants aging, both the 64 families prior to receiving feeding guidance, and the 58 families after receiving feeding guidance, were included in the analysis. The families with infants aged 6-8 months and 9-11 months were compared separately based on the presence or absence of feeding guidance. Statistical tests, including the Wilcoxon rank-sum test and χ2 test, were conducted to assess any significant differences. The study revealed that the proportion of infants engaging in self-feeding was found to be remarkably low (10% [0%, 40%]). Furthermore, a significant positive association was observed between the proportion of infants engaging in self-feeding and their age (p < 0.001). Notably, after receiving professional feeding guidance, the proportion of infants engaging in self-feeding significantly increased (from 1% [0%, 20%] to 30% [10%, 50%], p < 0.001 for infants aged 6-8 months; from 20% [10%, 50%] to 40% [30%, 50%], p < 0.001 for infants aged 9-11 months). These findings contribute valuable insights for improving postnatal care practices during the introduction of complementary foods for infants.
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Affiliation(s)
- Guochao Song
- Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing 100020, China;
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Beijing 100020, China; (J.C.); (H.G.)
| | - Jiahui Chang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Beijing 100020, China; (J.C.); (H.G.)
- Children’s Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China
| | - Hongyan Guan
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Beijing 100020, China; (J.C.); (H.G.)
- Nurturing Care Research and Guidance Center, Capital Institute of Pediatrics, Beijing 100020, China
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing 100020, China;
| | - Ting Zhang
- Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing 100020, China;
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Beijing 100020, China; (J.C.); (H.G.)
- Children’s Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China
| | - Zhaofeng Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
- Beijing’s Key Laboratory of Food Safety Toxicology Research and Evaluation, Beijing 100191, China
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Campoy C, Leis R. Methods of introduction of complementary feeding in the first year of life. An Pediatr (Barc) 2023; 98:247-248. [PMID: 36935276 DOI: 10.1016/j.anpede.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/19/2023] Open
Affiliation(s)
- Cristina Campoy
- Departamento de Pediatría, Facultad de Medicine, Universidad de Granada, Granada, Spain; Centro de Excelencia de Investigación Pediátrica EURISTIKOS, Universidad de Granada, Granada, Spain; Instituto Biosanitario de Granada (Ibs-Granada), Granada, Spain; CIBERESP, Instituto Carlos III, Madrid, Spain
| | - Rosaura Leis
- Unidad de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain; Grupo Nutrición Pediátrica, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, A Coruña, Spain; CIBERObn, Instituto Carlos III, Madrid, Spain; Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
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Métodos de introducción de alimentación complementaria en el primer año de vida. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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