Complementary Feeding Of Infants Research Articles

Diversification alimentaire : idées reçues et preuves scientifiques

Guidelines about complementary feeding should be evidence based. It is now clearly established that timing of the first introduction of solid food should not be delayed in allergy at-risk infants. All complementary food can be introduced between 4 and 6 months of age. After introduction of complementary foods, protein intakes are almost always higher than the recommended needs, but no deleterious effects have been demonstrated. The frequent restriction of lipid intakes after weaning is not justified, especially since recommended needs have been increased. Excess of sweetened foods should be avoided to prevent deficiencies, but it does not increase the risk of further obesity. No dietary intervention during weaning has ever demonstrated any efficacy in obesity prevention. Reduction of infants formulas consumption increases the risk of iron deficiency, which could only be avoided by growing-up milk and meat consumption. A better information of health care practitioners may contribute to reducing the diffusion of erroneous opinions about complementary feeding in infants.

Commentary: concerns for complementary feeding of infants in Brazil

Commentary: concerns for complementary feeding of infants in Brazil

Scientific Opinion on the appropriate age for introduction of complementary feeding of infants

Following a request from the Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver a scientific opinion on the appropriate age for the introduction of complementary food for infants in the EU. Many European countries have adopted the WHO recommendation for the duration of exclusive breast-feeding for 6 months, whilst other countries recommend the introduction of complementary feeding between 4 and 6 months. The Panel agrees with WHO and other authoritative national and international bodies that breast-milk is the preferred food for infants, but the focus in this opinion are the factors which determine the appropriate age for the introduction of complementary food into infants’ diets. The Panel has evaluated predominantly studies in breast-fed healthy infants born at term for indicators of an appropriate age at which to introduce complementary food irrespective of existing recommendations on breast-feeding duration and on exclusivity of breast-feeding. The Panel has focussed its evaluation on data from developed countries. On the basis of present knowledge, the Panel concludes that the introduction of complementary food into the diet of healthy term infants in the EU between the age of 4 and 6 months is safe and does not pose a risk for adverse health effects (both in the short-term, including infections and retarded or excessive weight gain, and possible long-term effects such as allergy and obesity).

The relationship between the clinic-based nutrition instructions given to nursing mothers and their complementary feeding practices in Enugu state

This study covered four different hospitals in Enugu State: University of Nigeria Teaching Hospital (UNTH), Mother of Christ Specialist Hospital (MCSH) both in Enugu and Comprehensive Health Centre (CHC), Bishop Shanahan Hospital both in Nsukka. This study ascertained the relationship between the clinic-based nutrition instructions given to the nursing mothers and their infant complementary feeding practices. Three hundred nursing mothers were randomly selected from the four hospitals. Validated questionnaires were used for data collection. There were uniformed infant nutrition instructions given to the nursing mothers by registered nurses in these selected baby-friendly hospitals. Pearson’s product moment correlation (r) analysis was used to obtain the correlation coefficients (r). The study revealed that the relationship between the clinicbased infant nutrition education given to the nursing mothers and their complementary feeding practices were effective for the four hospitals but MCSH had the highest r=0.68 followed by UNTH r=0.49. The t-test result comparing the nursing mothers’ infant complementary feeding practices in Enugu and Nsukka areas (t = 2.019) were significantly different at 5% probability level.

CONSUMPTION OF SOFT DRINKS AND OTHER SWEET DRINKS BY WIC INFANTS

The Journal has published numerous articles on consumption of soft drinks and other sweet drinks by children,1–4 but none of these articles has reported on infants. Papers published elsewhere on complementary feeding of infants have seldom considered these beverages. The Women, Infants, and Children (WIC) Infant Feeding Practices Study,5,6 a nationally representative 1-year longitudinal study carried out in the mid-1990s, found high levels of consumption of these beverages by infants. In the first month of life, 14% of infants received sweet drinks (i.e., sugar water, fruit-flavored drinks, sodas, tea, and coffee), and by the age of 4 months, nearly one third of infants received these drinks. This practice was most common among Hispanic infants—one fourth of whom were given sweet drinks in the first month and almost one half of whom were given sweet drinks in the first 4 months. Many Hispanic mothers reported giving their infants “manzanilla” tea in hopes of preventing or treating colic. Many infants also received fruit juice earlier than the recommended age of 6 months7—5% in the first month and almost half by the age of 4 months. There was little variation among White, African American, and Hispanic mothers. At the time the study was conducted, the WIC program recommended giving fruit juice only when the infant could drink from a cup, after about 4 months of age8; fruit juice has recently been removed from the WIC food package for infants younger than 4 months. The 2002 Feeding Infants and Toddlers Study9 documented that infants of all ages who were enrolled in WIC were much more likely than were nonparticipants to receive fruit juice. Consumption of sodas and other sweet drinks was not reported. A recent meta-analysis1 reported that soft drink intake among children and adults was associated with higher energy intake and body weight, lower intake of milk and calcium, and increased risks of several medical problems, particularly diabetes. Thus, the dramatic increase in soft drink consumption in children10 (which is likely to be mirrored in infants) is of great concern. Although health care workers are likely to talk with mothers about inappropriate feeding of juice to young infants, our study indicates that they should also advise against soft drinks and other sweet drinks for infants of any age.

Complementary Feeding and Growth of Infant and Young Child in China

To understand the status and problems of complementary feeding and to explore the strategy of improving complementary feeding for infants and young children in China. Data of urban and rural children were selected from the China Food and Nutrition Surveillance System (CFNSS) dataset to describe the status of complementary feeding and growth of children. Logistic Regression was used to analyze the relationship between child growth and the complementary feeding pattern. Applications of foods that come from animals, vegetable/fruit and dairy product in complementary feeding were negatively correlated to the prevalence of stunting and underweight. Attributable risk (AR) of no application of vegetable/fruit in complementary feeding to stunting was 30.2%, to underweight 35.4%; AR of no application of foods from animal products in complementary feeding to stunting was 28.2%, to underweight 11.7%; and the AR of no application of diary products in complementary feeding to stunting was 27.4%, to underweight was 15.9%. Complementary feeding contributed to the improvement of infants and young children growth in China. There is an urgent need to develop health education in the public on infants and young children complementary feeding, in the mean time, it is pressing to pay attention and take actions to develop and promote affordable, acceptable, and accessible fortified complementary food in rural areas of China.

Bases para una alimentación complementaria adecuada de los lactantes y los niños de corta edad

Infants can be exclusively breast fed or formula fed for the first 6 months of life and their nutritional requirements are completely fulfilled. However, from 6 months onwards, human milk is not sufficient to supply all the nutrients necessary for infants and young children. Therefore, adequate supplementary feeding, in terms of both quantity and quality, should be provided. The present article aims to describe the scientific bases for practical recommendations on complementary feeding during infancy and early childhood, which may be useful to pediatricians and should serve to improve the health status of the infant population in Spain. In this sense, the new international recommendations for energy, protein and other nutrient requirements are reviewed. In Spain, the law applicable to manufacturing infant cereals and homogenized infant foods is that published by the European Union in specific directives. However, taking into consideration new advances in knowledge of nutritional requirements, we have considered a number of issues that could be relevant for the manufacture of these foods. Finally, we propose a series of basic principles that should serve as a guide for the complementary feeding of infants (whether breast fed, formula fed, or receiving mixed feeding) and young children. These recommendations are particularly addressed to pediatricians working in primary health services.

The timing of complementary feeding of infants in Switzerland: Compliance with the Swiss and the WHO guidelines

Abstract Background: The importance of adequate complementary feeding of infants is increasingly acknowledged. Little is known of the actual complementary feeding practices in Switzerland. Aim: To report the prevalence of adequate timing of complementary feeding, comparing the compliance to Swiss and World Health Organization (WHO) guidelines, and to investigate factors influencing infant complementary feeding. Methods: In 2003 a cross‐sectional study was conducted of mother‐and‐infant pairs in Switzerland. The mothers, randomly chosen by local community mother‐and‐child health services, completed a 24‐h dietary recall questionnaire and reported the infant's age at the first introduction of various foods. Descriptive analysis, group testing and regression analysis of data collected were conducted. Results: Introduction of solids mainly occurred between the 5th and 6th months. Five per cent of the mothers introduced complementary food before the age of 4 mo. The main influencing factors for infant feeding were maternal age, language regions, mother's BMI and smoking status, the presence of siblings, and an allergic predisposition of the infant. Conclusion: The timing of the introduction of complementary foods meets with Swiss guidelines. WHO recommendations, however, are not met. This may be due to a misunderstanding of the Swiss Paediatric Association's age‐range recommendations or insufficient promotion of the WHO recommendations.

The timing of complementary feeding of infants in Switzerland: Compliance with the Swiss and the WHO guidelines

The importance of adequate complementary feeding of infants is increasingly acknowledged. Little is known of the actual complementary feeding practices in Switzerland. To report the prevalence of adequate timing of complementary feeding, comparing the compliance to Swiss and World Health Organization (WHO) guidelines, and to investigate factors influencing infant complementary feeding. In 2003 a cross-sectional study was conducted of mother-and-infant pairs in Switzerland. The mothers, randomly chosen by local community mother-and-child health services, completed a 24-h dietary recall questionnaire and reported the infant's age at the first introduction of various foods. Descriptive analysis, group testing and regression analysis of data collected were conducted. Introduction of solids mainly occurred between the 5th and 6th months. Five per cent of the mothers introduced complementary food before the age of 4 mo. The main influencing factors for infant feeding were maternal age, language regions, mother's BMI and smoking status, the presence of siblings, and an allergic predisposition of the infant. The timing of the introduction of complementary foods meets with Swiss guidelines. WHO recommendations, however, are not met. This may be due to a misunderstanding of the Swiss Paediatric Association's age-range recommendations or insufficient promotion of the WHO recommendations.

Conduite de la diversification alimentaire : enquête prospective jusqu'à l'âge de 6 mois

The aims of this work were to assess timing of complementary feeding in infants and to precise the underlying factors that may cause inappropriate complementary feeding. Patients and methods. – A cohort of 167 newborns, born in the same maternity ward during a 6 week-period, was prospectively analyzed. Only healthy neonates were included in the study. A phone questionnaire was filled at 4 and 6 months of age to evaluate modality of complementary feeding. Multivariate analysis (segmentation tree, analyse by multiple correspondence) was used to study factors associated with inappropriate diversification. Results. – Out of the 167 neonates included in the study, 132 mothers could be contacted at 4 months and 116 at 6 months of age. Sixty-seven per cent of mothers started breast feeding at birth. Among these, 33% still breastfed -at least partially- at 4 months and 17% at 6 months. Fifty-two percent of mothers started complementary feeding before 4 months, and 24% of infants received gluten at 4 months of age. Multi-gravida mothers, mothers aged more than 35 years old and mothers who gave infant or follow-up formulae before 4 months, started complementary feeding significantly earlier ( P < 0.05). Infants who were formula fed received more frequently complementary feeding before the age of 4 months than breast fed infants (57% vs 33%, P < 0.05). Conclusion. – Our study showed that half of infants were introduced solid food too early and allowed to identify a population at risk that could benefit from nutritional intervention programs.

Complementary feeding

OBJECTIVE: To present an updated review about complementary feeding in infants and children under 2 years old. METHODS: Relevant materials from scientific journals, technical books and publications by international organizations were used. The most important source of data was a publication by the World Health Organization on complementary feeding carried out in Montpellier, France, in December 1995. RESULTS: In recent years, new findings on ideal infant feeding have buried former concepts and practices. The value of exclusive breast-feeding during the first months of life and the introduction of timely and adequate complementary feeding has been acknowledged. Complementary foods are defined as any solid or liquid foods with nutritional value other than breastmilk, offered to breast-fed infants It is recommended that complementary feeding be initiated around the 6th month of life. These foods should be rich in energy, proteins and micronutrients, free from contamination, easily digestible and in adequate amount. On recommending a healthy diet, the availability, accessibility and cultural values of food should be taken into consideration. CONCLUSION: Health professionals have an important role in the improvement of infant nutrition. Those in charge of child care have to be properly advised and warned of the importance of a healthy diet for current and future health status.

Book Review: Breastfeeding and Complementary Infant Feeding, and the Postpartum Effects of Breastfeeding. DHS Comparative Studies No. 30.

Book Review: Breastfeeding and Complementary Infant Feeding, and the Postpartum Effects of Breastfeeding. DHS Comparative Studies No. 30.

Relative bioavailability in adults of iron from a soybean product intended for complementary feeding of infants

The relative bioavailability of iron sulphate added to a soybean product intended for use as a fortified product for complementary feeding of infants was determined. Ten adults received 100mg elemental iron in an aqueous Fe(II)-sulphate solution and 1 week later 100 mg elemental iron mixed into 30 g soybean milk powder. Plasma iron concentrations were measured before, and 1, 2, 4, 6, 8 and 10 h after consumption. The area under the concentration/time curve (AUC+), the peak plasma level (tmax) and the relative bioavailability were determined. The peak of the plasma iron level after receiving 100 mg of iron solution was 176.71 ± 39.05 μg/dl at tmax = 2.8 ± 1.03h while it was 139.82 ± 34.47 μg/dl at tmax = 2.4 ± 1.3 h after consuming 30 g of soybean milk product mixed with 100mg iron solution. The relative bioavailability of iron in the soybean product was 45.8% compared to iron solution. Based on these results it is suggested that the soybean product should be fortified with 10 mg/100 g product of iron sulphate to provide 30% of the iron RDA for infants.

Ripe banana as a complementary feeding in infants: A study of 444 cases

Summary Four hundred forty-four bottle-fed infants were fed ripe mashed banana as a complementary feeding beginning at the age of 6 weeks. The majority of these infants were either underweight or had complicating illnesses. Tangible, reportable evidence of the advantage of this complementary feeding demonstrates that (a) because of the banana's digestibility, it acts as an ideal first solid to offer infants to make them accustomed to solid food; and also (b) when given with cod-liver oil increases the ease of administering the oil to small infants. Although it is merely clinical observation and opinion, as no criterion except personal judgment is available, some at this institution share the belief that the turgor in the banana fed infants is better. Citing the small average amount of banana taken, others deny the possibility of affecting turgor; however, all agree on the ease of assimilation. Considering the large number of undernourished and sick infants reported, the incidence of gastrointestinal upsets is low (3.56 per cent), and this may be due to the fact that a little less carbohydrate can be used in the formula when the infant is getting a complementary banana feeding. Until a group of control infants who are not given complementary feeding is studied at the same time as those fed banana, these controversial opinions cannot be settled. A group of infants fed mashed ripe banana immediately after the cessation of diarrhea assimilated the fruit with ease and showed no recurrences.