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"Infants Weaning."
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Weaning from the breast
Exclusive breastfeeding provides optimal nutrition for infants until they are six months of age. After six months, infants require complementary foods to meet their nutritional needs. This is when weaning begins. Weaning is the gradual process of introducing complementary foods to an infant's diet while continuing to breastfeed. There is no universally accepted or scientifically proven time when all breastfeeding must stop. The timing and process of weaning need to be individualized by mother and child. Weaning might be abrupt or gradual, take weeks or several months, be child-led or mother-led. Physicians need to guide and support mothers through the weaning process. This document replaces a previous Canadian Paediatric Society position statement on weaning published in 2004.
Journal Article
Contribution of inappropriate complementary foods to the salt intake of 8-month-old infants
Background/Objective:
Complementary feeding is a critical developmental time for establishing variety, and appropriate feeding practices are important. These include recommendations for a maximum intake of sodium (salt), because of the potential harmful effect of excessive intake on the developing kidneys and blood pressure in later life. Sodium intakes were examined to establish, if inappropriate complementary feeding practices were contributing to high intakes.
Subjects/Methods:
Data were collected from a cohort of 1178 8-month-old infants born in 1991/92, participating in the Avon Longitudinal Study of Parents and Children, using a 3-day dietary records completed by their mothers. Sodium and energy intakes were calculated and infants were categorised into quartiles of sodium intake.
Results:
Majority of infants were first introduced to solids around 3–4 months, with plain baby rice, rusks and other cereals being the first foods consumed during complementary feeding. In the whole sample, 70% consumed in excess, of 400 mg sodium per day, the maximum UK recommendation for children up to age 12 months. The mean sodium intake for the highest quartile was 1060 mg per day. Infants in this quartile were often consuming cows’ milk as a main drink; eating three times the amount of bread compared with the lowest quartile and used salty flavourings such as yeast extract and gravy.
Conclusions:
Sodium intakes in this cohort of infants were higher than recommendations. Clear and practical education is needed on complementary feeding practice for mothers highlighting what foods to introduce and when. Manufacturers have a responsibility to reduce the sodium content of food products.
Journal Article
Baby-led weaning : the (not-so) revolutionary way to start solids and make a happy eater
\"Around 6 months, most babies are developmentally ready to self-feed. The philosophy behind baby-led weaning is to offer your baby healthy finger foods and let her determine how much or how little she wants to eat. The baby-led method has been proven to: Encourage healthy eating habits; Discourage pickiness; Help children learn to listen to their bodies; Build confident eaters... Baby-Led Weaning features at-a-glance nutrition and food tips as well as specific chapters on special diets and allergies.\"-- Provided by publisher.
BOOK
Weaning Preterm Infants from Mechanical Ventilation
Mechanical ventilatory support is required by a large number of neonates in respiratory failure. However, its use in preterm infants is frequently associated with acute complications and long-term respiratory sequelae. Therefore, it is recommended to avoid or limit the exposure to ventilatory support. This is a review of existing practices and novel strategies to achieve weaning of ventilatory support in this population.
Journal Article
Maternal anxiety during solid food introduction: insights from a comparative feeding practices study
Background
The introduction of solid foods to infants involves various feeding techniques other than traditional weaning (TW), such as baby-led weaning (BLW), and combination weaning (CW). While these methods are often studied for their nutritional implications, their impact on maternal mental health, particularly generalized anxiety disorder (GAD), remains understudied.
Research aim
This study aimed to explore the association between feeding practices (BLW, TW, and CW) and maternal GAD levels during the initial stages of solid food introduction.
Design
This study recruited mothers and their infants, categorizing them into three groups based on feeding practices: BLW, TW, and CW. Maternal GAD levels were assessed at regular intervals over a six-month period, allowing for the examination of any changes in anxiety levels associated with different feeding techniques. Additionally, maternal perceptions of BLW were compared between BLW and CW users to further contextualize anxiety levels.
Results
Our findings indicate that mothers practicing BLW experienced significantly greater levels of GAD across all six months than those using TW or CW. Compared with mothers in the TW (8.1 ± 3.3) and CW (8.3 ± 2.0) groups, mothers in the BLW group had the highest cumulative anxiety score (15.3 ± 1.7).
Conclusions
The results of our study revealed a persistent presence of GAD throughout the 6-month study period, with consistently higher levels observed among mothers who chose BLW compared to those who used other feeding methods. These findings highlight the need for healthcare providers to offer targeted support and guidance to mothers using baby-led weaning, helping to ease anxiety and improve feeding outcomes.
Journal Article
An Exploration of Complementary Feeding Practices, Information Needs and Sources
Following complementary feeding (CF) guidelines might be challenging for mothers lacking time, resources and/or information. We aimed to explore CF practices, information needs and channels used to obtain information in parents living in areas of socioeconomic deprivation. Sixty-four parents of infants aged 4–12 months completed a short questionnaire and 21 were interviewed. Mean (SD) weaning age was 5 ± 2.5 months, foods given >7 times/week included commercial baby foods (33%) and fruits (39%) while 86% gave formula daily. The main sources of CF information were friends and family (91%), the internet (89%) and health visitors (77%). Online forums (20%), e.g., Facebook and Netmums, were used to talk to other parents because they felt that “not enough” information was given to them by health professionals. Parents felt access to practical information was limited and identified weaning classes or online video tutorials could help meet their needs. Themes identified in qualitative findings were (1) weaning practices (i.e., concerns with child’s eating; and (2) information sources and needs (i.e., trust in the National Health Service (NHS) as a reliable source, need for practical advice). In conclusion, parents are accessing information from a number of non-evidence-based sources and they express the need for more practical advice.
Journal Article
Predictors of extubation readiness in preterm infants: a systematic review and meta-analysis
ContextA variety of extubation readiness tests have already been incorporated into clinical practice in preterm infants.ObjectiveTo identify predictor tests of successful extubation and determine their accuracy compared with clinical judgement alone.MethodsMEDLINE, Embase, PubMed, Cochrane Library and Web of Science were searched between 1984 and June 2016. Studies evaluating predictors of extubation success during a period free of mechanical inflations in infants less than 37 weeks’ gestation were included. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. After identifying and describing all predictor tests, pooled sensitivity and specificity estimates for the different test categories were generated using a bivariate random-effects model.ResultsThirty-five studies were included, showing wide heterogeneities in population characteristics, methodologies and definitions of extubation success. Assessments ranged from a few seconds to 24 hours, provided 0–6 cmH2O positive end-expiratory pressure and measured several clinical and/or physiological parameters. Thirty-one predictor tests were identified, showing good sensitivities but low and variable specificities. Given the high variation in test definitions across studies, pooling could only be performed on a subset. The commonly performed spontaneous breathing trials had pooled sensitivity of 95% (95% CI 87% to 99%) and specificity of 62% (95% CI 38% to 82%), while composite tests offered the best performance characteristics.ConclusionsThere is a lack of strong evidence to support the use of extubation readiness tests in preterm infants. Although spontaneous breathing trials are attractive assessment tools, higher quality studies are needed for determining the optimal strategies for improving their accuracy.
Journal Article
Complementary Feeding: Tradition, Innovation and Pitfalls
According to WHO, “complementary feeding (CF) is the process starting when breast milk alone or infant formula alone is no longer sufficient to meet the nutritional requirements of infants, and therefore, other foods and liquids are needed, along with breast human milk or a breastmilk substitute”. CF is one of the most important “critical and sensitive periods” in human life: indeed, timing and approaches to solid foods introduction in an infant’s nutrition are of utmost importance as potential epigenetic factors from infancy to adulthood. CF is also deeply influenced by each country and single-family traditions, culture, and beliefs. The aim of our narrative review is to analyze traditional CF practices, including innovative and alternative ones that emerged in the last decades, such as baby-led weaning or plant-based weaning, and to evaluate their effects on the risk of developing non-communicable diseases. Moreover, we will discuss pitfalls and misunderstandings that pediatricians frequently have to face when dealing with complementary feeding. Health care professionals must not have prejudices against parents’ wishes or traditions about CF; rather, they should support and educate them in case of any alternative CF choice, always pursuing the infant’s adequate growth, neuro- and taste development, and the achievement of correct eating behavior as the primary goal.
Journal Article