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Çocuklarda Tamamlayıcı Beslenme

Year 2019, Volume: 11 Issue: 5, 245 - 254, 01.09.2019

Abstract

Çocuklarda Tamamlayıcı beslenme tek başına anne sütünün yetmediği dönemde
besinsel gereksinimleri karşılamak için anne sütü ile birlikte anne sütü veya formül
mama dışında gıdaların verilmesidir. Bir başka deyişle, emzirilen bebeğin yaşına
ve gelişim basamaklarına uygun yeni besin maddelerini alması, besin madde çeşitliliği,
dengeli ve yeterli beslenmenin sağlanması, kendi kendini besleyebilir hale
gelmesi demektir. Ek besin olarak da adlandırılır. İki grupta incelenir; sütçocuğu için
özel hazırlanmış geçiş besinleri ve birlikte tükettiği aile yemekleri. Uygun zamanda
başlatılan ve uygun şekilde verilen tamamlayıcı beslenme bebeğin bir yaşında aile
sofrasında yiyecekleri tüketebilecek olgunluğa ulaşmasını sağlamaktadır. Doğumdan
itibaren ilk 6 ay anne sütü tek başına bebeğin enerji ve besin ihtiyaçlarını karşılamaktadır.
Ancak 6 aydan sonra anne sütü bebeğin gereksinimlerini karşılayamamaktadır.
Bu nedenle 6.aydan sonra anne sütüne ek olarak tamamlayıcı beslenmeye
başlanmalıdır. Tamamlayıcı beslenmeye başlarken önemli olan uygun zamanda
başlanmalı, miktarı ve verilme şekli bebeğin yaşına uygun seçilmeli, besin içeriği enerji,
protein, yağ ve mikrobesin gereksinimini karşılayabilmeli, güvenilir olmalı, temiz
ve hijyenik koşullarda hazırlanmalı ve bebeğin keyif alacağı bir öğünü olarak
düzenlenmelidir. Sadece anne sütü alanlar bebeklerde en erken 4 ay (17 hafta, 5.ayın
başlangıcı) ve 6 ay (26.hafta, 7.ayın başlangıcı) olarak önerilmektedir. Tamamlayıcı
gıdanın (anne sütü veya formül mama hariç tüm katı veya sıvı gıda) 4.aydan önce
veya 6.aydan sonra başlanmaması gerekmektedir. Besin seçiminin ise çeşitli tat ve
şekillerde hazırlanmalı, acımtırak tatlar dahil tüm yeşil sebzeler kullanılarak sebze
püresi şeklinde başlanması bebeğin katı gıdaya geçişinde ara basamak olarak denenebilir.
Tamamlayıcı gıdalar 4 ile 6 ay arasında ise tanıştırma amaçlı kullanılmalı,
asla ana öğün olmamalıdır. Tamamlayıcı gıda miktarının artması anne sütü verilme
miktarını azaltabilir. Bal ve inek sütü 1 yaşından önce önerilmemektedir. Alerjen gıdalar
ise 4 aydan önce tattırılmamalıdır. Yüksek alerji riski olan gıdaların özellikle
fıstığın, yumurtanın alerji uzmanlarının kontrolü altında 4 ile 11 ay arasında verilmesi
önerilmektedir. Gluten içeren gıdalar 4 ve 12.ay arasında başlanabilir, ancak
ilk haftalarında gluten içeriğinin fazla miktarda verilmemesi önerilmektedir. Glutenin 4.aydan önce başlanması Çölyak riskini arttırmaktadır.
Anne sütündeki demir içeriği azaldığından tamamlayıcı
gıdanın besin içeriğinin demir içerikli gıdalarla veya
etle desteklenmelidir. Vegan diyetler sadece uzmanlar ve
diyetisyenler kontrolünde uygulanabilir. Şeker ve tuz kesinlikle
eklenmemelidir. Meyve suları ve şekerli gıdalarda
uzak durulmalıdır. Beslenme zamanını aileler bebeklerinin
açlık ve tokluk durumuna göre ayarlamalıdır.

References

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  • 29. Morgan J, Taylor A, Fewtrell MS. Meat consumption is positively associated with psychomotor outcome in children up to 24 months of age. J Pediatr Gastroenterol Nutr 2004; 39: 493-98.
  • 30. Krebs NF. Meat as first complementary food for breastfed infants: feasibility and impact on zinc intake and status. J Pediatr Gastroenterol Nutr 2006; 42: 207-14.
  • 31. Harslof LB, Larsen LH, Ritz C, et al. FADS genotype and diet are important determinants of DHA status: a cross-sectional study in Danish infants. Am J Clin Nutr 2013; 97: 1403-10.
  • 32. Makrides M, Hawkes JS, Neumann MA, et al. Nutritional effect of including egg yolk in the weaning diet of breast-fed and formula-fed infants: a randomised clinical trial. Am J Clin Nutr 2002; 75: 1084-92.
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  • 36. Nehring I, Kostka T, Von Kries R, et al. Impacts of in utero and early infant taste experiences on later taste acceptance: a systematic review. J Nutr 2015; 145: 1271-79.
  • 37. Remy E, Issanchou S, Chabanet C, et al. Repeated exposure of infants at complementary feeding to a vegetable puree increases acceptance as effectively as flavour –flavour learning and more effectively than flavour-nutrient learning. J Nutr 2013; 143: 1194-200.
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  • 39. Cameron SL, Taylor RW, Health ALM. Development and pilot testing of baby-led introduction to solids-a version of baby-led weaning modified to address concerns about iron deficiency, growth faltering and choking. BMC Pediatr 2015; 57: 826-31.
  • 40. WHO Complementary Feeding: Family foods for breastfed children. France: FSG MediMedia Ltd; 2000: 1-51.
  • 41. Demirci M, Gündüz H. Süt Teknoloğunun El Kitabı, Hasad Yayınevi, 1991.
  • 42. Kurt A, Çakmakçı S, Çağlar A. Süt ve mamülleri muayene ve analiz metodları rehberi. Atatürk Üniversitesi 1993; 5: 252.
  • 43. Gönç S. Yoğurtta fermentasyon, aroma maddeleri oluşumu ve soğutmanın önemi. 3.Milli Süt ve Süt Ürünleri Sempozyumu, İstanbul, 1994.
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  • nutrional interventions on the development of atopic disease in infants and children: the role of maternal diet restriction, breastfeeding, timing of introduction complementary foods, and hydrolyzed formula. Pediatrics 2008; 121: 183-91.
  • 47. Krasevec J, et al. Age-appropriate complementary feeding practices are far from optimal among low and middle-income countries. Matern Child Nutr 2017; 13: 2.
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  • 52. Lionetti E, Castellaneta S, Francavilla R, et al. Introduction of gluten, HLA status and the risk of celiac disease in children. NEJM 2014; 371: 1295.
  • 53. Szajewska H, Shamir R, Chmielewska A, et al. PREVENTCD Study Group. Systematic review with meta-analysis: early infant feeding and coeliac disease-update 2015. Aliment Pharmacol Ther 2015; 41: 1038-54.
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  • 55. Cohen RJ, Brown KH. Determinants of growth from birth to 12 months among breast-fed Honduras infants in relation to age of introduction of complementary foods. Pediatrics 1995; 96: 504-10.
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  • 57. Damsgaard CT, Schack-Neilsen L, Michaelsen KF, et al. Fish oil affects blood pressure and the plasma lipid profile in healthy Danish infants. J Nutr 2006; 136: 94-99.
  • 58. Golley RK, Smithers LG, Mittinity MN, et al. Diet quality of UK infants is associated with dietary, adiposity, cardiovascular and cognitive outcomes measured at 7-8 years of age. J Nutr 2013; 143: 1611-17.
  • 59. Smithers LG, Golley RK, Mittinity MN, et al. Dietary patterns at 6, 15 and 24 months of age are associated with IQ at 8 years of age. Eur J Epidemiol 2012; 27: 525-35.
  • 60. Nyardi A, Li J, Foster JK, et al. Good-quality diet in the early years may have a positive effect on academic achievement. Acta Paediatr 2016; 105: e209-18.
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Year 2019, Volume: 11 Issue: 5, 245 - 254, 01.09.2019

Abstract

References

  • 1. WHO (World Health Organization). 2002 Complementary feeding, Report of the Global Consultation. Geneva, 10-13 December 2001. Summary of Guiding Principles. Accessed March 11, 2016.
  • 2. Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding; a systematic review. Geneva. World Health Organization 2002.
  • 3. WHO. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. Geneva. World Health Organization, 2009.
  • 4. World Health Organization (WHO). 2002. 55th World Health Assembly. Infant and Young Child Nutrition (WHA55.25). Accessed March 11, 2016.
  • 5. Agostoni C, Decsi T, Fewtrell M, et al. ESPGHAN Commitee on Nutrition, Complementary Feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutrition 2008; 46: 99-110.
  • 6. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) Scientific opinion on the appropriate age for introduction of complementary feeding of infants. EFSA J 2009; 7: 1423.
  • 7. Committee on Nutrition American Academy of Pediatrics. Complementary feeding. In: Kleinman RE, (ed). Pediatric Nutrition Handbook, 6th ed. American Academy of Pediatrics; 2009: 113-30.
  • 8. Fewtrell M, Bronksky J, Campoy C, et al. Complementary feeding: a position paper by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on nutrition. J Pediatr Gastroenterol Nutr 2017; 64: 119-32.
  • 9. Kramer MS, Guo T, Platt RW, et al. Infant growth and health outcomes associated with 3 compared with 6 mo of exclusive breastfeeding. Am J Clin Nutr 2003; 78: 291-95.
  • 10. Swedish National food Agency. Good food for infants under one year. Accessed March 11, 2016.
  • 11. Lanting CI, Heerdink-Obenhujsen HLL, Schuit-van Raamsdonk EMM, et al. JGZ-Richtling Voeding en Eetgedrag. Nederlands Centrum jeugdgezondheid, Utrecht 2013.
  • 12. Mehta K, Specker B, Bartholmey S, et al. Trial on timing of introduction to solids and food type on infant growth. Pediatrics 1998; 102: 569-73.
  • 13. EFSA NDA Panel. Scientific opinion on nutrient requirements and dietary intakes of infants and young children in the European Union. EFSA J 2013; 11: 3408.
  • 14. Kersting M. Nutrition of the healthy infant–food and meal related recommendations. Monatsschrift Kinderheilkunde 2001; 149: 4-10.
  • 15. Naylor AJ, Morrow A, editors. Developmental Readiness of Normal Full Term Infants to Progress from Exclusive Breastfeeding to the Introduction of Complementary Foods: Reviews of the Relevant Literature Concerning Infant Immunologic,
  • Gastrointestinal, Oral Motor and Maternal Reproductive and Lactational Development. Washington, DC: Weellstart International and the LINKAGES Project/Academy for Educational Development; 2001. Accessed March 11.2016.
  • 16. Mihatsch W, Braegger C, Bronsky J, et al. Prevention of vitamin K deficiency bleeding in newborn infants: a position paper by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2016; 63: 123-29.
  • 17. Braegger C, Campoy C, Colomb V, et al. ESPGHAN Committee on Nutrition. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr 2013; 56: 692-701.
  • 18. WHO. Guiding principles for feeding non breastfed children 6-24 months of age. WHO Press, World Health Organization, Geneva, Switzerland, 2005: 1-42.
  • 19. Daelmans B, Martines J, Saadeh R. Special issue based on a World Health Organization expert consultation on complementary feeding. Food and Nutrition Bulletin, 2003; 24: 1-44.
  • 20. Dewey KG, Cohen RJ, Rivera LL, et al. Effects of age of introduction of complementary foods on iron status breastfed infants in Honduras. Am J Clin Nutr 1998; 67: 878-84.
  • 21. Jonsdottir OH, Thorsdottir I, Hibberd PL, et al. Timing of the introduction of complementary foods in infancy: a randomized controlled trail. Pediatrics 2012; 130: 1038-45.
  • 22. Domellöf M, Braegger C, Campoy C, et al. ESPGHAN Committee on Nutrition. Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr 2014; 58: 119-29.
  • 23. EFSA NDA Panel, Scientific opinion on nutrient requirements and dietary intakes of infants and young children in European Union. EFSA J 2013; 11: 3408.
  • 24.Monterio PO, Victoria CG. Rapid growth in infancy and childhood and obesity in later life: a systematic review. Obes Rev 2005; 6: 143-54.
  • 25. Ong K, Loos R. Rapid infancy weight gain and subsequent obesity –systematic reviews and hopeful suggestion. Acta Paediatr 2006; 95: 904-908.
  • 26. Hörnell A, Lagström H, Lande B, et al. Protein intake from 0 to 18 years of age and its relation to health: a systematic review for the 5th Nordic Nutrition Recommendations. Food Nutr Res 2013: 57.
  • 27. EFSA NDA Panel. Scientific opinion on the essential composition of infant and follow –on formulae. EFSA J 2014; 12: 3760.
  • 28. Hopkins D, Steer CD, Northstone K, et al. Effects on childhood body habitus of feeding large volumes of cow or formula milk compared with breastfeeding in the latter part of infancy. Am J Clin Nutr 2015; 102: 1096-103.
  • 29. Morgan J, Taylor A, Fewtrell MS. Meat consumption is positively associated with psychomotor outcome in children up to 24 months of age. J Pediatr Gastroenterol Nutr 2004; 39: 493-98.
  • 30. Krebs NF. Meat as first complementary food for breastfed infants: feasibility and impact on zinc intake and status. J Pediatr Gastroenterol Nutr 2006; 42: 207-14.
  • 31. Harslof LB, Larsen LH, Ritz C, et al. FADS genotype and diet are important determinants of DHA status: a cross-sectional study in Danish infants. Am J Clin Nutr 2013; 97: 1403-10.
  • 32. Makrides M, Hawkes JS, Neumann MA, et al. Nutritional effect of including egg yolk in the weaning diet of breast-fed and formula-fed infants: a randomised clinical trial. Am J Clin Nutr 2002; 75: 1084-92.
  • 33. Birch EE, Hoffman DR, Castaneda YS, et al. A randomized controlled trial of long-chain polyunsatured fatty acid supplementation of formula in term infants after weaning at 6 wk of age. Am J Clin Nutr 2002; 75: 570-80.
  • 34. Hoffman DR, Birch EE, Castenada YS, et al. Visual function in breastfed term infants weaned to formula with or without long-chain polyunsaturates at 4 to 6 months; a randomized clinical trial. J Pediatr 2003; 142: 669-77.
  • 35.Mennella JA. Ontogeny of taste preferences: basic biology and implications for health. Am Clin Nutr 2014; 99: 704S-711.
  • 36. Nehring I, Kostka T, Von Kries R, et al. Impacts of in utero and early infant taste experiences on later taste acceptance: a systematic review. J Nutr 2015; 145: 1271-79.
  • 37. Remy E, Issanchou S, Chabanet C, et al. Repeated exposure of infants at complementary feeding to a vegetable puree increases acceptance as effectively as flavour –flavour learning and more effectively than flavour-nutrient learning. J Nutr 2013; 143: 1194-200.
  • 38. Cameron SL, Health ALM, Taylor RW. How feasible is babyled weaning as an approach to infant feeding: a review of the evidence. Nutrients 2012; 4: 1575-609.
  • 39. Cameron SL, Taylor RW, Health ALM. Development and pilot testing of baby-led introduction to solids-a version of baby-led weaning modified to address concerns about iron deficiency, growth faltering and choking. BMC Pediatr 2015; 57: 826-31.
  • 40. WHO Complementary Feeding: Family foods for breastfed children. France: FSG MediMedia Ltd; 2000: 1-51.
  • 41. Demirci M, Gündüz H. Süt Teknoloğunun El Kitabı, Hasad Yayınevi, 1991.
  • 42. Kurt A, Çakmakçı S, Çağlar A. Süt ve mamülleri muayene ve analiz metodları rehberi. Atatürk Üniversitesi 1993; 5: 252.
  • 43. Gönç S. Yoğurtta fermentasyon, aroma maddeleri oluşumu ve soğutmanın önemi. 3.Milli Süt ve Süt Ürünleri Sempozyumu, İstanbul, 1994.
  • 44. Anonim, 1989. Yoğurt. T.S.1330. T.S.E.Ankara.
  • 45. Anonim, 2001. Türk Gıda Kodeksi, T.C.Resmi Gazete, Ankara.
  • 46. Greer FR, Sicherer SH, Burks AW; American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Allergy and Immunology. Effects of early
  • nutrional interventions on the development of atopic disease in infants and children: the role of maternal diet restriction, breastfeeding, timing of introduction complementary foods, and hydrolyzed formula. Pediatrics 2008; 121: 183-91.
  • 47. Krasevec J, et al. Age-appropriate complementary feeding practices are far from optimal among low and middle-income countries. Matern Child Nutr 2017; 13: 2.
  • 49. Du Toit G, Katz Y, Sasieni P, et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol 2008; 122: 984-91.
  • 50. Muraro A, Halken S, Arshad SH, et al, EAACI Food Allergy and Anaphylaxis Guidelines Group. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy. Allergy 2014; 69: 590-601.
  • 51. Vriezinga SL, Auricchio R, Bravi E, et al. Randomized feeding intervention in infants at high risk for celiac disease. N Engl J Med 2014; 371: 1304-15.
  • 52. Lionetti E, Castellaneta S, Francavilla R, et al. Introduction of gluten, HLA status and the risk of celiac disease in children. NEJM 2014; 371: 1295.
  • 53. Szajewska H, Shamir R, Chmielewska A, et al. PREVENTCD Study Group. Systematic review with meta-analysis: early infant feeding and coeliac disease-update 2015. Aliment Pharmacol Ther 2015; 41: 1038-54.
  • 54. Piescik-Lech M, Chmielewska A, Shamir R, et al. Systematic review: early infant feeding and the risk of type 1 diabetes. J Pediatr Gastroenterol Nutr 2016.
  • 55. Cohen RJ, Brown KH. Determinants of growth from birth to 12 months among breast-fed Honduras infants in relation to age of introduction of complementary foods. Pediatrics 1995; 96: 504-10.
  • 56. Daniels L, Mallan KM, Fildes A, et al. The timing of solid introduction in an “obesogenic” environment: a narrative review of the evidence and methodological issues. Aust NZ J Public Health 2015; 39: 366-73.
  • 57. Damsgaard CT, Schack-Neilsen L, Michaelsen KF, et al. Fish oil affects blood pressure and the plasma lipid profile in healthy Danish infants. J Nutr 2006; 136: 94-99.
  • 58. Golley RK, Smithers LG, Mittinity MN, et al. Diet quality of UK infants is associated with dietary, adiposity, cardiovascular and cognitive outcomes measured at 7-8 years of age. J Nutr 2013; 143: 1611-17.
  • 59. Smithers LG, Golley RK, Mittinity MN, et al. Dietary patterns at 6, 15 and 24 months of age are associated with IQ at 8 years of age. Eur J Epidemiol 2012; 27: 525-35.
  • 60. Nyardi A, Li J, Foster JK, et al. Good-quality diet in the early years may have a positive effect on academic achievement. Acta Paediatr 2016; 105: e209-18.
  • 61. Selimoğlu MA. Sağlıkta ve Hastalıkta Çocuk Beslenmesi. Akademi Yayınevi, 2014; 55-62.
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There are 69 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section makale
Authors

Banu Yazıcı This is me

Publication Date September 1, 2019
Published in Issue Year 2019 Volume: 11 Issue: 5

Cite

APA Yazıcı, B. (2019). Çocuklarda Tamamlayıcı Beslenme. Klinik Tıp Pediatri Dergisi, 11(5), 245-254.
AMA Yazıcı B. Çocuklarda Tamamlayıcı Beslenme. Pediatri. September 2019;11(5):245-254.
Chicago Yazıcı, Banu. “Çocuklarda Tamamlayıcı Beslenme”. Klinik Tıp Pediatri Dergisi 11, no. 5 (September 2019): 245-54.
EndNote Yazıcı B (September 1, 2019) Çocuklarda Tamamlayıcı Beslenme. Klinik Tıp Pediatri Dergisi 11 5 245–254.
IEEE B. Yazıcı, “Çocuklarda Tamamlayıcı Beslenme”, Pediatri, vol. 11, no. 5, pp. 245–254, 2019.
ISNAD Yazıcı, Banu. “Çocuklarda Tamamlayıcı Beslenme”. Klinik Tıp Pediatri Dergisi 11/5 (September 2019), 245-254.
JAMA Yazıcı B. Çocuklarda Tamamlayıcı Beslenme. Pediatri. 2019;11:245–254.
MLA Yazıcı, Banu. “Çocuklarda Tamamlayıcı Beslenme”. Klinik Tıp Pediatri Dergisi, vol. 11, no. 5, 2019, pp. 245-54.
Vancouver Yazıcı B. Çocuklarda Tamamlayıcı Beslenme. Pediatri. 2019;11(5):245-54.