BEBEK LİDERLİĞİNDE BESLENME VE GELENEKSEL TAMAMLAYICI BESLENME EĞİTİMİNİN BEBEK GELİŞİMİNE ETKİSİ: PROTOKOL ÇALIŞMASI

Öz

Amaç: Bu çalışmada, Geleneksel tamamlayıcı beslenme (TCF) ve bebek liderliğinde beslenme (BLW) yöntemleri ile verilen tamamlayıcı beslenme eğitimlerinin 6 ve 12 aylık bebeklerde kendi kendine beslenme, erken katı gıdalara ve ev yemeğine geçiş, boğulma, anemi ve obezite risklerinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Bu çalışma, TCF ve BLW yöntemlerine ilişkin eğitimlerin tamamlayıcı beslenmeye geçiş üzerindeki etkisini incelemek amacıyla yapılmış deneysel ve randomize kontrollü bir çalışmadır. Araştırmanın evrenini, tabakalı randomizasyon yöntemiyle müdahale gruplarına atanan 4 ve 5 aylık 73 bebekten 62’si oluşturmuştur. Çalışma CONSORT-2010 kontrol listesine göre yürütüldü. Her iki müdahale grubunda da bebeğin ay cinsinden yaşına uygun sekiz seanslık beş tamamlayıcı beslenme modüler eğitimi gerçekleştirildi. Her iki grupta da eğitimler bebek 4 aylıktan 12 aylık oluncaya kadar devam edildi. Sonuçlar boy, kilo alımı, 12 ayda (yaşa göre boy) LAZ, (yaşa göre ağırlık) WAZ ve (boya göre ağırlık) WLZ skorları, demir alımı, hemoglobin, hematokrit ve ferritin seviyeleri, mikro besinler, boğulma riski, büyüme geriliği, katı gıdalara geçiş süresi, aile yemekleri ve kendi kendine beslenme, tamamlayıcı beslenmeye geçiş davranışları ve gelişimsel değerlendirme parametrelerini içermektedir. Uygulamaya Yönelik Öneriler: Bu çalışmanın, verilen eğitimlerin bebeğin vücut ağırlığını, büyüme ve gelişimini, demir ve mikro besin alımını, obezite, boğulma ve büyüme geriliği risklerini ne ölçüde etkilediği konusunda fikir vermesi beklenmektedir.

Anahtar Kelimeler

• Bebek liderliğinde beslenme
• geleneksel tamamlayıcı beslenme
• obezite riski
• demir eksikliği
• anemi riski
• büyüme geriliği

The Effect of Baby-Led Weaning and Traditional Complementary Feeding Trainings on Baby Development: Study Protocol

Öz

Aim: In this study, it was aimed to evaluate the risks of self-feeding, transition to early solids and home meals, choking, anemia and obesity in 6-and 12-month-old infants who were introduced to complementary feeding with the trainings of traditional complementary feeding (TCF) and baby-led weaning (BLW) methods. Material and Method: This study is an experimental and randomized controlled study conducted to examine the effect of the trainings of the TCF and BLW methods on the transition to complementary feeding. The population of the study consisted of 73 infants aged 4 and 5 months who 62 were assigned to intervention groups by stratified randomization method. The study was conducted according to the CONSORT-2010 checklist. Five complementary feeding modular trainings with 8 sessions, appropriate for the age of the baby in months, were carried out in both intervention groups. In both groups, the trainings were maintained until the baby was 4 months to 12 months old. The outcomes consisted of height, weight gain, LAZ (Length for age z-score), WAZ (Weight for age z-score), and WLZ (Weight for length z-score) scores at 12 months, iron intake, hemoglobin, hematocrit, and ferritin levels, micronutrients, choking risk, growth retardation, transition time to solid foods, family meals and self-feeding, behaviors of transition to complementary feeding and developmental assessment parameters. Practice Implications: This study, the trainings given are expected to give an idea about the extent to which they affect the infant's body weight, growth and development, iron and micronutrient intake, obesity, choking and growth retardation risks..

Anahtar Kelimeler

• Weaning
• complementary feeding
• pediatric obesit
• anemia
• iron deficiency

Kaynakça

1. Addessi, E., Galloway, A. T., Wingrove, T., Brochu, H., Pierantozzi, A., Bellagamba, F., & Farrow, C. V. (2021). Baby-led weaning in Italy and potential implications for infant development. Appetite, 164, 105286. https://doi.org/10.1016/j.appet.2021.105286
2. Alvisi, P., Brusa, S., Alboresi, S., Amarri, S., Bottau, P., Cavagni, G., ... & Agostoni, C. (2015). Recommendations on complementary feeding for healthy, full-term infants. Italian journal of pediatrics, 41(1), 1-9. DOI 10.1186/s13052-015-0143-5
3. Brown, A., & Lee, M. (2011). A descriptive study investigating the use and nature of baby‐led weaning in a UK sample of mothers. Maternal & child nutrition, 7(1), 34-47. https://doi.org/10.1111/j.1740-8709.2010.00243.x
4. Brown, A., & Lee, M. D. (2015). Early influences on child satiety‐responsiveness: the role of weaning style. Pediatric obesity, 10(1), 57-66. https://doi.org/10.1111/j.2047-6310.2013.00207.x
5. Cameron, S. L., Heath, A. L. M., & Taylor, R. W. (2012). Healthcare professionals’ and mothers’ knowledge of, attitudes to and experiences with, baby-led weaning: a content analysis study. BMJ open, 2(6), e001542. doi:10.1136/bmjopen-2012-001542
6. Cameron, S. L., Taylor, R. W., & Heath, A. L. M. (2015). 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 pediatrics, 15(1), 1-11. https://doi.org/10.1186/s12887-015-0422-8
7. Cameron, S. L., Taylor, R. W., & Heath, A. L. M. (2013). Parent-led or baby-led? Associations between complementary feeding practices and health-related behaviours in a survey of New Zealand families. BMJ open, 3(12), e003946, 1-9. doi:10.1136/bmjopen-2013-003946
8. Daniels, L., Heath, A. L. M., Williams, S. M., Cameron, S. L., Fleming, E. A., Taylor, B. J., ... & Taylor, R. W. (2015). Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding. BMC pediatrics, 15(1), 1-15. https://doi.org/10.1186/s12887-015-0491-8

9. Daniels, L., Taylor, R. W., Williams, S. M., Gibson, R. S., Fleming, E. A., Wheeler, B. J., ... & Heath, A. L. M. (2018). Impact of a modified version of baby-led weaning on iron intake and status: a randomised controlled trial. BMJ open, 8(6), e019036. https://doi.org/10.1136/bmjopen-2017-019036
10. Devecioğlu, E. & Gökçay, G. (2012). Tamamlayıcı beslenme. Çocuk Dergisi, 12(4), 159-163.
11. Dogan, E., Yilmaz, G., Caylan, N., Turgut, M., Gokcay, G., & Oguz, M. M. (2018). Baby‐led complementary feeding: Randomized controlled study. Pediatrics International, 60(12), 1073-1080. https://doi.org/10.1111/ped.13671
12. Fewtrell, M., Wilson, D. C., Booth, I., & Lucas, A. (2011). Six months of exclusive breast feeding: how good is the evidence? Bmj, 342- c5955. https://doi.org/10.1136/bmj.c5955
13. Köksal, E., Yalçin, S. S., Pekcan, G., Özbas, S., Tezel, B., & Köse, M. R. (2015). Complementary feeding practices of children aged 12-23 months in Turkey. Central European Journal Of Public Health, 23(2), 149.
14. Kurtuncu, M., Arslan, N. & Eyupoglu, N.D. (2018). A Baby Friendly Approach to Complementary Nutrition. Ed: Efe R. Health Sciences Research In The Globalizing World ISBN: ISBN978-954-07-4525-1, pp. 355-364, St. Kliment Ohridski University Press, Bulgaristan.
15. Moore, A. P., Milligan, P., & Goff, L. M. (2014). An online survey of knowledge of the weaning guidelines, advice from health visitors and other factors that influence weaning timing in UK mothers. Maternal & child nutrition, 10(3), 410-421. https://doi.org/10.1111/j.1740-8709.2012.00424.x
16. Morison, B. J., Heath, A. L. M., Haszard, J. J., Hein, K., Fleming, E. A., Daniels, L., ... & Taylor, R. W. (2018). Impact of a modified version of baby-led weaning on dietary variety and food preferences in infants. Nutrients, 10(8), 1092. https://doi.org/10.3390/nu10081092
17. Morison, B. J., Taylor, R. W., Haszard, J. J., Schramm, C. J., Erickson, L. W., Fangupo, L. J., ... & Heath, A. L. M. (2016). How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6–8 months. BMJ open, 6(5), e010665,1-11. https://doi.org/10.1136/bmjopen-2015-010665
18. Pearce, J., & Langley‐Evans, S. C. (2022). Comparison of food and nutrient intake in infants aged 6–12 months, following baby‐led or traditional weaning: A cross‐sectional study. Journal of Human Nutrition and Dietetics, 35(2), 310-324. https://doi.org/10.1111/jhn.12947
19. Pekcan, A.G. (2018). Tamamlayıcı Beslenme: Avrupa Pediatrik Gastroenteroloji, Hepatoloji ve Beslenme (ESPHGAN) Birliği Komitesi Görüş Raporu. Beslenme ve Diyet Dergisi, 46(1), 1-6.
20. Rapley, G. (2011). Baby -led weaning: transitioning to solid foods at the baby’s own pace. Community Practice, 84(6), 20-23.
21. Taylor, R. W., Conlon, C. A., Beck, K. L., von Hurst, P. R., Te Morenga, L. A., Daniels, L., ... & Heath, A. L. M. (2021). Nutritional implications of baby-led weaning and baby food pouches as novel methods of infant feeding: Protocol for an observational study. JMIR Research Protocols, 10(4), e29048. https://www.researchprotocols.org/2021/4/e29048
22. Taylor, R. W., Williams, S. M., Fangupo, L. J., Wheeler, B. J., Taylor, B. J., Daniels, L., ... & Heath, A. L. M. (2017). Effect of a baby-led approach to complementary feeding on infant growth and overweight: a randomized clinical trial. JAMA pediatrics, 171(9), 838-846. https://doi.org/10.1001/jamapediatrics.2017.1284
23. Townsend, E., & Pitchford, N. J. (2012). Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case–controlled sample. BMJ open, 2(1), e000298. https://doi.org/10.1136/bmjopen-2011-000298
24. Williams Erickson, L., Taylor, R. W., Haszard, J. J., Fleming, E. A., Daniels, L., Morison, B. J., ... & Heath, A. L. M. (2018). Impact of a modified version of baby-led weaning on infant food and nutrient intakes: the BLISS randomized controlled trial. Nutrients, 10(6), 740-756. https://doi.org/10.3390/nu10060740
25. World Health Organization (WHO). Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. 2009. https://apps.who.int/iris/handle/10665/44117.
26. Wright, C. M., Cameron, K., Tsiaka, M., & Parkinson, K. N. (2011). Is baby‐led weaning feasible? When do babies first reach out for and eat finger foods?. Maternal & child nutrition, 7(1), 27-33. https://doi.org/10.1111/j.1740-8709.2010.00274.x
27. Yazıcı, B. (2019). Çocuklarda Tamamlayıcı Beslenme. Klinik Tıp Pediatri Dergisi, 11(5):245-254.