Complementary Feeding For Healthy, Full-Term Infants

Yıl 2018, Cilt: 10 Sayı: 6, 6 - 12, 15.11.2018

Doç. Dr. Ömer Faruk Beşer

Öz

bstract

Introduction of complementary feeding is a very special and important period forgrowth of the children. It can play a major role in the infant’s future health.  Until today, this period is recognized as a critical window for promoting optimal growth, development, and good health. Not only in the short term but in the medium and longterm, appropriate feeding at this stage of life has an impact on health, nutritional status, and development of children. Besides, the role played by complementary feeding,for the onset of later diseases (i.e. type-2 diabetes, metabolic syndrome, obesity) has also been increasingly highlighted. The development of food preferences mainly starts when infants discover their firstsolid foods. The correct orientation of this period will ensure that the children have good nutritional habits in the-ir future life. In this context, exclusive or full breast-feeding should be promoted for 6 months. Complementary foods (solids and liquids other than breast milk or infant formula) should not be introduced before 4 months but should not be delayed beyond 6 months. Continued breast-feeding is recommended alongside complementary feeding.This review includes recommendations on complementary feeding, focussing on healthy term infants.

Anahtar Kelimeler

Infant feeding, healthy infants, complementary feeding

Zamanında Doğmuş Sağlıklı Çocuklarda Tamamlayıcı Beslenme

Öz

Öz

Tamamlayıcı beslenme dönemi çocukların büyümesi için çok özel ve önemli bir dönemdir. Bu dönem bebeğin yaşam boyu sağlığına etki edebilmektedir. Hayatın ilk iki yılı optimal büyüme ve gelişmenin sağlanması için kritik bir pencere olarak kabul edilmektedir. Yaşamın bu dönemindeki uygun beslenme, sadece kısa vadede değil orta ve uzun vadede de çocukların fizyolojik, nörolojik, psikolojik gelişimi üzerine etki edebilmektedir. Tamamlayıcı beslenme düzgün uygulanmazsa yaşamın ile-riki dönemlerinde oluşabilecek diabet, obezite gibi hastalıklara zemin hazırlayabilmektedir. Bu dönemin doğru yönetimi, çocukların gelecekteki yaşamlarında iyi beslenme alışkanlıklarına sahip olmasını sağlayacaktır. İlk 6 ayda bağışıklığın, sindirim enzimlerinin, mikrobiyotanın henüz tam gelişmediği göz önünde tutulduğunda, büyüme-gelişme,  nörolojik gelişim ve bağışıklığın olgunlaşması için tek seçenek annesütüdür. İlk 6 ayda sadece anne sütüyle beslenme teşvik edilmelidir. Tamamlayıcı beslenmeye 16. haftadan önce asla başlanmamalı, altıncı aydan daha geçe de bırakılmamalıdır.  Altıncı aydan sonra başlanan ek gıda temel besin olan anne sütüne ektir, azar azar başlanmalıdır ve ilk aylarda gün içinde ikiden fazla ek gıda verilmemelidir. Bu derlemede tamamlayıcı beslenmede uygun zamanlama, miktar ve içeriğin nasıl olması gerektiği ve bunların sağlık üzerine etkileri ele alınmıştır.

Anahtar Kelimeler

Bebek beslenmesi, sağlıklı sütçocukları, tamamlayıcı beslenme.

Kaynakça

• Kaynaklar 1.WHO (World Health Organization). 2002. ComplementaryFeeding. Report of the Global Consultation. Geneva, 10–13December 2001. Summary of Guiding Principles. http://www.who.int/nutrition/publications/Complementary_Feeding.pdf. 2.EFSA Panel on Dietetic Products, Nutrition and Allergies(NDA). Scientific opinion on the appropriate age for introduc-tion of complementary feeding of infants. EFSA J 2009;7:1423. 3.Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Ko-letzko B, et al. ESPGHAN Committee on Nutrition. Comple-mentary feeding: a commentary by the ESPGHAN Commit-tee on Nutrition. J Pediatr Gastroenterol Nutr 2008;46:99–110. 4.Bier DM. Growth in the First Two Years of Life. In: BarkerDJ,Bergman RL, Ogra PL, editors. The window of opportunity:pre-pregnancy to 24 months of age. Nestle Nutrition WorkshopSeri-es Pediatric Program. Basel: Karger; 2009. p. 135-44. 5.Iozzo P, Sanguinetti E. Early Dietary Patterns and Microbio-ta Development: Still a Way to Go from Descriptive Interac-tions to Health-Relevant Solutions. Front Nutr 2018;5:5. 6.Koletzko B, Shamir R, Phillip M. World Review of Nutritionand Dietetics. Nutrition and growth. Preface. World Rev NutrDiet 2014;109:IX. 7.Johnston M, Landers S, Noble L, Szucs K, Viehmann L. Bre-astfeeding and the use of human milk. Pediatrics2012;129(3):e827-41. 8.T.C. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdür-lüğü Beslenme ve Fiziksel Aktiviteler Daire Başkanlığı, Sağ-lık Bakanlığı ‘Anne Sütü’ Kitapçığı, Yayın No: 726 ISBN:978-975-590-242-5. 9.Kramer MS, Kakuma R. Optimal duration of exclusive bre-astfeeding. Cochrane Database Syst Rev 2012;(8):CD003517. 10.Swedish National Food Agency, 2016. Good Food for InfantsUnder One Year. http://www.livsmedelsverket.se/globalassets/english/foodhabits-health-environment/dietary-guidelines/good-food-for-infantsunder-one-year.pdf. 11.Lanting CI, Heerdink-Obenhuijsen HLL, Schuit-van Raams-donk EMM, et al. JGZ-Richtlijn Voeding en Eetgedrag. Ne-derlands Centrum jeugdgezondheid, Utrecht 2013. 12.Fewtrell M, Bronsky J, Campoy C, Domellöf M, Embleton N,Fidler Mis N, et al. Complementary Feeding: A Position Pa-per by the European Society for Paediatric Gastroenterology,Hepatology, and Nutrition (ESPGHAN) Committee on Nut-rition. J Pediatr Gastroenterol Nutr 2017;64(1):119-32. 13.Muraro A, Halken S, Arshad SH, et al., EAACI Food Allergyand Anaphylaxis Guidelines Group. EAACI food allergy andanaphylaxis guidelines. Primary prevention of food allergy.Allergy 2014;69:590–601. 14.Nwaru BI, Erkkola M, Ahonen S, et al. Age at the introduc-tion of solid foods during the first year and allergic sensiti-zation at age 5 years. Pediatrics 2010;125:50–9. 15.Ierodiakonou D, Garcia-Larsen V, Logan A, et al. Timing ofallergenic food introduction to the infant diet and risk of al-lergenic or autoimmune disease. A systematic review and meta-analysis. JAMA 2016;316:1181–92. 16.Du Toit G, Sayre PH, Roberts G, et al. LEAP Study Team. Ef-fect of avoidance on peanut allergy after early peanut consump-tion. N Engl J Med 2016;374:1435–43. 17.Fleischer DM, Sicherer S, Greenhawt M, et al. Consensus com-munication on early peanut introduction and the preventionof peanut allergy in high-risk infants. Allergy 2015;70:1193–5. 18.Lionetti E, Castellaneta S, Francavilla R, et al. Introductionof gluten, HLA status, and the risk of celiac disease in child-ren. NEJM 2014;371:1295–303. 19.Szajewska H, Shamir R, Mearin L, et al. Gluten introductionand the risk of coeliac disease: a position paper by the Eu-ropean Society for Pediatric Gastroenterology, Hepatology,and Nutrition. J Pediatr Gastroenterol Nutr 2016;62:507–13. 20.Domellöf M, Braegger C, Campoy C, et al. ESPGHANCommittee on Nutrition. Iron requirements of infants and todd-lers. J Pediatr Gastroenterol Nutr 2014;58:119–29. 21.Weber M, Grote V, Closa-Monasterolo R, et al. EuropeanChildhood Obesity Trial Study Group. Lower protein contentin infant formula reduces BMI and obesity risk at school age:follow-up of a randomized trial. Am J Clin Nutr2014;99:1041–51. 22.Agostoni C, Caroli M. Role of fats in the first two years of lifeas related to later development of NCDs. Nutr Metab Cardio-vasc Dis 2012;22:775–80. 23.EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutri-tion and Allergies). Scientific Opinion on the essential com-position of infant and follow-on formulae. EFSA J2014;12:3760. 24.Harsløf LB, Larsen LH, Ritz C, et al. FADS genotype and dietare important determinants of DHA status: a cross-sectionalstudy in Danish infants. Am J Clin Nutr 2013;97:1403–10. 25.EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutri-tion and Allergies). Scientific opinion on nutrient requirementsand dietary intakes of infants and young children in the Eu-ropean Union. EFSA J 2013;11:3408. 26.Bowen WH, Pearson SK, Rosalen PL, et al. Assessing the ca-riogenic potential of some infant formulas, milk and sugar so-lutions. J Am Dent Assoc 1997;128:865–71. 27.Remy E, Issanchou S, Chabanet C, et al. Repeated exposureof infants at complementary feeding to a vegetable puree in-creases acceptance as effectively as flavor-flavor learning andmore effectively than flavor-nutrient learning. J Nutr2013;143:1194–200. 28.Maier-No¨th A, Schaal B, Leathwood P, et al. The lasting in-fluences of early food-related variety experience: a longitu-dinal study of vegetable acceptance from 5 months to 6 yearsin two populations. PLoS One 2016;11:e0151356. 29.Cameron SL, Heath A-LM, Taylor RW. How feasible is baby-led weaning as an approach to infant feeding? A review of theevidence. Nutrients 2012;4:1575–609. 30.Cameron SL, Taylor RW, Heath AL. Development and pilottesting of Baby-Led Introduction to SolidS--a version of Baby-Led Weaning modified to address concerns about iron defi-ciency, growth faltering and choking. BMC Pediatr 2015;15:99. 31.Van Winckel M, Vande Velde S, De Bruyne R, et al. Vegeta-rian infant and child nutrition. Eur J Pediatr 2011;170:1489–94. 32.Tanzi MG, Gabay MP. Association between honey consump-tion and infant botulism. Pharmacotherapy 2002;22:1479–83. 33.Committee on Herbal Medicinal Products (HMPC) assessmentreport on Foeniculum vulgare miller. European MedicinesAgency Evaluation of Medicines for Human Use. February2008. EMEA/HMPC/137426/2006. 34.Hojsak I, Braegger C, Bronsky J, et al. Arsenic in rice: a cau-se for concern. J Pediatr Gastroenterol Nutr 2015;60:142–5.