Complementary Feeding in Italy: From Tradition to Innovation

Complementary feeding (CF) is a pivotal phase of the individual’s growth, during which children develops their future dietary habits. To date, only few studies investigated and compared weaning modalities between different geographical areas. The aim of this article is to describe the current Italian practice for CF in healthy term infants among different areas (North, Center, South) of Italy. Two different multiple-choice questionnaires were produced and sent to 665 Italian primary care pediatricians (PCP) and 2023 families with children under 1 year of age. As emerged from our investigation, in Italy CF is usually started between the 5th and 6th month of life. The preferred approach (chosen by 77% of families) involves the use of home-cooked liquid or semi-liquid ailments, or industrial baby foods. A new CF modality is emerging, consisting of traditional complementary foods with adult food tastings (10% of families). Approximately 91% of pediatricians give written dietary suggestions, and 83% of families follow their advice. We found significantly divergent weaning habits among different areas of Italy. PCP have a key role in guiding parents during the introduction of new foods in their infant's diet and should take this as an opportunity to educate the whole family to healthy dietary habits.

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Dietary habits of partly breast-fed and completely weaned infants at 9 months of age

Public Health Nutrition ◽

10.1017/s1368980011003247 ◽

2011 ◽

Vol 15 (4) ◽

pp. 578-586 ◽

Cited By ~ 13

Author(s):

Ulla Holmboe Gondolf ◽

Inge Tetens ◽

Kim Fleischer Michaelsen ◽

Ellen Trolle

Keyword(s):

Body Weight ◽

Dietary Habits ◽

Cross Sectional Study ◽

Absolute Amount ◽

Sectional Study ◽

Complementary Foods ◽

Term Infants ◽

Cross Sectional ◽

Diet Diversity ◽

Breast Fed

AbstractObjectiveTo test whether there are differences in diet diversity between children still being partly breast-fed at 9 months and those completely weaned at the same age.DesignCross-sectional study.SettingCross-sectional study (SKOT cohort) in the area of Copenhagen, Denmark.SubjectsHealthy term infants (n 312) at 9 months of age (mean 9·1 (sd 0·3) months).ResultsThe infants partly breast-fed (n 168) at 9 months had significantly lower body weight (P < 0·0001), were significantly shorter (P = 0·0022) and were introduced to complementary foods significantly later (P < 0·0001) than completely weaned infants (n 141) of similar age. Furthermore, they had lower intake of energy, both in absolute amount (P < 0·0001) and per kilogram of body weight (P = 0·049). Significantly lower intakes of most energy-yielding nutrients, in absolute amounts and as energy percentages, were seen for the partly breast-fed compared with the completely weaned infants. These differences appear to be caused primarily by differences in the type and amount of milk consumed, as the energy derived from sources other than milk was similar except for fatty spread and vegetables as a side dish. Only small differences were found for absolute intakes of foods between feeding groups, although fatty spread had significantly higher intake rates and consumption (P = 0·031) among partly breast-fed compared with completely weaned infants.ConclusionsAt 9 months the infants partly breast-fed did not eat a less diversified diet compared with those completely weaned at the same age. Despite later introduction to complementary foods compared with the completely weaned, their intake of foods was similar and no delay in their progression towards the family foods was noted.

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Adherence to complementary feeding recommendations for infants and implications for public health

Public Health Nutrition ◽

10.1017/s1368980015001433 ◽

2015 ◽

Vol 19 (4) ◽

pp. 638-649 ◽

Cited By ~ 9

Author(s):

Suzanne Fegan ◽

Emma Bassett ◽

Yingwei Peng ◽

Kathleen Steel O’Connor

Keyword(s):

Breast Feeding ◽

Information Sources ◽

Complementary Feeding ◽

Evidence Based ◽

Feeding Rates ◽

Complementary Foods ◽

Term Infants ◽

Kingston General Hospital ◽

Vitamin D Supplements ◽

Over Time

AbstractObjectiveThe current study investigates (i) the extent to which breast-feeding and non-breast-feeding mothers follow the Canadian Nutrition for Healthy Term Infants (NHTI) recommendations; (ii) the first complementary foods given and the differences by breast-feeding status; (iii) whether any breast-feeding is associated with earlier introduction to complementary foods relative to non-breast-feeding, after controlling for potentially confounding factors; and (iv) the need for improvements in timing and resources of interventions by examining breast-feeding rates over time and information sources used by mothers.DesignLongitudinal data from the Kingston, Frontenac, and Lennox & Addington (KFL&A) Infant Feeding Survey were used. Mothers completed a survey at the end of their hospital stay and were interviewed by telephone at 2, 4, 6 and 12 months thereafter.SettingThe study took place in the KFL&A region of Ontario, Canada.SubjectsThe sample consisted of 325 mothers who gave birth to a live infant of at least 36 weeks’ gestation and a birth weight of at least 1500 g at Kingston General Hospital between January and July of 2008.ResultsFour in five mothers introduced complementary foods prior to 6 months. Mothers not breast-feeding at 6 months introduced water, juice, infant cereals, fruit and vegetables, and foods not recommended by Canada’s Food Guide sooner than breast-feeding mothers. Breast-feeding mothers were more likely to introduce milks appropriately, but had low adherence to giving their infants vitamin D supplements.ConclusionsTo support adherence to NHTI recommendations, interventions should be conducted during early infancy and deliver consistent, evidence-based recommendations.

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Few primary care pediatricians screen for psychosis but many are willing

Schizophrenia Research ◽

10.1016/j.schres.2021.05.012 ◽

2021 ◽

Vol 232 ◽

pp. 65-67

Author(s):

Alexander B. Moxam ◽

Emily J. McClellan ◽

Consuelo Cagande ◽

Monica E. Calkins ◽

Daniel H. Wolf ◽

...

Keyword(s):

Primary Care ◽

Primary Care Pediatricians

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Introduction and feeding practices of solid food in preterm infants born in Salzburg!

BMC Pediatrics ◽

10.1186/s12887-021-02505-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Edda Hofstätter ◽

Verena Köttstorfer ◽

Patricia Stroicz ◽

Sebastian Schütz ◽

Lorenz Auer-Hackenberg ◽

...

Keyword(s):

Celiac Disease ◽

Preterm Infants ◽

Complementary Feeding ◽

Study Group ◽

Early Weaning ◽

Structured Interviews ◽

Term Infants ◽

The Mean ◽

The Difference

Abstract Background It is shown that meeting the increased nutritional demand of preterm infants from birth is not only important for survival but essentially contributes to the infants` overall development and long-term health. While there are established guidelines for weaning term infants, evidence regarding preterm infants is scarce and less precise. The aim of this study was to identify the current practices on introducing solids to preterm infants amongst caregivers in Salzburg and determine potential reasons for early weaning. Methods Altogether 68 infants born between 24 0/7 and 36 6/7 weeks were recruited and detailed structured interviews with the caregivers were conducted at 17 weeks corrected age. Weight, height and head circumference were collected. Results 52% of the study group received solids before the recommended 17 weeks corrected age. For this group the mean age being 13.77 ± 1.11 weeks corrected age. Premature introduction of solids significantly correlates with exclusively and early formula-feeding. 34% were weaned due to recommendation by their paediatrician. 23% of the preterm infants even received solids before 12 weeks corrected age, putting them at risks for developing obesity, celiac disease and diabetes. Conclusions This study shows the necessity for clear guidelines regarding the introduction of complementary feeding in preterm infants as well as the importance of their implementation. Caregivers should receive information on this topic early enough and they should fully understand the difference between chronological and corrected age.

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Cooking Education Improves Cooking Confidence and Dietary Habits in Veterans

The Diabetes Educator ◽

10.1177/0145721719848429 ◽

2019 ◽

Vol 45 (4) ◽

pp. 442-449 ◽

Cited By ~ 1

Author(s):

Ashley S. Dexter ◽

Janet F. Pope ◽

Dawn Erickson ◽

Catherine Fontenot ◽

Elizabeth Ollendike ◽

...

Keyword(s):

Primary Care ◽

Nutrition Education ◽

Weight Status ◽

Dietary Habits ◽

Medical Center ◽

Laboratory Data ◽

Dietary Quality ◽

Group Setting ◽

Lipid Panel ◽

Significant Difference

Purpose The purpose of the study was to evaluate a 12-week cooking education class on cooking confidence, dietary habits, weight status, and laboratory data among veterans with prediabetes and diabetes. Methods The sample for this study included 75 veterans within the Overton Brooks Veteran Affairs Medical Center who completed the 12-week class in an in-person group setting in Shreveport, Louisiana, or via Clinical Video Telehealth (CVT) in Longview, Texas. Veterans were referred to the Healthy Teaching Kitchen by their primary care provider or primary care dietitian. Enrollment in the class was on a volunteer basis. The cooking and nutrition education classes included topics such as carbohydrate counting, safety and sanitation, meal planning, and creating budget-friendly recipes. Participants completed 2 questionnaires for assessment of healthy dietary habits and confidence related to cooking. Changes in body weight, lipid panel, and hemoglobin A1C were assessed. Differences in class settings were tested via independent samples t tests. Paired samples t tests were completed to compare changes in mean laboratory results, weight, and questionnaire responses. Results Subjects lost a mean 2.91 ± 5.8 lbs ( P < .001). There was no significant difference in percent change in laboratory data and weight between subjects participating via CVT and subjects in the live class. Overall, there was significant improvement in the confidence questionnaire ratings and Healthy Habits Questionnaire responses. Conclusions Cooking and nutrition education can increase cooking confidence and dietary quality. These results provide support for the need for further research on the long-term effects of nutrition cooking education and for the benefits of using CVT software to provide education to remote facilities.

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Education for the Post?

PEDIATRICS ◽

10.1542/peds.61.6.938 ◽

1978 ◽

Vol 61 (6) ◽

pp. 938-939

Author(s):

Richard J. Gluckman

Keyword(s):

Primary Care ◽

Current Trend ◽

Hospital Setting ◽

View Point ◽

Family Practitioners ◽

Primary Care Pediatricians

Having read the commentary "Primary Care: We Need All the Help We Can Get!" (Pediatrics 59:315, March 1977), I agree with Dr. Haggerty and oppose Dr. White's view-point. I agree with Dr. Hoekelman that we need to "develop partnerships with family practitioners and others if we are to succeed" in providing "optimal primary care." The current trend in many pediatric training centers is not directed toward this goal. As has been stated many times, we are training more primary care pediatricians using sick patients in a hospital setting.

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Practice and Guidelines

PEDIATRICS ◽

10.1542/peds.97.4.604 ◽

1996 ◽

Vol 97 (4) ◽

pp. 604-605

Author(s):

John T. Benjamin

Keyword(s):

Primary Care ◽

Otitis Media ◽

Practice Guidelines ◽

Primary Care Pediatricians

As a former practicing pediatrician turned academic, I found the article entitled "The Management of Febrile Infants by Primary-Care Pediatricians in Utah: Comparison with Published Practice Guidelines"1 interesting if not disturbing. Three case scenarios were sent to 194 pediatricians: a 3-week-old infant with fever, a 2-month-old infant with rales and bilateral otitis media, and a 20-month-old infant with fever. Ninety-four pediatricians responded and their workups and approaches to treatment compared to ‘practice guidelines" developed by Baraff et al.2

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The Management of Febrile Infants by Primary-Care Pediatricians in Utah: Comparison With Published Practice Guidelines

PEDIATRICS ◽

10.1542/peds.95.5.623 ◽

1995 ◽

Vol 95 (5) ◽

pp. 623-627 ◽

Cited By ~ 1

Author(s):

Paul C. Young

Keyword(s):

Primary Care ◽

Practice Guidelines ◽

Laboratory Tests ◽

Blood Count ◽

Response Rate ◽

Expert Panel ◽

Complete Blood Count ◽

Age Groups ◽

Design Case ◽

Primary Care Pediatricians

Objective. To determine primary-care pediatricians' management of febrile infants and compare them with published practice guidelines. Design. Case scenarios were sent to 194 primary-care pediatricians in Utah, describing three febrile infants, ages 21 days, 60 days, and 20 months, corresponding to the three age groups: 0 to 28 days; 29 to 90 days, and 91 days to 36 months for which the guidelines suggest different strategies. Results. Ninety-four pediatricians responded (response rate, 48%). Compliance with the guidelines was 39% for the 21 day old, 9.6% for the 60 day old, and 75% for the 20 month old. No respondent followed the guidelines for all three infants. Performance of tests to determine if an infant was low risk varied from 3%, for a stool white cell examination in a febrile 2 month old with diarrhea, to 75% for a complete blood count in a 20 month old with a temperature of 40°C. Compliance did not differ between private and academic practitioners. Those in practice less than 5 years (n = 22) were more likely than those with more experience to follow the guidelines for the 21 day old but not the other two infants. Conclusion. Primary-care pediatricians in Utah manage febrile infants with fewer laboratory tests and less hospitalization than recent practice guidelines developed by an expert panel of academic specialists suggest.

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Pediatric Plastic and Reconstructive Surgery for Primary Care

10.1542/9781610023955 ◽

2020 ◽

Author(s):

Keyword(s):

Primary Care ◽

Reconstructive Surgery ◽

Plastic And Reconstructive Surgery ◽

Reconstruction Surgery ◽

Primary Care Pediatricians ◽

Comprehensive Coverage

With contributions from the leading experts, Pediatric Plastic and Reconstructive Surgery for Primary Care provides primary care pediatricians and other professionals who care for children comprehensive coverage of both common and rare congenital and acquired pediatric conditions. https://shop.aap.org/pediatric-plastic-and-reconstruction-surgery-for-primary-care-paperback/

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