Moving Complementary Feeding Forward: Report on a Workshop of the Federation of International Societies for Pediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN) and the World Health Organization Regional Office for Europe

Abstract

The WHO Regional Office for Europe and the Federation of International Societies for Pediatric Gastroenterology, Hepatology, and Nutrition held a joint workshop, “Moving Complementary Feeding Forward” at the sixth World Congress Pediatric Gastroenterology, Hepatology, and Nutrition in 2021. Here we summarize workshop presentations and discussions. The workshop covered health implications of complementary feeding (CF) including allergies, challenges to meet dietary needs during the CF period, quality of commercial complementary foods (CFD) and respective marketing practices, national CF guidelines in Europe, a nutrient profiling system for CFD, and global policy perspectives on the standards and regulation of marketing for CFD. Adequate CF practices are of critical importance for short and long-term child health, prevention of nutrient deficiencies, normal growth and development, and reducing the risk of allergies. The workshop identified the need to improve feeding practices, harmonize evidence-based information and develop guidance jointly with various stakeholders, improve the composition and marketing practices of commercial CFD and their transparent labeling based on nutrient profiling. Renewed efforts for collaboration between scientists, public health experts, pediatric associations, national governments, and the WHO are necessary for advancing progress.

Baby Food Pouches, Baby-Led Weaning, and Iron Status in New Zealand Infants: An Observational Study

“…This study presents the first data internationally on the relationship between iron status and the use of baby food pouches and baby-led weaning in infants. This assessment is important considering the recent concerns raised about the potential health implications of these feeding methods [3,[7][8][9][10]. The overall prevalence of suboptimal iron status among New Zealand infants aged 6.9 to 10.1 months was estimated to be 23% (although only 3% had iron deficiency anaemia), emphasising the importance of determining whether these new feeding approaches are associated with iron status.…”

“…The evolution of infant nutrition practices in many countries has seen a rise in the popularity of innovative complementary feeding methods such as baby food pouches and baby-led weaning [1][2][3][4][5][6]. This shift in infant feeding approaches has raised concerns about their potential impact on infant nutrition and health [3,[7][8][9][10]. One particular concern 2 of 18 is regarding the potential risk of iron deficiency.…”

L’alimentazione complementare. Fra dubbi e certezze, buone e cattive pratiche

“…• gli alimenti complementari casalinghi, ben preparati e senza aggiunta di sale e di zuccheri, offrono l'opportunità di apprendere una maggiore varietà di consistenze e di sapori culturalmente appropriati alle tradizioni alimentari e garantiscono una maggiore densità energetica rispetto ai baby food commerciali; • due studi hanno evidenziato un deficit di varietà vegetali nei cibi complementari commerciali, con una predominanza di verdure dolci come patate e carote; • nello studio tedesco di coorte DONALD i bambini con un'alta percentuale di consumo di baby food commerciali hanno presentato successivamente una minore assunzione di verdure nella prima infanzia e (nei maschi) un minor consumo di frutta e verdura in età prescolare e scolare. Varie indagini eseguite recentemente nei Paesi europei hanno svelato l'inadeguatezza nutrizionale di una percentuale elevata di baby food commerciali, in particolare per un eccesso di carboidrati totali e zuccheri liberi o aggiunti, oltre alla loro promozione inappropriata [Hutchinson J et al, 2021;WHO, 2019;Theurich M et al, 2022]. Nel Box 3 sono riportate alcune criticità associate al consumo di baby food commerciali.…”

“…Box 3. Criticità dei baby food commerciali -In un'alta percentuale di baby food commerciali esaminati in Europa è stato riscontrato un eccesso di carboidrati totali e zuccheri aggiunti il cui consumo abituale può indirizzare precocemente verso una spiccata preferenza alimentare per gli alimenti dal sapore dolce e aumentare il rischio di eccesso ponderale e carie dentali; sono molto utilizzati zuccheri aggiunti sotto forma di succo concentrato di frutta o liofilizzati di frutta o saccarosio [Hutchinson J et al, 2021;WHO 2019;Theurich M et al, 2022]. -Vi è inoltre un marketing diffuso di tè e tisane dolci per il primo anno di vita che hanno sapori molto dolci o alti livelli di sostituti di zuccheri.…”

Latent Iron Deficiency in Tender-Age Infants: Modern Preventive Measures

“…Причем очень важна своевременность введения железосодержащего прикорма -так, у детей на исключительно грудном вскармливании, если он вводился в возрасте от 4 до 6 мес, хотя уровень гемоглобина не отличался от детей, еще не получавших прикорм, уровень ферритина был существенно выше [112]. О важности своевременного введения прикорма, в том числе содержащего железо, заявила Федерация международного общества детской гастроэнтерологии, гепатологии и питания (FISPGHAN)так, введение богатых железом продуктов животного происхождения (мясо, рыба, яйца) лишь в 30 странах рекомендовано с 6-месячного возраста, а в 13 странах это рекомендуют делать позднее, иногда в 9-месячном возрасте [113].…”