National Recommendations for Infant and Young Child Feeding in the World Health Organization European Region

Koletzko, Berthold; Hirsch, Nathali Lehmann; Jewell, Jo; Santos, Quenia dos; Breda, João; Fewtrell, Mary; Weber, Martin

doi:10.1097/mpg.0000000000002912

Cited by 25 publications

(24 citation statements)

References 26 publications

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“…As WHO considers infant formula as a complementary food, their recommendations are not directly comparable with those from EFSA and ESPGHAN, which exclude infant formula from complementary food [ 18 , 19 , 20 , 21 ]. Therefore, it is not surprising that a recent study [ 22 ] showed that in 31 of 38 European countries (82%) the introduction of complementary foods was recommended before six months. It was found that age recommendations differed in some countries depending on whether the infant is breastfed or formula-fed.…”

Section: Introductionmentioning

confidence: 99%

Complementary Feeding Practices and Parental Pressure to Eat among Spanish Infants and Toddlers: A Cross-Sectional Study

Klerks

Román

Bernal

et al. 2021

IJERPH

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The introduction of complementary foods is a crucial stage in the development and determination of infants' health status in both the short and longer-term. This study describes complementary feeding practices among infants and toddlers in Spain. Also, relationships among sample characteristics (both parents and their child), feeding practices (timing, type of complementary food), and parental pressure to eat were explored. Cognitive interviewing with 18 parents was used to refine the survey questions. Responses from a national random sample of 630 parents, who were responsible for feeding their infants and toddlers aged 3–18 months, were obtained. Solids, often cereals and/or fruits first, were introduced at a median age of five months. Fish and eggs were introduced around the age of nine and ten months. Almost all children were fed with home-prepared foods at least once per week (93%), and in 36% of the cases, salt was added. Interestingly, higher levels of parental pressure to eat were found in female infants, younger parents, parents with a full-time job, the southern regions of Spain, and in infants who were not fed with home-prepared foods. Our insights underline the importance of clear feeding recommendations that can support health care professionals in promoting effective strategies to improve parental feeding practices.

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Section: Introductionmentioning

confidence: 99%

Complementary Feeding Practices and Parental Pressure to Eat among Spanish Infants and Toddlers: A Cross-Sectional Study

Klerks

Román

Bernal

et al. 2021

IJERPH

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“…The rationale for a 6-month cut-off was that it is likely to reflect children who do or do not receive complementary foods. In Poland [ 18 ], in line with the current European recommendations [ 19 ], exclusive or full breastfeeding should be promoted for at least 4 months (17 weeks, beginning of the 5th month of life), and exclusive or predominant breastfeeding for approximately 6 months is considered a desirable goal. Complementary foods should not be introduced before 4 months but should not be delayed beyond 6 months.…”

Section: Discussionmentioning

confidence: 99%

Retrospective and Prospective Determination of the Cow's Milk-Related Symptom Score (CoMiSS™) Values in Symptomatic Infants

Kozłowska-Jalowska

Horvath

Vandenplas

et al. 2021

Pediatr Gastroenterol Hepatol Nutr

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Purpose The Cow's Milk-related Symptom Score (CoMiSS™) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSS™ values of symptomatic infants based on retrospectively or prospectively obtained information. Methods CoMiSS™ values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSS™ values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSS™ total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. Results This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSS™ value ( p <0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. Conclusion CoMiSS™ values were retrospectively and prospectively determined. Lower CoMiSS™ values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSS™ in clinical practice.

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“…In our sample, only 6.3% of children were exclusively breastfed during the 6th month of life and thus met the WHO recommendation. However, a recent survey performed by the WHO Regional Office for Europe and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition revealed that more than 82% of European countries recommended the introduction of complementary feeding at the age of 4–5 months and hence exclusive breastfeeding for a shorter period than six months [ 37 ]. The rate of EBF in our study is lower than results for EBF at 4–6 months from European samples such as IDEFICS (45.5%) and COSI (lowest—10.5% for Spain), and from the World Health Statistics WHO—Reports [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding and Overweight in European Preschoolers: The ToyBox Study

et al. 2021

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The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates.

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National Recommendations for Infant and Young Child Feeding in the World Health Organization European Region

Cited by 25 publications

References 26 publications

Complementary Feeding Practices and Parental Pressure to Eat among Spanish Infants and Toddlers: A Cross-Sectional Study

Complementary Feeding Practices and Parental Pressure to Eat among Spanish Infants and Toddlers: A Cross-Sectional Study

Retrospective and Prospective Determination of the Cow's Milk-Related Symptom Score (CoMiSS™) Values in Symptomatic Infants

Breastfeeding and Overweight in European Preschoolers: The ToyBox Study

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