Weaning, the 15 things to know

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Philippe Gloaguen
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The weaning period has arrived! Here are all the main indications on starting the baby's complementary feeding: from when does self-weaning begin, from which milk is preferable in the first year of life to how to regulate oneself with proteins and more.



In this article

 



  • Weaning, when it starts
  • Weaning: because solid foods are introduced
  • Complementary nutrition: what it means
  • Remove restrictions on foods that are considered allergenic
  • One food at a time, to experiment
  • Green light to prolonged breastfeeding
  • Up to 12 months breast milk or formula
  • No sugar and no salt, possibly up to two years
  • Honey after 12 months for the Botox risk
  • Meat, fish, cheese: be careful not to overdo it with proteins
  • Is it better to give baby food or to cook fresh meat and fish?
  • Vegetarian weaning: how to proceed
  • At the table with mom and dad
  • The child refuses to eat: how to behave
  • I wean myself, or the choice of self-weaning

1. Weaning: when it starts


For the World Health Organization, the introduction of complementary foods to milk it should not take place before the sixth month, and various international companies and agencies are on the same line. The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPHGAN) and the European Food Safety Agency (EFSA), for example, recognize six months as an ideal time for the introduction of other foods besides milk, however suggesting that stay in a window of four to six months. And also according to the Association of American Pediatricians, the baby should only drink milk for the first four to six months.



Read also: Weaning, when to start

But be careful: these general indications cannot ignore the characteristics of the individual child. Pediatricians agree that to start weaning it is good to wait until the child himself on the one hand shows an interest in food (which can also happen early, between the fourth and fifth month of life) and on the other hand ready from a neuromotor point of view.

In short, the little one must know:



  • sit with your head straight,
  • swallow food well (thus having lost the extrusion reflex which leads him to spit out everything that is not liquid),
  • grasp food with your hands to bring it to your mouth.

"Some babies may be ready a couple of weeks before they turn six months, others a few weeks later," he said Ilaria Giulini Neri, nutrition pediatrician at the Melegnano hospital and researcher of the NutrMyModernsParents project of the Icans of our city, during the live broadcast of mymodernparents.com dedicated to weaning.

"Obviously - continues the specialist - there may be individual cases in which the pediatrician will recommend starting earlier (but in any case after the fourth month) the introduction of foods other than milk, for example if there are particular growth problems. in particular cases, the indication is to give milk - maternal or artificial - to the child up to approximately the sixth month ".

2. Weaning: because solid foods are introduced

The Ligurian pediatrician explains it well Alberto Ferrando in his book How to feed my child (LSWR 2022 Editions): “The milk consumed by the newborn it is no longer enough to completely satisfy its nutritional needs and, therefore, it is necessary to fill the iron deficiency, proteins, vitamins with foods that contain them. As for iron, term babies who are exclusively breastfed usually maintain sufficient supplies of it for the first six months ”.

What if the breastfed baby at six months is not yet ready for complementary feeding? How to avoid the risk of iron deficiency? Some pediatricians advise to insist a little, while others tend to respect the child's timing anyway, offering rather an iron supplement.

According to the Pediatric Cultural Association's point of view on complementary nutrition,

"If the mother did not suffer from nutritional problems during pregnancy and lactation and if the baby's umbilical cord was closed (clamped) at birth when it stopped pulsing, no iron supplementation is necessary. In all other cases it is it is preferable to supplement the infant with iron-based medicines, rather than proposing a complementary forced feeding "

3. Complementary nutrition: what it means

It means that foods other than milk enrich a diet which, however, remains predominantly milky for the first time. "Little by little children they get used to new flavors and new textures, but at first they continue to get most of the nutrients they need from breast milk or formula "explains the pediatrician Frank DeLuca, now a freelancer (formerly a community pediatrician in a Roman clinic), president of the Montessori Birth Center.

This implies that weaning must be considered as a slow and progressive phase: a series of small steps along which to accompany the baby patiently.

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4. No restrictions on foods considered allergenic

Until recently it was thought that the best way to prevent the risk of food allergies in children was to delay as much as possible the introduction of potentially allergenic foods, such as fish, eggs, tomatoes, strawberries and dried fruit. Hence the compilation of rather strict weaning roadmaps.

For about twenty years now, however, the scientific studies available have led to questioning this belief and today the recommendations have changed radically. An article recently published by the American Association of Pediatricians in the journal Pediatrics recalled this:

"There is no scientific evidence that delaying the introduction of allergenic foods beyond four to six months of life reduces the risk of developing food allergies, eczema, allergic rhinitis or asthma."

It is no coincidence that ESPGHAN recommends proposing all possible foods, without exception, at the beginning of weaning. And our Ministry of Health also says: "The order in which semi-solid and solid foods are introduced in weaning can vary according to the preference of the child and the gastronomic culture of the family and pediatrician". No more references to particular time windows more appropriate than the risk of allergies.

5. One food at a time, to experiment

Attention, the drop in restrictions with respect to foods considered allergenic does not mean that starting from the six months of the child it is necessary to "gorge" him with allergenic foods one after the other. Many pediatricians believe that it is still appropriate to propose new foods to the baby with one certain gradualness, to give it time to adapt to new flavors and new textures.

Read also: Weaning: how to prepare the first baby food, from theory to practice

6. Green light to prolonged breastfeeding

If the mother has breastfed her baby, there is no reason to stop breastfeeding once weaning has begun if she likes to continue. "You can definitely breastfeed during weaning, because breast milk provides the baby with one ideal nutrition, healthy growth and optimal development"writes Ferrando in his book.

In addition, breastfeeding also represents a affective reference relevant for the acquisition of security and autonomy. For this reason, the World Health Organization recommends it up to the second year of life and even beyond, if the mother-child couple so wishes.

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7. Up to 12 months breast milk or formula

According to ESPGHAN indications, "cow's milk should not be used as a main drink before 12 months, while small quantities are allowed in addition to food preparations" (such as mashed potatoes or bechamel, Ed.) ".

The main reasons for this "ban" are two: "The first has to do with proteins, which are too much in cow's milk"explains the professor Andrea Vania, head of the Center of Pediatric Dietology and Nutrition of the Maternal-Child and Urological Sciences Department of the Sapienza University of the city. And too much protein in the first two years of life is a problem because it is associated with an increased risk of childhood obesity. "Also, cow's milk is iron deficient, a very important micronutrient in this age group ".

Finally, some studies suggest that the consumption of cow's milk before the year of life may favor the appearance of intestinal microhemorrhages, promoting the risk of anemia. "It is an observation that has emerged above all from studies relating to the consumption of raw milk, but I see no reason why it should not be extensible to pasteurized milk as well" underlines the nutritionist.

8. No sugar and no salt possibly up to two years

In the first two years of life, the addition of sugars to baby food should be avoided. For example, if you propose yogurt, this should be natural, without sugar, with the addition of a few pieces of fruit at the most.

The ban stems from two considerations: the fact that children are so young they absolutely do not need these substances and the fact that in this age group the taste is formed and it is do not accustom the little ones to too sweet flavors. On the other hand, it is now well known that a diet rich in sugars from an early age is associated with a greater risk of obesity, hypertension, alterations in the level of fats in the blood, diabetes. Not to mention that sugar is the number one enemy of the teeth!

Read also: Teeth of young children: 5 tips to avoid cavities

Similar considerations apply to salt, the use of which can predispose to a preference for salty foods, increasing the risk of hypertension.

9. Honey after 12 months for botulinum risk

"Honey should never be given below the year of life because it could be a vehicle for spores of the botulinum bacterium" he explained to mymodernparents.com Marangione, head of the neonatology and neonatal pathology department of the Humanitas San Pio X hospital in our city. "The spores, in turn, can produce botulinum toxin and therefore cause food poisoning which can quickly lead to general paralysis of the body and, above all, that of the respiratory system".

"The fact is - said the expert - that the baby's intestine is not yet able to block the spores, because the bacterial flora is immature, so when they arrive they find fertile ground to multiply, then developing the disease. , the bacterial flora becomes more adequate and balanced, with a greater defensive capacity, therefore it expels the spores without having the possibility of developing the toxin ".

Even after 12 months, honey should still be used sparingly because it is extremely cariogenic.

10. Meat, fish, cheese: be careful not to overdo the proteins

One of the most common mistakes made when starting weaning is that of offer the child an excess of protein. Moreover, it is a mistake that we carry with us from the old habits of the past, when it was recommended to propose very "rich" baby food, containing both meat or fish and a generous dose of parmesan or parmesan.

As we said, however, we now know that an excess of protein in the first two years of life is associated with an increased risk of developing childhood obesity. "Today it is recommended to add 40-50 grams of protein foods (meat, fish, legumes, cheese) to baby food, but even these are exaggerated quantities" said the nutritionist pediatrician. Margherita Caroli, member of the board of directors of the European Childhood Obesity Group and coordinator of a new document on weaning that the Del Paesena Society of Preventive and Social Pediatrics (SIPPS) is preparing in view of the next national congress, scheduled for October. "In this document we will urge you to further reduce these unnecessary and potentially harmful doses, ea do not exceed 10-15 grams of protein per meal".

11. Is it better to give baby food or to cook fresh meat and fish?

"The choice has to do more with criteria of comfort and ease of use than of real opportunity" said the nutritionist pediatrician Giacomo Cagnoli, again during the live broadcast of mymodernparents.com on weaning. "If there is little time to cook, the baby food can be used with peace of mind, also because it is very safe and controlled. In the beginning, however, half a jar at a time is better so as not to exceed the protein quotas".

"Having time (and desire) to cook, on the other hand, is perfectly fine. In this way, among other things, it allows the child to taste a greater variety of flavors, since every single piece of meat or fish has a unique flavor. , while that of the homogenized is precisely more homogeneous ". Here you can find some ideas on how to offer fish to children.

12. Vegetarian weaning: how to proceed


Various scientific societies agree: it is possible to offer children a vegetarian or even vegan weaning, provided that certain conditions are respected. The main risks of this diet are two: vitamin B12 deficiency (which becomes a certainty in the case of the vegan diet, since this vitamin is found only in foods of animal origin) e low calorie intake, which can lead to growth problems.

However, these are risks that can be kept under control, with some precautions, which mymodernparents.com has extensively presented in the article Vegan diet for children: can it be done and under what conditions? Here they are:

  • think about it in time, that is, still during pregnancy. Vitamin B12 is also important for fetal neurological development: if the mother is vegan, she is the first to have to worry about her levels of this vitamin. Thus, in pregnancy and breastfeeding the vegan mom should take adequate vitamin B12 supplements, and regularly perform blood tests to assess the levels of this protein. Other deficiencies could concern iron, zinc, vitamin D and calcium: the gynecologist should therefore evaluate the situation with appropriate tests.
  • if you are not breastfeeding, choose suitable products in the first months of life. Not vegetable drinks made from cereals or legumes, but milk in specific formula, that instead of being made from cow's milk, it will be based on soy or rice.
  • after weaning, in the case of a strictly vegan diet, provide for thesupplementation with vitamin B12 for children (and many pediatricians also recommend it for vegetarian children.
  • for the little ones prefer energy-dense foods, such as legumes, soy derivatives, nuts, quinoa, and don't overdo it too much with vegetables, so as not to have an excess of fiber.
  • provide adequate checks on the growth and health of the child, to avoid sudden degeneration of the situation.
  • in case of doubt, always contact your doctor. In reality, not all pediatricians are actually experts in nutrition and even less in vegetarian or vegan nutrition. If possible, however, seek out a specialist with these specific skills.
Read also: Health balances, what they are and when to do them

13. At the table with mom and dad

Meal time is also a moment of sociability: it is a good habit to share it right away. Here are some tips from Alberto Ferrando to live it with serenity:

  • do not eat with the TV on;
  • always lead by example, in terms of both habits (you don't play at the table, you don't look at your cell phone, you sit) and food choices (try to eat healthy foods and vary your diet as much as possible);
  • encourage the autonomy of the child, allowing him to touch food with his hands;
  • avoid forcing to make him eat.

14. The child refuses to eat: how to behave

"In front of children who do not want to give up milk, do not want to eat or seem to eat little, there are two basic tips: trust them and have patience”. Word from Ilaria Giulini Neri and Giacomo Cagnoli.

Read also: Weaning: Why Does My Baby Not Want to Eat? What to do to convince him?

The first thing to do if the baby does not want to start weaning, abandoning the milk - mother or formula - that has fed him up to that moment is therefore to be patient. "Please wait and try again lateri, especially if the child still shows little interest in food "reads the book Learn to eat, the right weaning with the Margherita method (Giunti 2022), signed by the pediatricians Jacopo Pagani and Andrea Vania, in collaboration with the chef Luigi Nastri.

"It is not a tragedy either for him or for you if the start of complementary nutrition is delayed a bit".


Finally, a last useful indication for children who do not want to eat is try to change proposal: maybe you are insisting on a traditional baby food, and the baby would prefer to taste what is on your plate (as long as it is healthy!), with a tendency to be weaned. Or viceversa. Why not also make some attempts in this direction?

In any case, Ferrando remembers that:

  • if the child is healthy and hungry, he eats. If he does not eat, he is not hungry;
  • the alleged lack of appetite derives from a lack of balance between how much a child eats and how much in the family they think they should eat. It is resolved by reducing the family's expectations and not forcing the child to eat more.

15. I wean myself, or the choice of self-weaning

This is an increasingly widespread trend, which provides for the access of the child to "normal" family foods, prepared with some caution to make them more suitable for their specific nutritional needs. It is a weaning modality that presupposes the total respect for the time and skills of the child and his ability to regulate himself, and gives his parents particular attention to the correctness of the diet of the whole family. Not all pediatricians support it, but others do (for example, members of the Paediatricians Cultural Association). All the information on this proposal in the article Self-weaning, the 11 fundamental things to know.

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Weaning, what are the first baby food in the rest of the world?

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Sara Honegger in the book A world of baby food explains how children are weaned in various countries. Generally the first taste is fruit: apple, pear, banana, but also mango or papaya ....

TAG:
  • self-weaning
  • allergies children
  • breastfeeding
  • weaning
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