SIPPS advice: never start before four and after seven months. Yes to egg, peanuts, fish, peaches from 6 months onwards
Nutrition is one of the main determinants of health: the whole scientific community agrees that by adopting the wrong diet, our health is compromised. All the more so if we are talking about the nutrition of a very young child for whom the first thousand days of life are essential to determine his future health.
The transition from an exclusive milk-based diet to one based on solid foods is a very delicate period for parents. When to start weaning? Is it possible to make babies who start complementary feeding try any food? To answer these questions, the Italian Society of Preventive and Social Pediatrics (SIPPS), in collaboration with the Italian Federation of Pediatric Doctors (FIMP), the Italian Society of Pediatric Nutrition (SINUPE), the Italian Society of Developmental Origins of Health and Disease ( SIDOHaD), created the intercompany document on complementary nutrition. A vast publication that answers a series of questions by elaborating recommendations addressed not only to pediatricians, but also to parents and all operators involved in child nutrition, which can be consulted on the websites of the scientific societies involved.
- Weaning: when to start
- Breastfeeding with formula
- Self-weaning and complementary responsive feeding
- Responsive nutrition
- What foods to avoid
- Password: variety
Weaning: when to start
When to start? Do you have to wait six months or can you start earlier? One of the main recommendations, emphasizes Dr. Maria Carmen Verga, secretary of the SIPPS, is related to the age at which to introduce complementary nutrition. “A well-established fact is that complementary feeding must not begin before four and after seven months, because after that age the milk alone becomes insufficient for the baby and because going beyond it becomes more difficult to accustom him to a different diet. The uncertainty still exists – recalls Verga – is whether it is appropriate to start complementary nutrition between four and six months or at six months. From the review of the literature we have carried out, we have found that anticipating this feeding before six months of age does not bring any advantage to the baby and takes away a portion of breast milk which – the SIPPS pediatrician reminds us – not only serves to feed it, but to provide him with known and unknown elements also useful for brain development, immunity and many other functions. Maintaining exclusive breastfeeding for up to six months and giving as much breast milk as possible is therefore a strong recommendation “.
Breastfeeding with formula
In the case of formula feeding, the recommendation is less categorical because the formula does not have all the benefits of breast milk. “Even in this case, however, it is good to keep only the milk up to six months because replacing part of it with baby food means giving more calories that are not necessary if the baby is growing well”. On the subject of breastfeeding, the intercompany document recommends “the differentiation of complementary feeding according to whether the child takes breast milk or formula. The latter in fact – explains Maria Carmen Verga – is very rich in proteins, so when you introduce a complementary diet you can avoid giving meat, because we know that an excess of protein can be harmful. In the case of breast milk, on the other hand, an additional protein intake can be useful “.
Self-weaning and complementary responsive feeding
The document also provides clarifications on what is commonly referred to as self-weaning. The document states that “it is useful to clarify that self-weaning:
- it does not identify a type of weaning according to which it is the child who “weans alone”: no child is able to wean alone, but he needs a parent at his side;
- it should not and cannot be, as is sometimes erroneously reduced by both some parents and some pediatricians, the “do-it-yourself” weaning of parents who, regardless of the nutrition education indications proposed by the pediatrician, decide independently what to give from to feed the child “.
To avoid these risks, it is advisable to replace the improper term of self-weaning with the more correct term of Responsive Complementary Feeding since, as it was for the first 6 months of life with breastfeeding, the key element is the request of the child. “Responsive nutrition – clarifies the secretary of the SIPPS – receives the signals of hunger and satiety of the child and does not oblige him to a standardized nutrition, decided by the parents or the pediatrician. Its physiological need is therefore respected, as it should also happen during breastfeeding. It is a type of diet that is certainly advisable, also having a clear understanding of the quantities appropriate to the age and physiology of the child. This is difficult to perceive for parents who – notes the pediatrician – tend to adapt the portions of the children to their own. Responsive nutrition, however, must not introduce wrong eating habits – Verga warns – for example by allowing the child to eat continuously. However, it is necessary to define the time slots to which the meals correspond: breakfast, lunch, snack, dinner. It is also necessary to carefully evaluate the family’s eating habits before recommending a generic ‘give them what you eat’. The pediatrician, in fact, must realistically take into account the fact that in many families an incorrect diet is followed, especially in those of a low socio-cultural level: the child’s complementary nutrition can therefore be a precious opportunity to promote nutrition. healthier, and, last but not least, also to try to reduce inequalities, of which health is one of the most important factors “.
What foods to avoid
The publication does not just give indications on when and how to introduce complementary feeding, but also provides recommendations, based on solid scientific evidence, on what to feed infants who are no longer exclusively breastfed. On this point, Maria Carmen Verga clears the field of misunderstandings and false myths: “There are no foods to avoid in the first two years and the document recommends varying the diet as much as possible, introducing potentially foods from six months onwards. allergenic agents (egg, peanuts, fish, peaches), because delaying their introduction has been seen to increase the risk of allergies. Any exceptions are specified in the document. With regard to fish, it is good to avoid large ones because they are animals that tend to accumulate pollutants, while for example anchovies could also be eaten every day. What matters are the quality and quantity of food, the frequency with which it is offered and the method of cooking, without salt and with raw extra virgin olive oil. It is also important to respect seasonality and to favor products from one’s own territory “.
Also on this problem, the SIPPS-FIMP-SINUPE-SIDOHaD document comes to the rescue of parents. “Complementary nutrition – explains Verga – also accompanies the child in the discovery of all tastes and textures. Parents, however, must take into account that 20 or 30 tastings may be necessary to get used to and appreciate a flavor. It must also be considered that from 18 months up to about two or three years old, children enter a phase of opposition which is indicative of the maturation of character, they become people and therefore express their will. But since the latter does not always correspond to what is good for them, parents must not be discouraged by the obstinacy and strong opposition of their children ”, advises the pediatrician.