Complementary Feeding Practices: Recommendations of Pediatricians for Infants with and without Allergy Risk

Author:

Vassilopoulou Emilia12ORCID,Feketea Gavriela34ORCID,Pagkalos Ioannis1ORCID,Rallis Dimitrios5ORCID,Milani Gregorio Paolo26,Agostoni Carlo26ORCID,Douladiris Nikolaos7ORCID,Lakoumentas John1,Stefanaki Evangelia8ORCID,Efthymiou Zenon1,Tsabouri Sophia5ORCID

Affiliation:

1. Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece

2. Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy

3. Department of Pediatrics, “Karamandaneio” Children’s Hospital of Patra, 26331 Patras, Greece

4. Department of Pharmacology, “luliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania

5. School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece

6. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20157 Milan, Italy

7. Allergy Unit, 2nd Pediatric Clinic, University of Athens, 11527 Athens, Greece

8. Department of Pediatrics, General Hospital of Heraklion, Venizeleio and Pananio, 71409 Heraklion, Greece

Abstract

Aim: To investigate the routine guidance provided by pediatricians concerning the timing of complementary feeding (CF) for both healthy infants and those at a heightened risk of allergies. Methods: A total of 233 pediatricians participated in an anonymous online survey that included questions about demographics and recommendations for CF. Specifically, they provided guidance on the types of foods, preparation methods, supplements, time intervals for introducing new foods to infants at low and high allergy risk, and delayed food introductions for high-risk cases. Results: The respondents advised introducing certain foods at specific ages: fruits, starchy non-gluten grains, vegetables, olive oil, and meat were appropriate at 6 months; gluten-rich grains at 7 months; yogurt, hard-boiled eggs, and legumes at 8 months; fish at 8.5 months; and nuts at 9 months. Pediatricians, especially those with less than 15 years of practice, often introduced egg, seafood, gluten-rich grains, legumes, and nuts earlier for high-risk infants. Parenthood and male gender were associated with the earlier introduction of eggs and grains. Conclusions: Greek pediatricians follow a structured food introduction schedule for CF in infants. Interestingly, they tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants. Key Notes: Despite recent evidence-based indications on healthy complementary feeding strategies for infants, discrepancies persist among pediatricians regarding food choices and the order and timing of food introduction, both for healthy infants and those at risk of allergy. Guidance on complementary feeding by pediatricians is influenced by their individual characteristics. Pediatricians tend to delay the introduction of common food allergens and recommend longer intervals between introducing new foods, particularly for high-risk infants.

Publisher

MDPI AG

Reference72 articles.

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2. CDC (Centers for Disease Control and Prevention) (2023, September 10). Weaning. Nutrition, Available online: https://www.cdc.gov/nutrition/InfantandToddlerNutrition/breastfeeding/weaning.html.

3. Greek Ministry of Health (2023, September 10). Recommendations for the Introduction of Solid Foods in the 1st Year of Life, Available online: https://www.moh.gov.gr/articles/health/dieythynsh-dhmosias-ygieinhs/metadotika-kai-mh-metadotika-noshmata/c388-egkyklioi/5750-systaseis-gia-thn-eisagwgh-sterewn-trofwn-ston-1o-xrono-ths-zwhs.

4. Complementary feeding: A commentary by the espghan committee on nutrition;Agostoni;J. Pediatr. Gastroenterol. Nutr.,2008

5. Complementary feeding of infants and young children 6 to 23 months of age;Lutter;Nutr. Rev.,2021

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