[Guidelines for complementary feeding in healthy infants]

[Maternal perception of hunger-satiety signals and their impact on feeding and nutritional status of infants in Mexico]

Introduction

Introduction: nutrition during the first two years of life is crucial for the physical, cognitive, and emotional development of children. This study aimed to: 1) associate maternal perception of hunger and satiety signals with the type of feeding; 2) associate maternal perception of hunger and satiety signals with the infant's weight status; and 3) determine the influence of feeding type on the infant's BMI-for-age. Methods: a descriptive correlational cross-sectional study was conducted with 424 mother-infant dyads in Sinaloa, Mexico, using systematic random sampling. Mothers completed questionnaires on feeding practices and perception of hunger and satiety signals. Anthropometric data of the infant were measured, and the influence of feeding type on the infant's BMI-for-age z-score was analyzed using multiple linear regression. Results: 45.8 % of mothers reported a low perception of hunger and satiety signals. 30.2 % of infants were overweight. Mothers with a high perception of signals reported a lower proportion of overweight infants. Mixed feeding and early introduction of complementary foods significantly influence the increase in infant zIMC/age score. Conclusions: maternal perception of hunger and satiety signals influences the infant's weight status. Mixed feeding and early introduction of complementary foods increase the risk of overweight in infants. It is crucial to promote adequate perception of these signals to prevent nutritional problems in early childhood.

Breastfeeding Contributes to Physiological Immune Programming in the Newborn

The first 1,000 days in the life of a human being are a vulnerable stage where early stimuli may program adverse health outcomes in future life. Proper maternal nutrition before and during pregnancy modulates the development of the fetus, a physiological process known as fetal programming. Defective programming promotes non-communicable chronic diseases in the newborn which might be prevented by postnatal interventions such as breastfeeding. Breast milk provides distinct bioactive molecules that contribute to immune maturation, organ development, and healthy microbial gut colonization, and also secures a proper immunological response that protects against infection and inflammation in the newborn. The gut microbiome provides the most critical immune microbial stimulation in the newborn in early life, allowing a well-trained immune system and efficient metabolic settings in healthy subjects. Conversely, negative fetal programming by exposing mothers to diets rich in fat and sugar has profound effects on breast milk composition and alters the immune profiles in the newborn. At this new stage, newborns become vulnerable to immune compromise, favoring susceptibility to defective microbial gut colonization and immune response. This review will focus on the importance of breastfeeding and its immunological biocomponents that allow physiological immune programming in the newborn. We will highlight the importance of immunological settings by breastfeeding, allowing proper microbial gut colonization in the newborn as a window of opportunity to secure effective immunological response.

Many Infants and Young Children Are Not Compliant with Mexican and International Complementary Feeding Recommendations for Milk and Other Beverages

Mexican and international authorities provide guidelines for milk and beverage consumption for young children. This study classifies beverages as appropriate or inappropriate by age (0-5.9, 6-11.9, and 12-23.9 months) and details consumption patterns, amounts consumed, and the associated socio-demographic characteristics. Analysis of the Mexican National Nutrition and Health Survey (ENSANUT 2012) was conducted (n = 949). Among 0-5.9 month olds, 66.7% consumed either breast milk, infant formula, or a combination with no other beverages, whereas 29.3% consumed breast milk and/or infant formula with water (mean = 58 g/day) and/or other beverages (mean = 115 g/day), such as 100% fruit juice, milk, and sugar-sweetened beverages (SSBs). For infants 6-11.9 months, appropriate beverages include breast milk, infant formula, and water; only 40.2% met these recommendations. Many 6-11.9 month olds consumed age-inappropriate beverages, including milk (31%) and SSBs (35%). After 12 months of age, appropriate beverages include water, milk, and a limited amount of 100% fruit juice and SSBs; 32.4% complied fully, 18.3% consumed appropriate and inappropriate beverages, and 49.3% consumed only inappropriate beverages. Among 12-23.9 month olds, 58% consumed milk, 18% juice, and 42% water while 63% consumed SSBs. Many infants and young children are not compliant with Mexican and international breastfeeding and complementary feeding guidelines for beverages. Communication and guidance about age-appropriate beverages should be improved.

Food Sources of Energy and Nutrients in Infants, Toddlers, and Young Children from the Mexican National Health and Nutrition Survey 2012

Food sources of nutrients in Mexican children are not well known. To fill the knowledge gap, dietary intake was assessed in 2057 children using a 24-h dietary recall. All reported foods and beverages were assigned to one of 76 food groups. Percent contribution of each food group to nutrient intake was estimated for four age groups: 0–5.9, 6–11.9, 12–23.9, and 24–47.9 months. Breast milk, infant formula, and cow’s milk were the top sources of energy and nutrients, especially in younger groups. Among infants aged 6–11.9 months, the top food sources of energy included soups and stews, cookies, fruit, tortillas, eggs and egg dishes, and traditional beverages. The same foods plus sweetened breads, dried beans, and sandwiches and tortas were consumed as the top sources of energy among toddlers and young children. Milk, soups, and stews were the top contributors for all nutrients and tortillas, eggs, and egg dishes were among the top contributors for iron and zinc. This study showed that low nutrient-dense cookies, sweetened breads, and traditional beverages were among the core foods consumed early in life in Mexico. This compromises the intake of more nutritious foods such as vegetables and fortified cereals and increases the risk of obesity.