Limits...
Patterns of nutrients' intake at six months in the northeast of Italy: a cohort study.

Pani P, Carletti C, Knowles A, Parpinel M, Concina F, Montico M, Cattaneo A - BMC Pediatr (2014)

Bottom Line: These consumed significantly higher quantities of commercial baby foods than breastfed infants.Contrary to what is recommended, 94% of infants were not exclusively breastfed and were given complementary foods at six months.The proportion of daily energy intake from complementary foods was around 50% higher than recommended and with significant differences between breastfed and non-breastfed infants, with possible consequences for future nutrition and health.

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Services Research and International Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137 Trieste, Italy. adriano.cattaneo@burlo.trieste.it.

ABSTRACT

Background: Adequate complementary feeding is recognized as an important predictor of health later in life. The objective of this study was to describe the feeding practices and nutrients' intake, and their association with breastfeeding at six months of age, in a cohort of infants enrolled at birth in the maternity hospital of Trieste, Italy.

Methods: Out of 400 infants enrolled at birth, 268 (67%) had complete data gathered through a 24-hour feeding diary on three separate days at six months, and two questionnaires administered at birth and at six months. Data from feeding diaries were used to estimate nutrients' intakes using the Italian food composition database included in the software. To estimate the quantity of breastmilk, information was gathered on the frequency and length of breastfeeds.

Results: At six months, 70% of infants were breastfed and 94% were given complementary foods. The average daily caloric intake was higher in non-breastfed (723 Kcal) than in breastfed infants (547 Kcal, p < 0.001) due to energy provided by complementary foods (321 vs. 190 Kcal, p < 0.001) and milk (363 vs. 301 Kcal, p = 0.007). Non-breastfed infants had also higher intakes of carbohydrates, proteins, and fats. The mean intake of macronutrients was within recommended ranges in both groups, except for the higher protein intake in non-breastfed infants. These consumed significantly higher quantities of commercial baby foods than breastfed infants.

Conclusions: Contrary to what is recommended, 94% of infants were not exclusively breastfed and were given complementary foods at six months. The proportion of daily energy intake from complementary foods was around 50% higher than recommended and with significant differences between breastfed and non-breastfed infants, with possible consequences for future nutrition and health.

Show MeSH
Daily caloric intake (Kcal) from breastmilk (BM), formula (F), commercial and non commercial baby food in ABF (n = 188) and NBF (n = 80) infants (n = 268).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4048623&req=5

Figure 1: Daily caloric intake (Kcal) from breastmilk (BM), formula (F), commercial and non commercial baby food in ABF (n = 188) and NBF (n = 80) infants (n = 268).

Mentions: Four hundred mother-and-child pairs were enrolled in the study; complete data from the six months follow up are available for 268 (67%). Mothers had a mean age of 33.4 years (sd 4.5), 89% had a medium-to-high level of education, and 81% were employed. These values were similar in the ABF and NBF groups and there were no statistically significant differences. The percentage of employed mothers was lower at six months (81%) than at enrolment (95%) [13], probably because some mothers with a temporary job had meanwhile become unemployed. Employment status, however, was not associated with the initiation nor with the continuation of breastfeeding. Most infants (91%) were born between 38 and 42 weeks of gestation and 80% had a vaginal delivery. Seventeen (5%) infants weighed more than 4,200 g at birth, 54 (16%) were over 53 cm long, these values corresponding to the 97th WHO percentile [36]. Additional details collected at enrolment have already been published [13]. Mothers lost to follow up had a higher level of education and were more likely to be Italian and to be employed at baseline compared to those still in the study at six months, but there were no significant differences in breastfeeding rates at enrolment. At six months, most infants were healthy, except for 10% (26/268) affected by minor ailments (flu or cold) one or more days during the period of data collection. Anthropometric data of 185 out of 268 infants were collected at the routine well-child visits and are shown in Table 1. The mean BMI z-score was −0.36 (sd 1.0), slightly lower than the WHO standard [36], with no statistically significant differences between ABF and NBF infants (p = 0.206). There were no significant differences in energy and nutrients intakes between infants with or without anthropometric data.At six months of age, 70% (188/268) of infants were still breastfed; 94% (252/268) were receiving complementary foods with no statistically significant differences between ABF and NBF infants (93% vs. 96%, p = 0.407). The mean daily caloric intake was 599 Kcal and Figure 1 shows the breakdown by food category and the differences between groups. The overall daily caloric intake was higher in NBF (mean 723 Kcal, sd 194; median 680 Kcal, IQR 541–849) than in ABF infants (mean 547 Kcal, sd 162; median 528 Kcal, IQR 443–645) (p < 0.001) due to the energy provided by complementary food (median 321 Kcal, IQR 157–526 vs. median 190 Kcal, IQR 56–356; p < 0.001) and milk (median 363 Kcal, IQR 274–469 vs. 301 Kcal, IQR 243–393; p = 0.007). The mean energy density of complementary foods was higher in NBF than in ABF infants: 0.97 vs. 0.86 Kcal/g (p = 0.015). NBF infants had a slightly higher intake of milk (formula or formula + cow milk) than ABF infants (estimated breastmilk only or estimated breastmilk + formula), but differences were not statistically significant (median 545 g, IQR 420–700 vs. 485 g, IQR 393–640; p = 0.145).


Patterns of nutrients' intake at six months in the northeast of Italy: a cohort study.

Pani P, Carletti C, Knowles A, Parpinel M, Concina F, Montico M, Cattaneo A - BMC Pediatr (2014)

Daily caloric intake (Kcal) from breastmilk (BM), formula (F), commercial and non commercial baby food in ABF (n = 188) and NBF (n = 80) infants (n = 268).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4048623&req=5

Figure 1: Daily caloric intake (Kcal) from breastmilk (BM), formula (F), commercial and non commercial baby food in ABF (n = 188) and NBF (n = 80) infants (n = 268).
Mentions: Four hundred mother-and-child pairs were enrolled in the study; complete data from the six months follow up are available for 268 (67%). Mothers had a mean age of 33.4 years (sd 4.5), 89% had a medium-to-high level of education, and 81% were employed. These values were similar in the ABF and NBF groups and there were no statistically significant differences. The percentage of employed mothers was lower at six months (81%) than at enrolment (95%) [13], probably because some mothers with a temporary job had meanwhile become unemployed. Employment status, however, was not associated with the initiation nor with the continuation of breastfeeding. Most infants (91%) were born between 38 and 42 weeks of gestation and 80% had a vaginal delivery. Seventeen (5%) infants weighed more than 4,200 g at birth, 54 (16%) were over 53 cm long, these values corresponding to the 97th WHO percentile [36]. Additional details collected at enrolment have already been published [13]. Mothers lost to follow up had a higher level of education and were more likely to be Italian and to be employed at baseline compared to those still in the study at six months, but there were no significant differences in breastfeeding rates at enrolment. At six months, most infants were healthy, except for 10% (26/268) affected by minor ailments (flu or cold) one or more days during the period of data collection. Anthropometric data of 185 out of 268 infants were collected at the routine well-child visits and are shown in Table 1. The mean BMI z-score was −0.36 (sd 1.0), slightly lower than the WHO standard [36], with no statistically significant differences between ABF and NBF infants (p = 0.206). There were no significant differences in energy and nutrients intakes between infants with or without anthropometric data.At six months of age, 70% (188/268) of infants were still breastfed; 94% (252/268) were receiving complementary foods with no statistically significant differences between ABF and NBF infants (93% vs. 96%, p = 0.407). The mean daily caloric intake was 599 Kcal and Figure 1 shows the breakdown by food category and the differences between groups. The overall daily caloric intake was higher in NBF (mean 723 Kcal, sd 194; median 680 Kcal, IQR 541–849) than in ABF infants (mean 547 Kcal, sd 162; median 528 Kcal, IQR 443–645) (p < 0.001) due to the energy provided by complementary food (median 321 Kcal, IQR 157–526 vs. median 190 Kcal, IQR 56–356; p < 0.001) and milk (median 363 Kcal, IQR 274–469 vs. 301 Kcal, IQR 243–393; p = 0.007). The mean energy density of complementary foods was higher in NBF than in ABF infants: 0.97 vs. 0.86 Kcal/g (p = 0.015). NBF infants had a slightly higher intake of milk (formula or formula + cow milk) than ABF infants (estimated breastmilk only or estimated breastmilk + formula), but differences were not statistically significant (median 545 g, IQR 420–700 vs. 485 g, IQR 393–640; p = 0.145).

Bottom Line: These consumed significantly higher quantities of commercial baby foods than breastfed infants.Contrary to what is recommended, 94% of infants were not exclusively breastfed and were given complementary foods at six months.The proportion of daily energy intake from complementary foods was around 50% higher than recommended and with significant differences between breastfed and non-breastfed infants, with possible consequences for future nutrition and health.

View Article: PubMed Central - HTML - PubMed

Affiliation: Health Services Research and International Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137 Trieste, Italy. adriano.cattaneo@burlo.trieste.it.

ABSTRACT

Background: Adequate complementary feeding is recognized as an important predictor of health later in life. The objective of this study was to describe the feeding practices and nutrients' intake, and their association with breastfeeding at six months of age, in a cohort of infants enrolled at birth in the maternity hospital of Trieste, Italy.

Methods: Out of 400 infants enrolled at birth, 268 (67%) had complete data gathered through a 24-hour feeding diary on three separate days at six months, and two questionnaires administered at birth and at six months. Data from feeding diaries were used to estimate nutrients' intakes using the Italian food composition database included in the software. To estimate the quantity of breastmilk, information was gathered on the frequency and length of breastfeeds.

Results: At six months, 70% of infants were breastfed and 94% were given complementary foods. The average daily caloric intake was higher in non-breastfed (723 Kcal) than in breastfed infants (547 Kcal, p < 0.001) due to energy provided by complementary foods (321 vs. 190 Kcal, p < 0.001) and milk (363 vs. 301 Kcal, p = 0.007). Non-breastfed infants had also higher intakes of carbohydrates, proteins, and fats. The mean intake of macronutrients was within recommended ranges in both groups, except for the higher protein intake in non-breastfed infants. These consumed significantly higher quantities of commercial baby foods than breastfed infants.

Conclusions: Contrary to what is recommended, 94% of infants were not exclusively breastfed and were given complementary foods at six months. The proportion of daily energy intake from complementary foods was around 50% higher than recommended and with significant differences between breastfed and non-breastfed infants, with possible consequences for future nutrition and health.

Show MeSH