Article short contents


Slovenska pediatrija 2012; 19: 94-103


Review article

NEW INFANT FEEDING RECOMMENDATIONS IN SLOVENIA

M. Sedmak
Klinični oddelek za gastroenterologijo, hepatologijo in nutricionistiko, Pediatrična klinika, UKC Ljubljana, Ljubljana, Slovenija

M. Homan
Klinični oddelek za gastroenterologijo, hepatologijo in nutricionistiko, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

J. Brecelj
Klinični oddelek za gastroenterologijo, hepatologijo in nutricionistiko, Pediatrična klinika, Univerzitetni klinični center Ljubljana in Katedra za pediatrijo, Medicinska fakulteta Ljubljana, Ljubljana, Slovenija

D. Mičetić Turk
Klinični oddelek za pediatrijo, Univerzitetni klinični center Maribor, Maribor, Slovenija

N. Fidler Mis
Klinični oddelek za gastroenterologijo, hepatologijo in nutricionistiko, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

A. Širca Čampa
Klinični oddelek za endokrinologijo, presnovne bolezni in diabetes, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

M. Bigec
Klinični oddelek za pediatrijo, Univerzitetni klinični center Maribor, Maribor, Slovenija

V. Plevnik Vodušek
Specialistična alergološka in pediatrična ordinacija, Ljubljana, Slovenija

T. Battelino
Klinični oddelek za endokrinologijo, diabetes in presnovne bolezni, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

R. Orel
Klinični oddelek za gastroenterologijo,hepatologijo in nutricionistiko, Pediatrična klinika, Univerzitetni klinični center Ljubljana in Katedra za pediatrijo, Medicinska fakulteta, Ljubljana, Slovenija

B. Bratanič
Klinični oddelek za neonatologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

T. Vesel
Služba za alergologijo, revmatologijo in klinično imunologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

T. Avčin
Služba za alergologijo, revmatologijo in klinično imunologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

C. Kržišnik
Katedra za pediatrijo, Medicinska fakulteta, Univerza v Ljubljani, Ljubljana, Slovenija

Abstract

New infant feeding recommendations were presented in 2010 at the paediatric continuing education »Derčevi dnevi«. The recommendations were prepared by the Nutrition working group, which is multidisciplinary and involves experts from different elds: neonatology, allergic diseases, endocrinology, nutrition, gastroenterology and general paediatrics. Infant feeding recommendations in Slovenia have been issued for healthy and full-term babies. Exclusive breast-feeding or full breast-feeding is recommended in the rst six months of life. If breast-feeding is not possible, infant formula is recommended, in accordance with the Codex Alimentarius Standard, revised in 2007. It is not yet possible to make general recommendations for antiregurgitation infant formula and infant formulas with added prebiotics, probiotics and synbiotics. Soy infant formula is not the formula of choice for healthy infants. The recommendation for the minimal daily intake of vitamin D for newborns and infants is 400 IU, starting after the rst week of the newborn's life (the same dosage applies for breast-fed infants and for infants on formula or follow-on formula). It is recommended that complementary feeding (i.e. solid foods and liquids other than breast milk or infant formula and follow-on formula) are not introduced before 17 weeks and not delayed beyond 26 weeks of age. During the complementary feeding period, more than 90% of the iron requirements of a breast-fed infant must be met by complementary foods, which should provide sufcient bioavailable iron. Cow’s milk is a poor source of iron and should not be used as the main drink before the age of 12 months, although small volumes may be added to complementary foods. Since the results of studies on the inuence of the later introduction of potentially allergenic foods, such as sh and eggs, on the reduction in the incidence of allergies are incomplete and in part contradictory, it is recommended to introduce egg yolk and sh after 6 months of age and egg white and seafood after the age of one year. The introduction of gluten in complementary feeding should not be too early, i.e. < 4 months of age, and not too late, i.e. ≥ 7 months of age. In this safe period or “safe window”, it is recommended that gluten be introduced gradually, in small amounts at between 6 and 7 months of age while the infant is still breast-fed, as this may reduce the risk of coeliac disease, type 1 diabetes mellitus and wheat allergy. Honey contains spores of Clostridium botulinum and can cause the development of botulism in infants. Therefore, it is recommended that honey be introduced after the infant’s rst birthday. The addition of salt and sugar is also recommended after the rst year of life.

Key words: breast-feeding, infant formulas, complementary feeding, infants.


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