+

Third Parenting Program25th May 2013

Weaning

+ Breastfeeding

“formula milk is just a food, whereas breast milk is a complex living nutritional fluid that contains antibodies, enzymes and hormones, all of which have health benefits”

Hoddinott P et al. BMJ 2008:336:881-7

+Content

1. Weaning : when to start

2. Intestinal flora modification

3. Allergy

4. Three nutritional gaps

5. Take home messages

+What is weaning?

The introduction of solid foods

+

WHO = 6 months

Europe = 4-5 months

Who are we talking about?

NEVER BEFORE 4 MONTHS

+Common mistakes in Mauritius

Timing

Elders are wrong most of the time

Cheese

Salt

Honey

Gripe water, baby soif.

Step by step

+Content

1. Weaning : when to start

2. Intestinal flora modification

3. Allergy

4. Nutritional gaps

5. Take home messages

+ Flore Intestinale

+Probiotics

Probiotics

+Prebiotics

Encourages the development of probiotics

+Prebiotiques et probiotiques

Protective effect

Normalise the intestinal transit.

Influenced by nutrition

Permanent programing of immune system : allergy !

+Allergies

Linked with intestinal flora.

Roots during weaning period.

Permanent programing by the intestinal flora

+Content

1. Weaning : when to start

2. Intestinal flora modification

3. Allergy

4. Three nutritional gaps

5. Take home messages

+

During weaning, babies are more susceptible to infections :

“Window of Weakness” at weaning

“Environmental challenges” that may bring common childhood infections

The Weaning Gap

+Infants of 6 to 11 months old are more prone to diarrhea than older children

(Kosek, WHO Bulletin, 2003)

+Baby’s immune system develops in two ways

+There is a Protection Gap starting at 3-6 months of age

Weaning context… a critical period of challenges

+ Growth during first year of life

Birth weight triples by the end of the first year

Height increases by 50% over the first year and by 25% from 1 to 3 years

Muscle mass grows from a value of 22% total body weight at 3 months to 35% at 5 years

+Energy required by age and the amount supplied from breast milk

En

erg

y (

kca

l/d

ay)

1000

800

0-2 m 3-5 m

Age (months)

Energy Gap

Energy from breast milk

6-8 m 9-11 m 12-23 m

600

400

200

0

+ Pre-school age children

Country (2006)

Proportion of anemia (Hb

<11)95% C. I. Public health

issue?

Seychelles 24% 7-57 Moderate

Mauritius 17% 13-22 Mild

South Africa 24% 22-26 Moderate

Madagascar 68% 65-71 Severe

Kenya 69% 66-71 Severe

+ Iron deficiency

+ Iron deficiency

Retarded growth and

development

Reduced resistance to

infection

Irreversible behavioural and

mental development

+Iron requirements during infancy

+Effectiveness of Fortified Infant Cereals

+Big nutrition for small tummies…

+

Take home messagesTiming : 6 months (WHO) but...

Never before 4 months

One new food every 3 days