1.15 Infant feeding

Question 1

What 2015 studies are available regarding feeding and the primary dentition

Answer 1

Avila et al 2015

Tham et al Acta paediatr 2015

Question 2

What did Avila et al 2015 involve?

Answer 2

Systematic review and meta analysis
5 cross sectional studies.
1 case control.
1 cohort study

Question 3

What did Avila 2015 state?

Answer 3

breast fed children had fewer caries than BOTTLE FED

Question 4

Issues with Avila 2015?

Answer 4

meta analysis was performed on the 5 cross sectional studies- WEAK EVIDENCE

Susceptible to residual confounding factors i.e. oral health, fluoridation

Question 5

What did Tham et al acta paediatr state?

Answer 5

children fed up to 12 months had fewer caries than those exposed to smaller periods

Children BF >12 months at increased risk compared to <12 months

Amongst >12 month, nocturnal/frequent feeders at higher risk

Question 6

Possible benefits to breastfeeding

LEON-CAVA 2001 summary

Answer 6

reduced diarrhoea

protection against respiratory disease

reduced risk of shigellosis

BIRTH CONTROL via delaying maternal menses

Question 7

Possible benefits for nocturnal breast feeding

Answer 7

Improves milk supply- higher prolactin
possible

Contraceptive via lactational amenorrhea

Reduce SIDS via environmental arousal

Promotes sleep via seratonin

Question 8

Advantages to on demand

Answer 8

RECOMMENDED BY WHO

Prevents hunger upsets- increases Oxytocin to make baby happier

some regulation to blood sugar and temp?

Question 9

Cow milk ruling in children

Answer 9

Non before 6 months- TOO MANY MINERALS AND RISK OF ALLERGY

Not main milk before 12 months- not enough iron

Semi skimmed milk after 2 ONLY if overweight

NEVER give skimmed milk below 5 years- the children need the calories from fat!

Question 10

Cohort study regarding SUGAR in bottles

Answer 10

Children aged 1-5 have association with ECC

Sweetened milk and juice also assassinated

Question 11

Why do people add sugar to bottles (ASSUMPTIONS)

Answer 11

treat constipation

Aid digestion

Help sleep, reduce pain

Question 12

Alternative methods to reduce constipation

Answer 12

<6 months, 2 Tablespoons of cooled boiled water 1-2x daily

> 6 months , 4 Tablespoons of cooled boiled water OR give prunes, plums, Peach, Peas, apricots

BANANAS AND APPLES FIRM UP THE STOOL

Question 13

What age should complementary foods be introduced?

Answer 13

6-7 months

on family foods by 12 months

Question 14

Are supplements required with complementary foods

Answer 14

Yes, in Vit A C and D UNLESS they are having at least a pint of infant formula- this is as it is already fortified

Question 15

What food should be encouraged during the complementary food stage

Answer 15

Unsweetened cereals, Fruits and Veg, unsweetened yogurts

No point switching out sugar for other types of sugar

Question 16

Ruling on drink at the complementary food stage.

Answer 16

Should be mostly water and milk

Drinks from cups should be encouraged from and bottles discouraged from 12 month

Bottle water- they are not all the same- may have minerals that are too high. opt for boiled tap water

Question 17

What is the recommended nutrient break down <5 years?

Answer 17

50% from fat
<5% from free sugar
AVOID VERY HIGH FIBRE
supplements advised

Question 18

UK recommendations for under 5s?

Answer 18

mini version of “5 a day”
3 portions of dairy daily
2-3 portions meat, 3-4 protein rich vegetarian
NO MORE THAN 19G FREE SUGAR

Question 19

Family based dietary intervention studies

Answer 19

Wagner 2014 CASE CONTROLED, mothers that also participated had much lower caries.

Chaffee 2013 ECC lower in mother who took nutritional advice