From pregnancy and nutrient deficiencies to feeding challenges

The cornerstone for child health is laid down during pregnancy. Events in this critical period affect health with long-lasting consequences this includes nutritional deficiencies. Later on, some children may experience feeding challenges such as functional gastrointestinal disorders (FGID), which can be mild and self-resolving or affecting the well-being of the infant more severely. Parents and caregivers are affected when the child is crying and sleeping poorly during colic or constipation or sorting out how to manage the child's regurgitation (or vomiting) and diarrhoea. Besides the common symptoms and diagnosis criteria we introduce some of the management options of FGID and other feeding challenges like allergies and nutrient deficiencies.
Parts of a natural growth path are steered through breastfeeding () and further influenced  by complementary feeding and the introduction of "weaning foods". This is the phase in which the child's energy needs are no longer met by breast milk and it gets introduced to textures other than the liquid/creamy emulsion from the breast. At about six months, the pureed foods are offered that in the course of the year slowly increase in texture accounting for the child's growing capabilities to manage suckling, chewing, nibbling, swallowing and breathing.  

Fewtrell 2017 ESPGHAN on complementary feeding / 10.1097/MPG.0000000000001454

Complementary feeding - a paper synopsis

The European Society­ for Paediatric Gastroenterology, ­Hepatology, ­and Nutrition­ (ESPGHAN) Committee on Nutrition published their position on Complementary Feeding in 2017 - and we summarized this extensive and well developed paper for a quick and easy read. Complementary feeds are introduced at about six months of age in parallel to breastfeeding, which ideally continues until 24 months of age. Complementary foods are covering the infant's energy and nutritional needs but also support the child's development: it learns about tastes other than milk and textures that challenge its ability to coordinate breathing with chewing and swallowing. This is a period, in which the children are prone to experience nutrient deficiencies (e.g. iron ) when they are switched to adult foods that do not meet the child's nutritive needs in support of the rapid growth in the first two years of life. ESPGHAN is proposing timing and composition of complementary feeding, feeding methods, and practices with focus on healthy term infants in Europe.

Download this paper synopsis


Why the digestive system matters so much

Similar to skin and lung, the intestine is exposed to the environment. Our biggest immune organ is governed not only by hormones but both the somatic and autonomic nervous systems, houses millions of bacteria, the cells that responsible for digestion and absorption and those that help defend the body against sickness and disease. Coordinating that the local bacteria remain in manageable proportion and precisely localized so that they cannot cause sepsis is just as fine-tuned as the renewal of enterocytes in their specialized function every three to five days. Mastering the many functions and connections through two parts of the nervous system requires a high degree of sensitivity. This balance can be disrupted through stress and anxiety and many other factors. In infancy, disturbances may occur because coordination is not well established, which may lead to feeding challenges ().