Jump to comment:

• In Child we trust
  Lucio Piermarini
  Published on: 30 March 2009

• Published on: 30 March 2009

  In Child we trust

  • Lucio Piermarini, pediatrician

  Dear Sir I absolutely agree with your conclusions about demand feeding being something “we might all be able to live with”, but we should really respect the children’s “demand”. I also agree that there is no strong evidence to support exclusive breast feeding for six months, but there is neither strong evidence about the optimal complementary diet and there is not any certainty that the child introduced to solid foods wi...

  Show More

  Dear Sir I absolutely agree with your conclusions about demand feeding being something “we might all be able to live with”, but we should really respect the children’s “demand”. I also agree that there is no strong evidence to support exclusive breast feeding for six months, but there is neither strong evidence about the optimal complementary diet and there is not any certainty that the child introduced to solid foods will accept them assuming the pediatrician's "scientifically" prescribed doses. On the contrary this is the least likely event, in the sense that children will - - in general -- eat more or less of that which was prescribed. Moreover offering solid foods to a child who is not interested at all to them, one is just looking for feeding problems. Man proposes, Child disposes. It is about eight years since a considerable group of family paediatricians, throughout Italy, started practicing what we today define “Demand Complementary Feeding”, i.e. “Baby led introduction of complementary foods in the context of family meals whenever and wherever they take place.” The proposal was first published in 2002 (1), and then reaffirmed in 2006 (2). The point is that the change in WHO recommendations about the most appropriate age of introducing solid foods, gradually sliding towards more mature stages of child development, allowed us to catch those cues you talked about, without the confusing confounding factors arising from the practice of an imposed weaning. So, today, we can not say any more that babies on an exclusive milk-diet show interest in table-food because they are hungry or antsy for something different. They do not know yet that such thing is food. They are, as every baby between five to six month old, interested in table-food as well as in every other thing parents, or other trusty caregivers, are doing all day long. Only after parents yield to their irresistible staring, flustering and reaching, babies taste, often recognize, appreciate and finally accept happily “that thing”,-- which they did not know what it was -- as food. In a cohort study (personal data) in which mothers were followed during pregnancy, they were instructed through specific courses and interviewed in the second half of the first year. Nearly all of them had recognised timely their children's "interest cues" and most of them had carried on meeting their increasing requests of any food on the table, at the children’s pace. Obviously, they did not show problems of refusal or of selected diet, and their mother never worried about insufficient intake or fights for the last crumb. And, on the other hand, there is a decrease in useless work for the paediatrician. Sooner or later all children, gradually, within the end of the first year substituted their midday and evening milk-meals with solid food. At last, but not least, all that, obviously and inevitably, entails an elementary and simple parent’s education about the optimal diet (from now on) for the whole family, that does not necessarily means a tasteless diet. Weaning, as well breast feeding, is primarily a family task.

  1) Lucio Piermarini. Autosvezzamento. Medico e Bambino 2002;21:468- 471 2) Lucio Piermarini. Complementary feeding at request. Medico e Bambino 2006;25:439-442

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top