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Too much of a good thing?

Survey finds communication gap on early childhood nutrition, Annie May reports.

There needs to be increased communication between healthcare professionals and parents to improve understanding about the right nutrition practices for children, a new survey has found.

The international survey involving 1200 GPs, paediatricians, paediatric nurses and nurse practitioners from 12 countries revealed that 36 per cent of Australian healthcare professionals perceive that parents are “not too concerned” or “not at all concerned” that their child is getting too much of some nutrients.

In today’s obesity-conscious environment, getting an optimal balance of nutrients during the first years of life is crucial for life-long health and well-being, says Kate Di Prima, accredited practicing dietitian and infant nutritionist.

“Most parents understand the importance of infants getting enough nutrients, but many don’t realise that too much of certain nutrients can also negatively impact long-term health. It’s a case of too much of a good thing can be a bad thing,” Di Prima told Nursing Review.

Clinical and observational studies have investigated factors in early life which may affect long-term health outcomes, including an association between high protein and high energy intake in infancy and weight gain in later childhood. Rapid weight gain during infancy has been associated with risk of later obesity.

“One in four children in Australia today is in the overweight category. That number is too high. Many of these kids grow into overweight or obese adults, with 66 per cent of Australian adults fitting in to that category,” says Di Prima.

“To reverse this trend it is so important to get our children off to a good start and for that to happen parents need to be about healthy growth and appropriate feeding practices for infants and young children.”

The Nourish survey, conducted by Pfizer Nutrition, also revealed healthcare professionals in Australia were fairly evenly divided on whether ‘more is better’ when it comes to nutrients in children’s formula. It also found 25 per cent of professionals in Australia do not agree or are unsure that a child can have too much of some nutrients, even if they are needed for development.

“There is evidence which suggests high intake of dietary protein contributed to potentially unhealthy weight gain in early childhood. The survey highlighted that a degree of misunderstanding prevails amongst a proportion of healthcare professionals, as well as parents, around what proper nutrition means in terms of getting an optimal balance of nutrients for formula-fed babies,” says Di Prima.

While breast milk was always the preferred option, she says it was not always possible for all mothers to feed their newborns in this way and a good alternative was needed.

“There are studies that show formula-fed babies grow too quickly but companies are working on getting the right balance of nutrients to make it as close to breast milk as possible,” says Di Prima.

While that takes place, the Brisbane-based dietitian and mother of two says parents of formula-fed babies need to be mindful of overfeeding.

“Breast-fed babies self-regulate their milk intake but bottle-feeding is directed by the caregiver, and this can lead to overfeeding. Parents who feed their baby either expressed breast milk or formula with a bottle need to pay special attention to their baby’s feeding cues,” she says.

“Mothers may push the baby to empty the bottle, but if they’re breast-feeding, there’s no way to see how much the infant is consuming. It is important to recognise the cues of when an infant has had enough. Often when they stop sucking or pull away from the bottle parents think they are distracted or being fussy and will make them drain the bottle.”

Information on how to identify these cues and other nutritional advice needs to be given to parents from the very beginning.

“Parents are not experts. They are also given advice from their mothers, mother-in-laws and friends with children. This is well intentioned, and something it is the correct advice, but it is up to GPs, nurses and dietitians to make sure parents are well educated. It’s also no good waiting to when infants are putting on weight too quickly. It needs to happen before it starts.”

Nutrition facts
Children with deficient growth before age two are at an increased risk of chronic disease as adults if they gain weight rapidly in later stages of childhood.

Globally, in 2010 around 43 million children under the age of five were overweight.

The term “malnutrition” refers to deficiencies, excesses, or imbalances in intake of energy, protein, and/or other nutrients. Contrary to common usage, “malnutrition” actually refers to both under-nutrition and over-nutrition.

Malnutrition in childhood can cause lifelong health problems.

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