Chapter 2 – Changing in the child feeding: from lactation to primary school.

As sustained by the European Food Safety Authority (EFSA), the maternal milk it is enough to satisfy the nutritional demands of the greatest part of the babies at 6 months. The weaning should not be on its way before the 17a week of life, of it over the 26a (European Society for Pediatric Gastroenterology, Hepatology and Nutrition – ESPGHAN).

In the baby the requirement of lipids is great in comparison to the following ages: up to the first year of life, a fat contribution of the 40% of the daily calories recommends him, percentage that has decreased to 35-40% since 12 to 36 months thin to arrive, after the three years gradually to the recommended quota for the adults (from 20 to 35%).

In fact, the milk to the beginning of the feed is to contained lower part of fats and to tall content of lactose, sugar, proteins, vitamins, mineral and water. During the feed, the content of fats (50%) increases and that of sugars (7%) decreases. Such percentage allows the baby to take less risks than to become obese, since a possible correlation exists among elevated protein assumption in the first phases of the life and the risk increased to develop obesity and chronic-degenerative illnesses in the following periods of the life.

Besides maternal milk contains over 700 types of bacteria that help her child to develop the immune system and to build the intestinal bacterial flora.

Then maternal milk offers the good approach to his child to a healthy and rich life of affection: in fact, during the feed, his child lives an intimate relationship with his mother, which initially is no other from himself and then becomes the first representation of the world.

Although the maternal milk both a complex inimitable biological system, from 1915 the first prepared formula is had on industrial base beginning from bovine milk: today day the formulas of the artificial milk extend to draw near to that some maternal milk more and more, even if it needs to underline that in the artificial milk it increases the quantity of the consequential calories from proteins and that it needs to be careful to the qualities of the ingredients of the milk in dust.

Therefore, an assignment of the pediatrician is also that to prescribe a type of milk rather than another in base to the demands of the baby, explaining to his/her parents which are the characteristics of that determined artificial milk and because it is fitter for that newborn, making besides to understand to the people the differences of price among the different products, that could appear unjustified to an inexperienced eye.

According to the OMS indications, toward the sixth month it is necessary to begin the weaning because in this phase alone maternal (or of formula) milk is not enough to satisfy the increasing nutritional  requirement of the baby, above all as it regards energy's contribution, proteins, iron, zinc and vitamins, so the feeding must be integrated with fit complementary foods. Besides, in general, the baby is ready to receive solid foods to six months. In fact, around this age "the intestinal maturation is completed and the neurological development allows to grab, to chew and to swallow in effective way”.

Specific ways and menu don't exist to begin the weaning: the proper timing for the introduction of the first different foods from the milk depends on numerous individual variables, among which the specific nutritional demands, the neuro-physiological and anatomical-functional development, the stature and ponderal growth, the relationship mother-child, the specific demands of mother and the partner-cultural context.

Following the lines drives for the weaning of the World Health Organization, it gradually needs to introduce in the diet of child seed-solid foods and then solid, in other words "complementary foods" that they don't forcedly have to replace the maternal milk but to integrate it: in fact, even though more exclusive, the nursing to the breast must also continue after the introduction of other foods, and it is desirable for the psycho-physical (a smaller incidence of certain typologies of tumor is ascertained as the childish leukemia, and of certain types of metabolic and autoimmune illnesses and a great intellectual development) comfort of child up to that such practice continues when child and mother desire it, also over one year of age.

The complementary foods can be classified in:

• Foods of transition (past, in purea, semisolid), belonging foods that is to specific categories but adapted for responding to the particular nutritional demands and physiological of the baby.
• Family foods, based on a various and balanced family diet, with some small adaptation.

Between the 6 and the 8 months these foods must be offered 2-3 times a day, increasing to 3-4 times after the 9 months and adding a nourishing snack 1 - 2 times a day after the 12 months, if child desires it. Then generally the weaning is begun with fruit and eat up of it, but "without forcing child, allowing him to touch food in the dish and to eat with the hands" (baby led approach) and "alternating different foods for color, taste and consistence.

Initially not approved food must have proposed him however with patience in following days, eventually prepared in different way. And then it is important that child eats sat with the erect back (preferably in the high chair) to avoid the risk of suffocation and to allow to actively participate him in the meal, touching and messing up with the food.

As it regards the nutritional demands of child from 1 to 3, the general energetic contribution must adequately be divided among the different macro-nourishing. According to the recent indications of the "Levels of Assumption of Reference and Energy for the population" (LARN), such contribution should derive for 50% from the carbohydrates, for 40% from the fats and only for around 10% from the proteins.

The carbohydrates include the flours and the sugars. They are naturally found in all of this that contains flour of whatever type (bread, pasta, laughed etc.) and in all of this that contains sugar (sweets, fruit, honey etc.).
The proteins are contained especially in every kind of meat, fish, eggs, dairy products, cereals and vegetables.

The fats: they are divided in saturated, present in the milk-cheese products, in fat meats and in certain vegetable (oil of palm and oil of coconut) oils, and in unsaturated, present especially in the vegetable (oil of olive) oils, walnut-trees, filberts, peaches, olives.

To underline it is the fact that, in comparison to the past years, the criterion of the progressive introduction of the foods is set aside according to the degree of allergic reaction, for a great attention to the character and the tastes of child. In fact, the weaning poses some practical problems, what the problem of the teaspoon, of the taste, of the consistence, of the tolerance that the educators can overcome trying to:

• to be reasonable, or to try to understand what’s the best moment to begin the weaning in accordance with the characteristics of your child;
• possession calm: to gradually introduce in the diet new foods, assuring himself that child is meanwhile adapted to those precedents;
• to be prudent: being very careful to as your child put up with every new food;
• possession patience: it is important that during the meals attention is paid to your child, encouraging him and not forcing him to eat, avoiding distractions around him, speaking to him and helping him with love.

In the menu processing, it is recommended to respect some principles:

• Little salt
• Few simple sugars
• No pepper or spicy seasonings
• Fruit and vegetable always present
• Few fat of animal (to prefer the thin meat) origin
• To offer white fish e/o yields of sea 2-3 times a week
• To offer an ample range of nourishing foods
• Threshold the quantity of fruit juices
• For a child not nursed to the breast, after the 12 months, 200-400 ml / die of whole bovine non-diluted milk are recommended if others foods of animal derivation are included in the diet, 300-500 ml / die if I am not it
• To avoid honey to 1 year
• To prefer the use of seasonal and biological foods
• To prefer the simple cooking as the steam cook.

Generally weaning is begun with "it eats up only", where all the ingredients are mixed together, for then to pass to some foods to thin (beginning with vegetable, cheese, fish and so on) to reach the meal to more courses. The "it eats up only" she realizes with the vegetable broth. Vegetable broth is prepared using fresh vegetables of season. With this broth the creams of cereals (rice, corn, oats, rye, mixed cereals) are melted getting used child step by step to a great consistence, and passing from the creams to the semolina, to the bows and finally to the pastina or to the well-cooked rice.

After the preparation of the it eats up, they are added parmesan cheese, oil virgin extra of olive and finally 2 - 3 teaspoons of past vegetable, the same one used for getting the vegetable broth.

Together the meat is added: it is begun with freeze-dried and homogenized of chicken, turkey, rabbit and lamb, less allergens, for then to also insert calf and steer.

Gradually other protein sources are fitted into the diet, as fish, vegetables, cheeses, reducing the daily contribution of meat to three times a week, the correct dose for a baby that has been growing then for the year in.
For the portions, for a 7-8 month-old child it can be used 50g of past of vegetable (potatoes, carrots, zucchini and lettuce) or 200 ml of vegetable broth, with addition of 14 g (2 table spoons) of pastina or 12 g (two table spoons) of cream (rice, fines cereals, corn and tapioca), a teaspoon of oil of olive. Like protein source, it can be chosen among: 40 g of homogenized meat or fish; 25 g of ricotta of cow; 5 g of meat lyophilizate or 12 g of dry (around 1 table spoon) lentils.

Between the 9 and the 12 months they are also added as protein sources the egg, the cooked or raw ham without fat (15g) or the ricotta of cow (25 g). Between the 12 and the 24 months they increase pasta's (28 g) portions, rice and semolina (25g) for first; meat or fish fresh (30g); dry vegetables (15g); fresh cheese (25g) for second course, to always serve with mixed (100 g meal) vegetables. Between the 24 and the 36 months the portion of pasta, rice or pastina reaches 45 g, with also a slight increase of the protein (20 g of affected and 40 g of fresh fish) quota.

Focus on babies’ vegan / vegetarian diet

In front of the increasing number of individuals and families that the so-called alternative alimentary regimes choose, in the different kindergartens vegetarian/vegan menu has been introduced in the different kindergartens, in base to the "lines of national address for the scholastic food service" that they foresee suitable substitutions of foods correlated to reasons ethical - religious or cultural: who refuses the foods of animal origin for ethical motives, it does it not to cause sufferings to the animals and to have an inferior environmental impact on the ecosystem.

The vegetarian diet foresees the elimination of meat and fish, but it admits the consumption of all the other animal foods as eggs, milk and cheeses; instead the vegan diet excludes all the foods of animal origin, that is it foresees a feeding 100% vegetable: accordingly to replace the animal proteins, the vegan diet offers pasta, laughed and other cereals, vegetables and soups, fruit shoal, bread, pizza breads and salty cakes, algae, vegan variety of the typical dishes, through the use of the tofu (milk of soy) in substitution to the cheese and of the seitan (wheat's gluten) to the place of the meat.

To underline it is that still heated is the debate among the experts of health and feeding respect to the veganism, or if the vegan diet is proper for his/her/their children from a nutritional point of view: in fact the babies vegans are more exposed to deficiencies of vitamin B12, folic acid (vitamin B9), zinc, iron and kick and the assimilation of the essential substances for the organism it is around the triple one in the foods of animal origin in comparison to those vegetable (matter of the bioavailability of the nourishing ones).