Nutrition in the first years of life: an interview with Professor Marcello Giovannini

In this interview, prof. Marcello Giovannini, emeritus professor of pediatrics at the University of Milan, president of the European Academy of Nutritional Science, provides useful advice for nourishing the baby well.

Q. How is the nutrition of the little ones in Italy today? According to the latest data from the WHO, World Health Organization, it seems that childhood overweight and obesity are decreasing ....

A. "In reality, there are still many excesses and deficiencies in the nutrition of children in the first 3 years of life. Unfortunately, even if there are signs of a slight improvement, this is still not enough.
According to the data that emerged from the "Okkio alla Salute 2014" survey promoted by the Ministry of Health, in Italy overweight children are 20.9%, while obese children are 9.8%, with a prevalence in the regions of central and southern Italy. These are still very worrying figures.
This is why we must not let our guard down, but it is important to lay the foundations for proper nutrition right away.
In fact, eating habits are built right from the fetal period, so it is important that the mother follows a balanced diet, and offers the small child the best possible nourishment right after birth ".

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Q. Speaking of the best possible nutrition, you always stress the importance of choosing breast milk. Is it true that Italy is among the countries with the highest percentage of breastfeeding mothers?

R "I would like to remind you that exclusive breastfeeding is recommended for at least the first 6 months of life. Afterwards it should be extended, as part of a diversified diet, as long as possible, according to the wishes of mother and child. .
Breastfeeding has infinite benefits, both for the baby and for the mother. Breast milk contributes to the construction of a correct intestinal bacterial flora and a solid immune system. Furthermore, babies who are exclusively breastfed, at least for the first 6 months of life, are better protected from allergies, asthma, dermatitis, diabetes mellitus, overweight and obesity.
In our country, the percentage of mothers who breastfeed at the time of hospital discharge is over 80%, but already by the fifth month it is reduced to 50%.
And we also know that many mothers introduce cow's milk in their baby's diet as early as 9 months ".

Q. What does the early introduction of cow's milk involve? And what do you suggest as an alternative?

A. “Cow's milk, which has a protein content of about three times that of breast milk and is low in iron, is the least suitable for newborns and infants and is not recommended before 12 months. An even more prudent attitude could be to suggest postponing the introduction of cow's milk after 24 months. The early introduction of cow's milk could lead to an imbalance in the diet. This food, in fact, does not meet the needs of a child. Compared to an adult, a baby needs for example 5 times more iron.
As a possible strategy, within a diversified diet, starting from the 12th month, the pediatrician has formulas available for children aged 12 to 36 months, the so-called "growth milk", a milk with an optimized protein profile and which it can contribute to a correct intake of iron, calcium and vitamins, recommended for 1 to 3 years ".

D., In Italian families, after the first year there is a tendency to offer their child the same type of milk and the same foods as adults. Why is it important to keep specific milk even after the year?

A. "Even after the year, the child is not a" little adult "and therefore milk must also be made to measure. Milk, like any food, is therefore essential for proper growth. For this reason, even at this stage, breast milk would be preferred. If not available, growth milk (12 to 36 month formula) can be a viable alternative.
It is known that in the first 1000 days, nutrition plays a crucial role especially for its impact in building future good health ".

Q. Speaking of 1000 days, can you tell us how the child grows, what happens to his organism in this phase?

A. “It is important to give the child the right stimuli, because in the first years the main verbal and cognitive faculties develop. For example, from the first to the third year, the child learns up to 900 new words. It is therefore essential to take more nutrients such as iron and vitamin D, which help physical growth and the development of verbal and cognitive skills.
Physical growth is also important: in this period of life, the child grows significantly in length, even reaching 25 cm in the first year ".

D. Breakfast is of great importance to combat childhood obesity and overweight, as it is the first meal after an overnight fast. It is therefore essential to take the right amount of calories and nutrients. What, in your opinion, is the right caloric intake for a child's breakfast?

A. "For breakfast, about 15-20% of calories of the total daily intake should be consumed. The quantity must be commensurate with the physical activity that the child normally performs during the day. It is also good that breakfast is consumed on average within a reasonable time, which must not be less than 10 minutes, usually 15 minutes. After one year of age, if breast milk is no longer available, the baby can switch to growth milk, as always heard the opinion of the pediatrician ".

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