Do I Give Them The Food They Want Or The Food They Need?

Learning to be parents for the first time:

Jesus and Federica are responsible for little Aldo, 8 months old. First child. Federica, 23, who is a secretary, provides the baby with breast milk from birth and hopes to continue doing so for another 6 months.

However, her work does not allow her to continue feeding her baby with the same frequency.

On the other hand, the child's father, aged 25, is an industrial engineer with basic cooking skills.

He knows how to prepare rice, soup and stews; he fries meat, chicken, fish and makes natural juices, but the big challenge has been to get the baby to accept his meals.

Before the baby's birth, this Colombian couple calculated a plan for their care: they would divide the obligations of caring for the little one, whom they still do not want to leave to others, as a precaution. But nothing has gone as planned.

"I have had problems with his feeding. Everything I try to prepare for her spits up or the baby doesn't like it," Jesus says with concern. His wife, who doesn't know what the right food is, has had the same difficulty.

Jesus and Federica know that a balanced and nutritious diet is made up of fruits, vegetables and protein, yet they are unable to 'connect' with the child or educate him or her properly to eat.

"We have done everything, even giving the child cookies and packaged goods, as well as yogurts and sweets, because that is the only thing that receives us. We look for vitamin supplements for babies without suspending their milk, so that they don't lose weight," says Federica.

Lack of information

According to Betty Leon, a pediatrician, childcare worker and researcher at the Simón Bolívar University, this scenario is more frequent than one might think.

"Many parents have doubts about everything related to child nutrition, and dietary transgressions or errors in feeding their children happen very often.

The doctor explains that probably due to lack of information from a reliable source or medical guidance, these parents could malnourished their child without being aware of it.

Reviewing the literature, sources such as UNICEF, in its latest report entitled 'The State of the World's Children 2019 - Children, Food and Nutrition - Growing well in a changing world', says that "child-friendly nutrition - recognizing the signs of hunger and satiety in children and responding to them in the right way - helps to establish healthy eating habits from childhood and to combat both underweight and childhood obesity".

In terms of nutrition, the report explains that it is necessary to ensure that healthy food is available. Generally, children should be fed in a safe, comfortable environment with few distractions to eat; signs of hunger and satiety should be addressed; and the needs for food should be recognized and met in a timely, loving and developmentally appropriate manner that is positive for improving eating habits.

According to the study, good nutrition is not only what calms hunger but also what ensures the physical and mental development of children.

In Latin America and the Caribbean, 4.8 million children under 5 suffer from growth retardation and 0.7 million from emaciation (low weight for height) due to under-nutrition, while 149 million children under 5 in the world suffer from growth retardation and almost 50 million have emaciation.

Children should not be forced to eat.

"There are situations where the caregiver controls and dominates the intake; others where it is the child who controls, or where the caregiver ignores the child.

When the caregiver dominates the situation, he or she may not only ignore the child's signals of hunger and fullness, but also interfere with the development of the child's autonomy and independence," the UNICEF report states.

On the other hand, overweight and obesity continue to represent health problems in the Americas and are being studied by various authors and countries. In the annual UNICEF/WHO/World Bank Group Joint Child Malnutrition Estimate for 2019, the figures for levels and trends in child malnutrition are reported by continent, where the Americas as a whole have 5.8 million overweight and obese children.

"This phenomenon observed especially in Latin America is called the double burden of malnutrition, where both malnutrition and child obesity coexist and have brought new challenges for medicine and health policies," says Leon, who said feeding children from birth is a challenge.

In Colombia, even though child malnutrition figures have decreased, it still represents a public health problem, along with child obesity.

Regarding the situation of overweight and obesity in Colombia, the National Survey of the Nutritional Situation in its last report published in 2015 reports that 6.3% of children under 5 years were overweight. In school children, excess weight represented 24.4% and in adolescents, excess weight was 17.9%.

Nutrition in children, a challenge for public health in Norte de Santander

Since April 2019, with the support of an interdisciplinary team of professionals from the Unisimón, Leon led an exploratory study to learn about the state of excess weight disorders in children and adolescents in the city of Cúcuta.

A total of 187 surveys were conducted among parents of children between 6 and 16 years old. In addition, each child and adolescent was determined the Body Mass Index (BMI) for the diagnosis of nutritional status, according to the tables of the World Health Organization.

The preliminary results of this study, reported that the prevalence of overweight was 22.5% and obesity 16.6%. In addition, as an extra data, it was obtained that 36.7 % of the children and 57.4 % of the girls, presented a healthy weight.

In conclusion, the data obtained are in accordance with the data published at national level. "The percentage of overweight children is striking, because they are the population at greatest risk of developing obesity in the short term or at risk of making a transition to obesity in the short term," said the researcher.

Similarly, the 'Growing Up Healthy' program was created, in which researchers have carried out different activities promoting healthy eating from the first months of life until adolescence.

"One of the purposes of the program is to inform parents or caregivers about the factors that make it difficult for their children to eat well, what elements are indispensable for a balanced diet, and to debunk myths associated with eating," Leon added.

Recommendations:

• Breastfeeding for the first six months of life should be exclusive and on demand.
• If artificial feeding is offered, it should be administered in the same way during the first six months of life, on demand.
• Milk formulas will never outweigh the benefits of breast milk, both for the child and the mother.
• Complementary feeding should begin at 6 months of age.
• The foods should be administered one at a time and, after verifying that there are no allergy processes, they can be combined with each other.
• Preferring whole foods or pieces to smoothies or porridge.
• Offer foods at any age that are as unprocessed as possible.
• Salt and sugar should not be added to children's foods before the age of two.
• Children's diets should be varied and colorful.

Set an example for your children: reinforce healthy habits at home, balanced meals and regular physical activity.