Clinically Relevant Topics and New Tendencies in Childhood Nutrition during the First 2 Years of Life: A Survey among Primary Care Spanish Paediatricians.

A multicenter cross-sectional study was conducted among 245 experienced Spanish paediatricians, who completed an online survey based on clinically relevant topics in nutrition during the first two years of life and their recommendations to parents in daily clinical practice. Most participants advise about the choking risk associated with baby-led weaning (BLW) and more than 60% consider that infants can receive an insufficient variety and quantity of nutrients with this practice. The general opinion is that there is a lack of evidence for delaying the introduction of gluten and other allergenic foods in the complementary feeding of healthy infants. Most participants agree/strongly agree that two servings of dairy products are the adequate daily amount in a diversified diet and 93.4% disagree/strongly disagree with the use of vegetal beverages under 1 year of life. There is a general agreement to avoid added salt and sugar before 12 months of life, the consideration that organic foods do not have a better nutritional profile than non-organic ones, and the limitations of vegetarian diets especially for adequate provision of micronutrients. Overall, there is an adequate knowledge of the new trends by paediatricians and younger ones seemed more in favor of them and interested in receiving more information on most topics.

Differences between parents' and paediatricians' perceptions of mild respiratory infections in childhood: contrast study.

Introduction: Mild respiratory infections are a common reason for consultation in paediatrics, both in the emergency department and in primary care clinics. These conditions, mostly viral and self-limiting, have a significant impact on the healthcare system, school and work absenteeism, and family routines. Despite being common and banal illnesses from a medical perspective, they involve a significant concern in families. The main objective of the contrast study was to compare the perceptions of parents and paediatricians regarding mild respiratory infections in childhood and their impact on family conciliation. Materials and methods: Two online, cross-sectional surveys were conducted among Spanish paediatricians and parents with children aged 6 months to 12 years, involving 504 paediatricians and 1,447 families, with questions on attitudes towards visits to the paediatric consultation, care burden of minor pathologies, work, and family conciliation, and treatment and prevention of these illnesses. Results: Results showed significant differences in paediatricians' and parents' perceptions in many aspects. According to 34.5% of paediatricians and 27% of parents, families regularly go to the paediatrician without a scheduled visit. Only 4% of parents report having self-medicated their child, while paediatricians raise this percentage significantly to 48%. Regarding the question: "it is normal for a child to have an average of 4 colds a year," only 25.5% of the surveyed families "strongly agree" unlike to 70.2% of paediatricians. 72.8% of paediatricians "strongly agree" with: "in my opinion, it is good for children to get sick to improve their immune system" reduced to 45.9% of parents. Consultations for minor pathologies represent a "high workload" for 60.9% of paediatricians, while this opinion is agreed by only 18.9% of the parents. Conclusion: Mild respiratory infections in childhood are perceived differently by paediatricians and parents. While paediatricians perceive them as a common and manageable phenomenon, parents tend to show higher concern and demand for medical attention. This study underlines the need to improve communication between paediatricians and parents to align perceptions, optimise the use of the health system resources, and improve the efficiency in the management of these common paediatric illnesses.

[Early life nutrition and immunity]. / Nutrición e inmunidad en las primeras etapas de la vida.

Introduction: The first 1,000 days of life, from conception to two years of age, are a critical time window for human growth and development, since the interaction of different factors can generate relevant changes in different structures and functions of the organism, both at short and long term. Most of the studies in this area have been carried out in the prenatal and neonatal period. Some of the most relevant factors that can affect immune development at this time are smoking, maternal obesity and inadequate intake of micronutrients during pregnancy. In the case of the postnatal period, breastfeeding is primarily the most important factor related to the nutritional and immunological status of the newborn, also being associated with a protective effect against obesity. Subsequently, the proper introduction of complementary feeding will be essential to offer an adequate percentage of nutrients. Likewise, the intestinal microbiota also plays a key role during this period since it is part of different metabolic, protective, and immunological functions of the host. Fluctuations in homeostasis will condition the appearance of dysbiosis, which is associated with the development of different diseases in childhood, adolescence, and adulthood.

Introducción: Los primeros 1.000 días de vida, que van desde la concepción hasta los dos años, son una ventana de tiempo crítica para el crecimiento y desarrollo humano, ya que la interacción de diversos factores puede generar cambios relevantes en diferentes estructuras y funciones del organismo tanto a corto como a largo plazo. La mayoría de los estudios en este ámbito se han realizado en el periodo prenatal y neonatal. Algunos de los factores más relevantes que pueden afectar el desarrollo inmunitario en esta etapa son el tabaquismo, la obesidad materna y la ingesta inadecuada de micronutrientes durante el embarazo. En el caso de la etapa posnatal, la lactancia materna es en primera instancia el factor más importante relacionado con el estado nutricional e inmunológico del recién nacido, asociándose también con un efecto protector frente a la obesidad. Posteriormente, la introducción apropiada de la alimentación complementaria será fundamental para ofrecer un porcentaje adecuado de nutrientes. Por su parte, la microbiota intestinal también juega un papel clave durante este periodo, ya que interviene en diferentes funciones metabólicas, protectoras e inmunológicas del hospedador. Fluctuaciones en su homeostasis van a condicionar la aparición de disbiosis, la cual se asocia con el desarrollo de diferentes enfermedades, tanto en la niñez como en la adolescencia y también en la edad adulta.

Nutrición e inmunidad en las primeras etapas de la vida / Early life nutrition and immunity

Los primeros 1.000 días de vida, que van desde la concepción hasta los dos años, son una ventana de tiempo crítica para el crecimiento ydesarrollo humano, ya que la interacción de diversos factores puede generar cambios relevantes en diferentes estructuras y funciones delorganismo tanto a corto como a largo plazo.La mayoría de los estudios en este ámbito se han realizado en el periodo prenatal y neonatal. Algunos de los factores más relevantes que puedenafectar el desarrollo inmunitario en esta etapa son el tabaquismo, la obesidad materna y la ingesta inadecuada de micronutrientes durante elembarazo. En el caso de la etapa posnatal, la lactancia materna es en primera instancia el factor más importante relacionado con el estadonutricional e inmunológico del recién nacido, asociándose también con un efecto protector frente a la obesidad. Posteriormente, la introducciónapropiada de la alimentación complementaria será fundamental para ofrecer un porcentaje adecuado de nutrientes.Por su parte, la microbiota intestinal también juega un papel clave durante este periodo, ya que interviene en diferentes funciones metabólicas,protectoras e inmunológicas del hospedador. Fluctuaciones en su homeostasis van a condicionar la aparición de disbiosis, la cual se asocia conel desarrollo de diferentes enfermedades, tanto en la niñez como en la adolescencia y también en la edad adulta. (AU)

The first 1,000 days of life, from conception to two years of age, are a critical time window for human growth and development, since theinteraction of different factors can generate relevant changes in different structures and functions of the organism, both at short and long term.Most of the studies in this area have been carried out in the prenatal and neonatal period. Some of the most relevant factors that can affectimmune development at this time are smoking, maternal obesity and inadequate intake of micronutrients during pregnancy. In the case of thepostnatal period, breastfeeding is primarily the most important factor related to the nutritional and immunological status of the newborn, alsobeing associated with a protective effect against obesity. Subsequently, the proper introduction of complementary feeding will be essential tooffer an adequate percentage of nutrients.Likewise, the intestinal microbiota also plays a key role during this period since it is part of different metabolic, protective, and immunologicalfunctions of the host. Fluctuations in homeostasis will condition the appearance of dysbiosis, which is associated with the development of differentdiseases in childhood, adolescence, and adulthood. (AU)