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      Baby led weaning, ¿seguro y eficaz? Una revisión narrativa Translated title: Baby led weaning, safe and effective? A narrative review

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          Abstract

          Resumen Introducción El baby led weaning (BLW) o destete dirigido por el bebé es una técnica de alimentación complementaria que se ha puesto de moda en los últimos años gracias principalmente a su difusión por internet. Objetivo: determinar si dos de las principales críticas recibidas por este método (riesgo de atragantamiento y déficits nutricionales) son reales en comparación con otras técnicas de alimentación complementaria. Metodología Revisión narrativa de estudios de cohorte y diseños aleatorizados publicados en los últimos años en las bases de datos PubMed y Google Scholar. Resultados Once trabajos (siete relacionados con el atragantamiento y cuatro vinculados con los déficits nutricionales) fueron incluidos y analizados en esta revisión. Conclusiones El BLW se presenta como una técnica de alimentación complementaria segura ya que no presenta más riesgo de atragantamiento que otras. En relación a su eficacia nutricional, no existe una evidencia sólida en relación a la exposición de alimentos ricos en hierro en niños que siguen el BLW con respecto a niños que siguen otra técnica.

          Translated abstract

          Abstract Introduction The baby led weaning (BLW), or weaning directed by the baby, is a complementary feeding technique that has become fashionable in recent years thanks mainly to its diffusion on the internet. Objective: to determine if two of the main criticisms received by this method (risk of choking and nutritional deficits) are real compared to other complementary feeding techniques. Methodology Narrative review of cohort studies and randomized designs published in recent years in the PubMed and Google Scholar databases. Results Eleven works (seven related to choking and four related to nutritional deficits) were included and analyzed in this review. Conclusions The BLW is presented as a safe complementary feeding technique since it presents no more choking risk than others. Regarding their nutritional efficacy, there is no solid evidence regarding the exposure of iron-rich foods in children who follow the BLW with respect to children who follow another technique.

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          Most cited references38

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          Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation

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            Optimal duration of exclusive breastfeeding

            Although the health benefits of breastfeeding are widely acknowledged, opinions and recommendations are strongly divided on the optimal duration of exclusive breastfeeding. Since 2001, the World Health Organization has recommended exclusive breastfeeding for six months. Much of the recent debate in developed countries has centred on the micronutrient adequacy, as well as the existence and magnitude of health benefits, of this practice. To assess the effects on child health, growth, and development, and on maternal health, of exclusive breastfeeding for six months versus exclusive breastfeeding for three to four months with mixed breastfeeding (introduction of complementary liquid or solid foods with continued breastfeeding) thereafter through six months. We searched The Cochrane Library (2011, Issue 6), MEDLINE (1 January 2007 to 14 June 2011), EMBASE (1 January 2007 to 14 June 2011), CINAHL (1 January 2007 to 14 June 2011), BIOSIS (1 January 2007 to 14 June 2011), African Index Medicus (searched 15 June 2011), Index Medicus for the WHO Eastern Mediterranean Region (IMEMR) (searched 15 June 2011), LILACS (Latin American and Caribbean Health Sciences) (searched 15 June 2011). We also contacted experts in the field.The search for the first version of the review in 2000 yielded a total of 2668 unique citations. Contacts with experts in the field yielded additional published and unpublished studies. The updated literature review in December 2006 yielded 835 additional unique citations. We selected all internally-controlled clinical trials and observational studies comparing child or maternal health outcomes with exclusive breastfeeding for six or more months versus exclusive breastfeeding for at least three to four months with continued mixed breastfeeding until at least six months. Studies were stratified according to study design (controlled trials versus observational studies), provenance (developing versus developed countries), and timing of compared feeding groups (three to seven months versus later). We independently assessed study quality and extracted data. We identified 23 independent studies meeting the selection criteria: 11 from developing countries (two of which were controlled trials in Honduras) and 12 from developed countries (all observational studies). Definitions of exclusive breastfeeding varied considerably across studies. Neither the trials nor the observational studies suggest that infants who continue to be exclusively breastfed for six months show deficits in weight or length gain, although larger sample sizes would be required to rule out modest differences in risk of undernutrition. In developing-country settings where newborn iron stores may be suboptimal, the evidence suggests that exclusive breastfeeding without iron supplementation through six months may compromise hematologic status. Based on the Belarusian study, six months of exclusive breastfeeding confers no benefit (versus three months of exclusive breastfeeding followed by continued partial breastfeeding through six months) on height, weight, body mass index, dental caries, cognitive ability, or behaviour at 6.5 years of age. Based on studies from Belarus, Iran, and Nigeria, however, infants who continue exclusive breastfeeding for six months or more appear to have a significantly reduced risk of gastrointestinal and (in the Iranian and Nigerian studies) respiratory infection. No significant reduction in risk of atopic eczema, asthma, or other atopic outcomes has been demonstrated in studies from Finland, Australia, and Belarus. Data from the two Honduran trials and from observational studies from Bangladesh and Senegal suggest that exclusive breastfeeding through six months is associated with delayed resumption of menses and, in the Honduran trials, more rapid postpartum weight loss in the mother. Infants who are exclusively breastfed for six months experience less morbidity from gastrointestinal infection than those who are partially breastfed as of three or four months, and no deficits have been demonstrated in growth among infants from either developing or developed countries who are exclusively breastfed for six months or longer. Moreover, the mothers of such infants have more prolonged lactational amenorrhea. Although infants should still be managed individually so that insufficient growth or other adverse outcomes are not ignored and appropriate interventions are provided, the available evidence demonstrates no apparent risks in recommending, as a general policy, exclusive breastfeeding for the first six months of life in both developing and developed-country settings.
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              How to write a systematic review.

              The role of evidence-based medicine in sports medicine and orthopaedic surgery is rapidly growing. Systematic reviews and meta-analyses are also proliferating in the medical literature.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                December 2021
                : 23
                : 92
                : e163-e171
                Affiliations
                [2] Albacete orgnameUniversidad de Castilla-La Mancha orgdiv1Facultad Educación orgdiv2Ciencias de la Actividad Física y el Deporte Spain
                [1] Guadalajara orgnameServicio de Salud de Castilla-La Mancha orgdiv1Hospital Universitario de Guadalajara España
                Article
                S1139-76322021000400019 S1139-7632(21)02309200019
                d391db45-7a59-4ec4-ab56-45babc54fe07

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 0
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                SciELO Spain

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                Nutritional deficit,Alimentación complementaria,Atragantamiento,Supplementary feeding,Baby led weaning,Déficit nutricional,Nutrición,Choking,Nutrition

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