Thursday, March 31, 2011

Ethnocentric Weaning And Problems

There was March 11, 2011 weekly report from the Centers from Disease Control concerning the practice of adult caregivers chewing table food and giving it to their babies/toddlers. The report focused on HIV infected caregivers primarily young mothers from 9 different HIV treatment centers. The survey was inspired by an August 2009 issue of Pediatrics that contained an article about three babies who acquired HIV from infected moms. The survey revealed that 152 out of 192 respondents having babies engaged in the practice. Two-thirds of those were African-American. One quarter were Hispanic. Only 7% were white. The remainder were "miscellaneous."

It is important to consider some things about using pre-chewed food, often referred to as pre-masticated food to wean babies from breast milk or formula. First and foremost is the fact that HIV is not easily/usually transmitted in saliva. However, other disease organisms are known to be transmitted that way, notably Hepatitis B, Group A Streptococcus, Herpes, and the Epstein-Barr virus. Gertrude Petlo and others at Cornell University published a study in a 2010 issue of Maternal and Child Nutrition of pre-mastication in Han China. It was actually two studies. Remarkably, one found that 63% of university students responding had been raised on pre-masticated food. The article noted some important benefits of pre-mastication. One benefit was the reduction iron deficiency because of the iron rich food that is passed through pre-mastication. Another mentioned was the fact that saliva in infants under 9 months old is less efficient at digesting complex starches. The adult saliva in pre-masticated food prevents this.

The behavior of pre-mastication is, as described in the G. Petlo et al. article, the second arm (following breast feeding) of providing nutrition to infants when considered on an international scale. Pureed food (aka, baby food) lacks exclusivity in so many cultures, and socio-economic groups. Many problems have not been consider concerning this practice.

We know that there are pharmaceutical warnings about medications that are passed along in breast milk. We can honestly say that there are no such warnings concerning medications that are passed along in saliva with pre-masticated food. That is a huge problem. It is also less than certain that this is a consideration when ill toddlers present at the offices of pediatricians and at Emergency Departments of hospitals/medical centers.

The next part of this involves tobacco. No one really knows how many mothers pass tobacco by products to children in pre-masticated food. It is known that nicotine and its by-products can make babies sick.

It is probably reasonable to consider whether infants seen for illness have been fed pre-masticated food by caregivers who take medication, are infected with a transmittable disease, or use tobacco products. It is probably not something that is routinely done.

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