الفهرس 
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Abstract
Maternal breast feeding is the most natural and safe way to feed
an infant. Breast feeding provides a unique combination of proteins,
lipids, carbohydrates, minerals, vitamins and enzymes, as well as
nutritional, immunological, psychological and economic benefits.
Exclusive breast feeding is defined as consumption of human
milk with no supplementation of any type (no water, no juice, no
foods, and no non-human milk) except for vitamins, mineral and
medications.
Although breast milk meets most nutritional needs until 1 year
of age, at some point in time, exclusive breastfeeding no longer meets
a growing infant’s nutrient needs and complementary foods must be
added. These additional foods are not intended to replace or interfere
with breastfeeding.
The term weaning was used to indicate the transition between
exclusive breastfeeding and the cessation of breastfeeding. Nowadays,
the term ”full weaning” is used to indicate the total cessation of breastfeeding.
Complementary feeding is the provision of any nutrient
containing foods or liquids other than breast milk and included both
solid foods and infant formula.
In the United Kingdom the terms ”weaning” and
”complementary feeding” are sometimes used synonymously.
The needs for growth are relatively high due to the higher
metabolic and nutrient turnover rate of infants and children compared with adults. Because the rapid rates of growth are accompanied by
marked developmental changes in organ function and composition,
failure to provide sufficient nutrients during this time likely to
have adverse effects on development as well as growth.
The 2008 European Society of Pediatric Gastroenterology,
Hepatology and Nutrition (ESPGHAN) Committee on Nutrition
concluded that exclusive or full breast-feeding for about 6 months is a
desirable goal and that complementary feeding should not be
introduced before 17 weeks and not later than 26 weeks (ESPGHAN,
2008).
El Shafie et al., (2009) advised with starting weaning of the
breastfeed infants after the age of four months with introduction of
recommended nutritional program from Pediatric Department, Faculty
of Medicine, Menoufia University
Also the American Academy of Pediatrics evidence that
complementary foods may be introduced between 4 and 6 months of
age on the basis of developmental readiness and nutritional needs as
there is no significant benefit of exclusive breast feeding for 6 month
(AAP, 2011).
Research has shown an infant’s estimated iron and Zinc
requirements cannot be met at any stage of infancy by human milk
alone, and the infant must rely on endogenous prenatal stores to meet nutrient needs in the early months of life.
Although it‟s estimated that these stores are sufficient to meet
the needs of average, full term breast feed infants for about 6 months,
there is concern that if prenatal stores are exhausted, an infant will
quickly become deficient unless an exogenous source is provided.
Most babies are born with enough iron stores to meet their
needs for about the first 6 months of life. Breast milk contains very
little iron (~0.35 mg/liter). The institute of medicine recommends that
infants 6-12 months old get 11 mg of iron per day.
Acquired copper deficiency is a clinical syndrome that occurs
mainly in infants, although it has also been described in children and,
in adults. Copper deficiency is usually the consequence of low copper
stores at birth, inadequate dietary copper intake, poor absorption, and
elevated requirements induced by rapid growth or increased copper
losses.
Physiological decline in the Zinc content of human milk, which
occur regardless of maternal zinc status, my lead to marginal zinc
status in infants from four to five months of age on words. Other
micronutrient which can occasionally be deficient before six months
of age in some fully breast fed infants, are iron and Vitamin A, D, E,
B12 and riboflavin.
Antioxidants have many different types, including nutritional
antioxidant (vitamins, mineral), enzymatic antioxidant and other
antioxidant.
The aim of this study was to compare the early weaning
(programmed and non-programmed) versus late weaning as regarding
the effect on development of the infants in Menoufia Governorate.
Our study included 171 healthy breastfed infants, their ages
were four and six months of age at the beginning of the study then
became 150 because of non compliance of 21 mothers, who were
chosen according to inclusions criteria from the clinics of Menoufia
University hospital in Shebin Alkom city and all mothers were given
information about our weaning program at age of four months (ElShafie et al., 2009). Then classified into 3 groups according to their
desire of feeding pattern for weaning of their infants : , group I
included 50 infants weaned early after 4 months of age on a
recommended weaning program from pediatric department in faculty
of medicine Menoufia University, group II included 50 healthy infants
with early weaning after 4 months of age according to family
knowledge without interference from researcher and group III
included 50 infants with late weaning after 6 months of age
(exclusively breastfed till the age of 6 months) according to family
knowledge without interference from researcher.
All cases were submitted to complete history taking, through
clinical examination, recording all developmental milestones
according to Baroda Developmental Screening Test For Infants
starting at 4 month of age and follow up visits monthly till the age of
18 months were done.
This study showed that there was a non-significant difference
among the three studied group as regards socio-demographic data.
Our study showed that from the age of five months to the age of
18 months there is a significant difference between the three groups
in the development scores according to Baroda Development
Screening Test For Infants. group (I) recorded the highest
development scores among the three groups and that were of significant difference from the group (II) and from group (III). And
also group (II) recorded higher scores than group (III) which were of
significant difference.
In our study by calculation of the Developmental Quotient
according to Baroda Development Screening Test For Infants , The results showed that Developmental Quotients are significantly
different among the three groups.
from the age of the 5 months to the age of 18 months, the
developmental quotients are significantly different among the three
groups. we found that, group (I) recorded the highest percentage of the
developmental quotient (DQ) which was significantly different from
group (II) and group (III) . group (II) recorded higher percentage of
the developmental quotient (DQ) than group (III) and was of
significant difference .