Effective Complementary Feeding

Without a doubt, exclusive breastfeeding provides the best start for your baby as far as the first four to six months of life are concerned. But as the baby grows, she needs more vitamins, more minerals, more proteins, and more carbohydrates! After a while, breast milk is just not enough – and its time to introduce complementary feeding.

The World Health Organisation recommends that complementary feeding begins at 6 months, with 2-3 feeds a day between 6 and 8 months (besides breast milk) and increasing to 3-4 feeds between 9 and 11 months, with wholesome snacks once or twice a day. Some babies need complementary foods a little earlier than six months while others are perfectly satisfied with breast milk even after the six month mark has passed by.

Complementary feeding helps transition from breast milk to other foods. But complementary foods are not meant to replace breast milk, they are meant to be given in addition to breast milk. Too often, mothers resort to complementary feeding because the baby is not getting enough breast milk and not because the baby is developmentally ready for complementary foods. If the baby is not getting enough breast milk but is not ready for other foods, formula would be a better substitute. The risk with formula is that some babies tend to lose interest in breast milk once introduced to it. Alternatively, try using a breast pump if you are working outside the home.

Unfortunately, many mothers start complementary feeding too early, (or too late), or just stop breastfeeding altogether as soon as they start introducing other foods. This exposes their babies to high risk of malnutrition.

Complementary foods must be nutritionally balanced. At this time, your baby is especially vulnerable to malnourishment and subsequent stunted growth; which is rarely reversed later on in life. In girls, malnourishment could affect future reproductive health.

The period between 6 and 11 months is also delicate because baby is just learning to eat. So she must be given soft foods frequently and patiently. Use mashed foods like potatoes and bananas and semi-solid foods. These foods must be softened with milk – breast milk, if possible. At 8 months, you can start transiting from mashed and semi-solid foods and slowly introduce baby to the family diet once she is a year old.

Be warned that giving the baby a very high quantity of food that is poor in nutritional value could result in the child taking less breast milk, thus denying her vital nourishment. Improve baby’s energy intake by increasing the number of times you breastfeed, increasing portions of foods and providing more energy-dense foods. For vitamins and minerals, be sure to include fruits, vegetables, and animal products. Food introduced for complementary feeding varies from community to community. Cereal based and mashed foods are the ones used as complementary feeds. Enriched porridge is a common complementary feed. The porridge should not be of different flours mixed as this will contain phytates that bind calcium, making it unavailable to the baby; leading to rickets. Mashed potatoes, and bananas enriched with milk, or oil are also ideal for weaning. Fruit pulp from fruits that are not acidic like pawpaw or ripe bananas are another example of complementary foods.

Foods likely to cause allergies include cows milk and other animal proteins, and citrus fruits. Food allergies are common in children who exhibit allergic tendencies e.g. eczema. These foods are introduced one at a time so as to detect any allergic manifestation e.g. skin rashes, body swelling after eating the particular food.

Avoid salt, sugar and very fatty foods. An ideal complementary diet should incorporate locally available healthy foodstuffs. Identify traditional foods and build on them.

The child’s caregiver should practice active feeding, by paying attention to the child’s clues for hunger and actively encouraging the child to eat. So it’s not just the food you are offering the child that matters, it also matters how you go about feeding the child. Usually when babies don’t get enough nutrients, it’s not because there’s lack of food in the house – rather it’s because of inappropriate feeding.

Active feeding can be done by encouraging children to eat when they lose interest or have poor appetite. Talk to baby during feeding time. Try offering foods that they like, don’t keep insisting on something they dislike. Bring different combinations of foods, different tastes, different colours of foods, just try not to be too predictable or baby will get bored. Talk to her as she feeds and don’t allow too many distractions. Finally do not force-feed your baby.

For older babies and toddlers, breast milk can still provide some much needed energy, protein, vitamins and minerals. Continue breastfeeding up to 24 months and even beyond. And if your child is ill or recovering from illness, increase the proportion of breast milk in her diet, and give more fluids than usual.

Good hygiene and proper food handling. Wash your hands and your baby’s hands before preparing or eating food. Store food  hygienically and safely by ensuring that storage vessels are clean and storage areas are clean and dry. Utensils used for cooking, preparation and serving of food should be washed; and children should be served using clean cups and bowls. Use of feeding bottles should be avoided.

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