Friday 16 May 2014

Complementary Feeding - How to successfully wean your baby


Hot chocolate, ovaltine and cocoa drinks, fenugreek and dill seeds, moringa and other herbs are some of the elements that constitute many mothers’ diets in the first six months after the birth of their babies. This is not to mention the jugs of porridge and bone soup, black beans and traditional vegetables that they have to take religiously all in a bid to increase their breast milk and ensure their little ones have enough to drink. So when the babies hit the 6 months mark it’s a period of celebration for most mothers not just because they have exclusively breastfed for 6 months but also because they no longer have to worry about the quantity of breast milk they have since the baby is now allowed to take a little more than just breast milk. The mother no longer has to be overly concerned about what they eat and of course, the extra weight that comes from eating all manner of food, can now be shed.

It is indeed a major milestone that however, brings in new challenges because the breast milk is no longer adequate for the baby and the mother has to start complementary feeding. While on breast milk the mother would never have to worry about preparation or whether the nutrient value of the milk was adequate, because the breast milk comes ready to drink meaning no preparation is required except warming and it is nutritionally whole with the full complement of nutrients that the baby requires for growth and development.

The transition to family food by complementary feeding is critical because if it is not done in the right way, the growth of a baby who was flourishing on breast milk could be slowed and in some circumstances the baby growth can be stunted. Poor food handling during this time can result in infections like diarrhoea that further affect the growth. Hence, a lot of caution has to be exercised during this period to ensure that the gains made during the period of exclusive breastfeeding are sustained.

What is complementary feeding?

Complementary feeding is the introduction of food to a baby’s diet in addition to the breast milk. It is recommended that complementary feeding begins from six months of age up to 24 months so as to ensure that the baby receives adequate nutrients to continue growing strong and healthy.

Before six months of age, the mother’s milk in combination with the babies nutrient reserves stored in the infants body when he was growing in the uterus, are usually adequate to meet the nutritional requirements for optimal growth. However, by six months of age, the baby has used most of the nutrients that had been stored and needs extra.

The other reasons why complementary feeding should commence at six months of age is that the babies’ growth and development is very rapid at this age, hence, they require additional nutrients to sustain adequate growth and development during this period. Also their digestive system has matured adequately to be able to digest other foods apart from breast milk.

The quality and quantity of food

It is critical that complementary feeding be practiced in a manner that ensures that the quality and quantity of food the baby receives is adequate to sustain optimal growth and development. The nutritional value in the food being given to the baby has to be adequate. In this regard, the baby should receive food from all the classes i.e proteins, carbohydrates and vitamins.
The frequency of feeding should be optimum i.e., the food should be introduced gradually beginning with around two feeds a day and gradually increasing to whole meals and snacks like the rest of the family.

The consistency of the food should be carefully changed as the child grows i.e., the food should not be too thick or too thin. Large sized shaped pieces of food should be initially avoided as they can easily choke a child. The variety of food provided during this period should be adequate to cover the child’s nutritional needs. Avoid giving the child only one type of food.

As a way of maintaining optimum quality, parents should ensure that the risk of food contamination is minimized. In order to reduce the risk of infection to the child, the caregiver should prepare and give the food in a clean environment and observe simple measures like proper hand washing before handling the baby’s food and thoroughly cleaning utensils used by the baby.

How do you encourage the baby to feed?

The transition from breastfeeding to eating may be challenging to most babies and effort needs to be put into making the process easier. It is important to make the process as smooth as possible so that the baby can easily adapt.

The caregiver should be sensitive to the child’s cues for hunger and respond appropriately. Do not let the child cry for food before they’re fed. Feeding the child when they’re too tired or sleepy limits the amount of food they can take. The food should be at the correct temperature, a baby may find it difficult to eat food that is either too hot or too cold.

The baby should not be forced to feed and neither should they be punished even if they’re reluctant or fussy feeders. The caregiver should be patient and encourage the baby to feed. The baby should be allowed to take all the time they need without being rushed. It’s okay for a baby to play in between feeds as long as they continue to eat.

The baby should be engaged by talking to them and complimenting them as they feed. Positive reinforcement will motivate them to eat more. Distractions should be minimized. If the caregiver becomes harsh, the baby might resent feeding and this will ultimately affect their food intake and growth.
Ultimately the caregiver should ensure that the feeding experience is interesting and happy otherwise the baby may develop a negative attitude towards feeding altogether hence compromising their growth and development.

It is recommended that the feeding is commenced gradually and slowly increased as the baby grows:
  • Between 6 and 8 months: the baby should be fed 2 to 3 times a day.
  • Between 9 and 11 months: the baby is fed 3 to 4 times daily.
  • Between 12 and 24 months: the baby is fed 3 to four times with additional nutritious snacks in between meals.

Food preparation to a big extent determines the ease with which a baby will take food hence, caregivers should be careful to ensure that the food is appropriate for age and time.
High standards of hygiene should be observed when preparing the baby’s food. Care should be taken to ensure that hands are always washed with soap and water before handling the food and before actually feeding the baby. Fruits and vegetables should always be washed before preparation and the baby’s utensils should be thoroughly cleaned.
It is recommended that parents start their children on food that is easily available and affordable in their local setting since this will ensure that the baby’s food is always fresh. Cooked food should be preferably used in a day because storing for future use risks the food being stale.
While it is important to ensure that food is tasty, it is recommended that the use of salt and sugar is minimal. Spices and herbs should be initially avoided until the baby is ready to take family food.

How to introduce food
One food should be introduced at a time to allow the child to get used to it and also for observation of allergies and tolerance .i.e, do not introduce two different types of food at the same time.
The texture of food should gradually change from semi-solid food to solid. By eight months babies can eat finger food and by one year most babies can comfortably eat the same type of food as the rest of the family.
The variety of food should also gradually change and increase as the child grows i.e, alternate different proteins, carbohydrates and fruits at different meals to get a good range of nutrients.
If the locally available foods are not adequate in meeting the nutritional needs of the child, then fortified foods should be considered to avoid the risk of malnutrition.

There are common challenges while introducing complementary feeding such as lack of knowledge on the appropriate food to feed the child - many parents do not have access to professional advice on complementary feeding hence they rely on information provided by relatives and friends which may not be adequate. As a result the quality of food is compromised:
  • Foods provided may be lacking or have insufficient quantities of essential nutrients including minerals and vitamins.
  • The variety of food provided is too little and the baby gets bored and refuses to eat.
  • The consistency of the food is inappropriate for their age hence difficult for the child to feed on.
A lot of working parents are unable to stay at home with their babies during this time because of work commitments hence, the children are left with caregivers who may not adhere to recommended practices like hygienic food preparation and proper cleaning of utensils.
Competing economic priorities may be another challenge. A very small portion of the family budget is allocated to food for the child because of other pressing needs.

Breastfeeding should not be stopped during this period. Breast milk is still important in
ensuring the babies get adequate nutrition hence should be continued as food is gradually introduced.

The period between 6 months and 24 months is very critical for babies because there is rapid growth and development and if the nutritional needs are not adequately met this time, the baby can become malnourished and affected for the rest of their life.
Malnutrition experienced in the first two years of life is majorly due to poor complementary feeding practices and can have long term irreversible consequences because the brain and body development being affected.

The long term consequences of malnutrition at this age include reduced future learning abilities, reduced ability of the body to fight infection and reduced economic output. Children are most vulnerable to illness during this period because of the risk of infection during the introduction of food and handling of food hence, a lot of caution should be exercised during this period.

Attribution: Avallain Ltd 

1 comment:

  1. Hey mums. Just recalling that time when I had to begin weaning/complementary feeding for my child. I have a list of challenges I went though back then including what to feed, how often, the consistency of the food and how to tell if my child was getting enough. What was/is your dilemma? See here a helpful article.