COMPLEMENTARY FEEDING IN INFANTS- 

Ms Aarti Sachdeva, 

MSc (Nutrition), 

Pediatric Nutritionist, SBISR

PRINCIPLES OF FEEDING:

   ü  Feed infants directly and assist older children when they feed themselves, be sensitive to their hunger and satiety cues.

    ü  Feed slowly, patiently, and encourage children to eat, but do not force them.

    ü  If children refuse many foods,experiment with different food combinations, tastes, textures and methods of encouragement;

    ü  Minimize distractions during meals if the child loses interest easily

    ü  With older infants one may use the two-spoon technique where the bowl has two spoons and each time a feed is given to the baby…mama has one spoon as well….

    ü  Remember that a baby who is crying when he/she sees his/her mother with a feeding bowl in her hand has probably developed an aversion to the act of feeding and needs help.

    ü Foods should be added 1 at a time to allow detection of reactions to individual components.

        STEP WISE INTRODUCTION (What and How?)

            6-8 Months:                                  

• ·        Staple cereal of the family can be used to make the first food of the infant.

• ·        Porridge can be made with suji (semolina),atta( wheat flour ,flattened rice (chirwa/poha) puffed rice (murmura),  ragi , millet (jowar/Bajra) etc by using little water or milk and sugar and fat .

• ·        Roasted flour of any cereal can be mixed with boiled water, sugar and little oil

• ·        Fruits like banana, cheeku, papaya, mango in mashed form

• ·        Pulses in overcooked mashed form

• ·        Vegetables…ground and cooked in a soupy form

• ·        Normal milk (avoid using cow’s/buffaloes milk) may be used for food preparation at this stage

• ·        Ensure that whatever you give is semi-liquid and non-granular…watery or liquid stuff is low in nutritional value and caloric density and may just fill up the baby’s stomach without providing much nutrition.

• ·        Introduction should be slow and quantity taken initially is not important …just concentrate on introduction of taste

• ·        Salt and sugar in minimal quantities to improve palatability may be used

• ·        Water is allowed at this stage and one may offer after every semi-solid meal

• ·        The semi-liquid feed may be given 2-3 times per day while minimizing the disruption of the milk feeding schedule (introduce in between milk feeds while avoiding replacing milk feeds) as milk is still the most important part of the diet.

• ·        Concentrate on homemade foods and although one may occasionally give commercial products like cerelac and fruit crushes they should not form the staple diet and may only be one of the many tastes one introduces (typically one may try one of these things once a week)

    9-11 months:                                                     

• ·        Pieces of chapati soaked in milk or water, mashed properly and served with added sugar and fat

• ·        Mixed foods containing cooked cereal, pulses and vegetables eg. khichdi, upma, idli, chapatti mashed in dal

• ·        Finger foods like biscuits, rusk, carrot etc may be handled by baby under supervision

• ·        Introduce lumpy or granular foods and most tastes by about 9 to 10 months.

    12-24 months

• · Offer same types of foods as consumed by the rest of the family (keeping in mind the need for nutrient-dense foods by adding sugar or oil)…feed from the family pot 

• · Training in self-feeding is important at this stage…try to train the baby to feed self with cup without spilling by 15 months and with a spoon by 18 months….this co-incides with the stage where most kids want to do everything themselves and psychologically this is often a point of conflict with the mother who seeks to keep control of the eating…best way out in this difficult phase is to allow baby to feed by self even he/she makes a mess. 

• · It is acceptable to add small volumes of cow’s milk to complementary foods, but it should not be used as the main drink before 12 months. 

• · Avoid confectionary, chocolates and fast foods and the mostly they would compromise the intake of nutritionally more balanced foods 

• · Avoid foods that may cause choking (i.e., items that have a shape and/or consistency that may cause them to become lodged in the trachea, such as nuts, grapes, raw carrots)