complementary feeding complementary food is any food locally prepared or manufactured, suitable as a...
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Complementary feeding
Complementary food is any food locally prepared or manufactured, suitable as a complement to mothers milk after it is insufficient to satisfy nutritional requirements of the infant after 6 mths of age
Weaning vs complementary food Home made food to be
emphasized Avoid use of word Weaning as it
almost implies that we advise to discontinue BF
Reinforce the need to continue BF in addition to CF
Emphasize the need to start CF after completion of 6 months
Why 6 monthsEnergy gap at 6 mths 70% of cals and 80% proteins are provided by breast
milk At 9 mths 50% cals and 60% proteins At 12-24 mths 30% cals and 40% proteins
By 6 months voluntary control of sucking swallowing is achieved and child doesn’t push solids out of the mouth
Pancreatic enzymes are fully matured. By 9 months child can use lips to clear a spoon and use spoon
to move food between teeth
When complementary foods are introduced too late ……
Nutrition suffers Growth & development slows downs or stops Risk of deficiencies – iron , vit A ,Vit C Increase risk of diarrhoea, pneumonia due to
malnutrition 60 % of Under 5 deaths occur in malnourished
children
What to introduce ?
Family food always First food
- staple – rice / wheat / maize/ ragi/ corn
- Starch – potato
- Fruits- banana /chickoo/sitaphal
- Vegetables – green leafy, peas, beans
- Amylase rich flour- can be added to staple
Proteins
Legumes:Matki
Dals: Moong, Masoor
Nuts: Almonds
Dairy items : Butter, Paneer
Balanced Diet
Staple
Cereals: Wheat, Rice
Millets: Ragi, Bajra
Energy
Jaggery Butter
Sugar Paneer
Ghee Oil
Cheese
Vitamins & Minerals
Fruits &Vegetables
Breastmilk
Foods to enrich staple Oil , butter , ghee Pulses – use in ratio of 1:3 Coconut, groundnut No sugary drinks – soda , coffee , tea… Use spoon & katori but never BOTTLE Consistency of food – should be like ghee which stays easily on spoon without running off when
tilted. Later foods – meat , poultry , eggs if consumed by family Mash food with hand and not mixer Avoid dal water,thin soups
Responsive feeding Practice responsive feeding- by giving help and
encouragement to the child & by feeding slowly and patiently and by experimenting with diff. foods , taste, combinations & textures.
Minimize distractions Use plenty of smiles, eye contact and
encouraging words so that feeding becomes a time for learning and love
Don’t force feed
Hygiene & Sanitation
Store food safely Use fresh foods if possible Use within 2 hrs if unrefrigerated Wash and clean hand and utensils before
preparing food and feeding Avoid Feeding BOTTLES Kitchen garden
Frequency of feeding Energy needs from CF are - 200kcal /day at 6-8 months - 300kcal/day 9-11 months - 350kcal/day 12- 23 months 6 – 8 months feed 2-3 times a day 9- 24 months feed 3-4 times a day Nutritious snack can be given 1-2 times /day Continue breastfeeding till minimum 2 years
Consistency and Variety Begin with soft foods , but child
learns to chew by 8 months By 8 months give them finger foods By 12 months they can eat all of
family food from family pot cut into small bits and softened if needed.
By 12 months the child is able to eat ½ of what an adult eats
Disadvantages of processed complementary foods (tinned food, biscuits, bread etc)
Main food may be starch & sugar May be deficient in micronutrients Colour & preservatives are added Bacterial contamination COST
Feeding the child who is ill
Encourage the child to eat and drink with lot of patience
Feed small amounts frequently Give foods that the child likes Give variety of nutrient rich foods Continue to breast feed
Feeding during recovery EXTRA Meal EXTRA amount of food EXTRA rich food EXTRA patience while feeding EXTRA breast feeds EXTRA love EXTRA duration for at least 2 weeks after illness