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EDUCATION CORNER
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    Infant Nutrition

    The biggest challenge for every new mother is to provide optimal nutrition to her baby as it is the most important factor influencing the growth and development of the baby.

    Nutrition is one of the major factors that impacts a child’s overall development in terms of growth and learning.

    Nourished children have high immunity levels that minimizes the probability of various illness.


    Baby Feeding (0-12months)



    • Infant feeding (for 0-6months): The first six months of the baby are very crucial. Baby should be given exclusive breastfeeding till six months as it the most natural, hygienic, economical and the perfect source of nutrition for the baby. Breast milk is a source of natural immunity and has anti-infective and anti-allergic properties
    • Complementary feeding( for 6months-1year): After 6 months of age, the nutritional needs of the baby are not met by breast milk alone. Introduction of complementary foods at 6month of age in baby’s diet fills in the energy gap and provides extra minerals and vitamins. Breastfeeding should be continued till 2years of age to provide the major caloric intake.
    • Solid Feeding (For 1 year & Above): It is a time when your baby start taking solid foods.

    Infant feeding (For the first six months)

    The first six months of the baby are very crucial. Baby should be given exclusive breastfeeding till six months as it the most natural, hygienic, economical and the perfect source of nutrition for the baby. Breast milk is a source of natural immunity and has anti-infective and anti-allergic properties.

    Breast milk composition is tailor-made for the baby so that a preterm baby’s mother has preterm milk. 

    Baby should be breastfed on demand 

    Pre-lacteal, top feeding, water, bottles, and pacifiers should be avoided for the first 6 months as it hampers breastfeeding


    Complementary feeding (6 months to 1 year)

    After 6 months of age, the nutritional needs of the baby are not met by breast milk alone. Introduction of complementary foods at 6month of age in baby’s diet fills in the energy gap and provides extra minerals and vitamins. Breastfeeding should be continued till 2 years of age to provide the major caloric intake.


    Complementary foods are started in small amounts and increased progressively so as to provide more than half the nutritional requirement by the age of one year.

    The period of 6-12 months of age is a very critical time of transition for the baby because if appropriate complementary feeding practices are not established, the child becomes vulnerable to have malnutrition and increased risk of infections. 


    A baby’s first food should be: 

    • Cereal or root staple-based food
    • Soft and flowing
    • Thicker than breast milk
    • Bland in taste 
    • Mashed or strained without any lumps
    • eg. Rice kheer, dal with ghee, pureed fruits, and vegetables


    Frequency of complementary foods: to start, give a small amount of food 1-2 times a day and gradually increase it to 3-4 times per day by one year. The amount should also be increased and after one year of age complementary food should be given 4-5 times I.e. three meals and 2 snacks should be given along with breastfeeding.


    How to feed the child 

    • One food should be introduced at a time.
    • The consistency of the food should be gradually changed from liquid to semisolid and solid with different textures with the advancing age of the child.
    • Start with a small amount and gradually increase the volume of the feed. Food should be served in a separate bowl rather than out of someone else’s plate to have an idea of the amount of feed baby takes. This also encourages the child to feed on its own. 
    • Initially baby may spit out the food as swallowing semisolid food is difficult. It doesn't mean they don’t like it. Introduce one type of food at a time and give it daily to develop the taste and liking of the baby. 
    • Never force feed a child. Be patient but determined. If a child doesn’t like a particular food, it should be removed from the diet and can be re-introduced later.
    • If any particular food makes the child sick or pale that food should not be given as the baby may be allergic to it.
    • Variety of foods in different colors, textures, flavors, and shapes should be added to make the food appealing and more nutritious for the baby. 
    • Food should not be spicy 
    • A child should be encouraged to feed on its own as children can feed themselves by one year of age under supervision
    • It is not necessary to cook separately for the baby. The family meal can be easily modified for the baby.
    • Always start with carbohydrates first and then proteins
    • Food should be hygienic and properly cooked and should be used within 3hour of preparation. 
    • Continue breastfeeding along with complementary feeding.
    • When a baby is started on complementary feeding the number of stools may increase. Personal hygiene should be maintained.

    6 -9 months - after initiation of cereal-based solid food, non-vegetarians can initiate small amount of well-cooked meats (chicken and fish) 

    • The food should be mashed or finely chopped and preferably home cooked. 
    • Introduce a broad range of new foods and textures to ensure balanced nutrition like fruits, green leafy vegetables, pulses, cereals.
    • Frequency should be 2-3 times a day
    • Gradually increase the amount, increase to half a cup in 3-4 weeks
    • Add oil of ghee to make the meal energy dense.
    • Continue breastfeeding


    9-12 months:

    • Give almost anything cooked at home
    • Wheat products (Pasta, bread, oats) can be added along with cheese and eggs
    • The texture should be roughly mashed and chopped.
    • Frequency should be 3-5 times a day
    • Baby is ready for finger food.
    • Continue breastfeeding.


    12 months and above 

    • Baby should eat at least half the amount that the mother eats.
    • Finger food and family food should be included, and baby should be encouraged to eat themselves.
    • Cow milk can be introduced in the diet.
    • Breastfeeding should continue.


    References:-

    https://www.who.int/nutrition/topics/complementary_feeding/en/

    Frequently Asked Questions

    Mother should take care of following during while starting weaning foods for her baby: 

    • Introduce only one food at a time.
    • Start with liquid consistency and slowly move to the semi-solid and then solid form of foods. 
    • Give food in small quantities in the beginning and gradually increase its amount. 
    • Never force-fed the baby. 
    • Remove the food that a child doesn’t like and introduce other food. 
    • Baby’s food should not be spicy. Never add too much salt as the baby’s kidney cope with it
    • Sugary foods and drinks should be avoided until 1 year of age as it may cause tooth decay 


    Breastfeeding should be continued up to the age of 2 years. After 2 years, you should start giving your baby more solid diet and discontinue breastfeeding. 

    In case your baby is suffering from diarrhea, you should give him plenty of fluids to avoid dehydration. Oral fluids/ORS or salt+sugar solution offers the best support to prevent dehydration.

    For breastfeeding babies, keep on feeding on demand. 

    For formula feeding babies, do not dilute the formula and continue as you gave him earlier. You can also offer your child the food he or she normally eats.

    Give a diverse range of fluids more frequently along with foods they normally eat to older babies.


    Different types of foods should be introduced in your baby’s diet to give her complete nutrition. Frequent feeds of small amount from different types of food groups like lentils, dairy product, animal proteins, vegetables, and fruits should be given. 

    According to the recommendations of WHO, complementary foods should be introduced to the infant around the age of 6 months alongside breast milk. At first, it should be provided about 2-3 times per day somewhere between 6 to 8 months. Later, expanding to about 3-4 times on a regular basis between 9 to 11 months and 12-24 months with added healthy snacks that should be given about 1-2 times per day, accordingly

    Babies do not eat much and it is hard to give them complete nutrition. Different types of foods should be introduced in your baby’s diet to give her complete nutrition. Also, give her a small number of foods multiple times. 

    Small amounts of cow's milk can be introduced in cooking from six months onwards. But the direct introduction of cow’s milk should be started after one year of baby’s age. 

    Danger Signs (Food Allergies/Reactions)

    Food allergy is a condition in which baby is very sensitive to or allergic to one or more of the proteins found in certain food items like milk, soy, eggs, wheat, peanuts, tree nuts, fish or shellfish (common food allergies). This is different from intolerance or sensitivity to a particular type of food(s). A person can have a food allergy to one or more kind of foods. 

    Causes of food allergy: An allergic reaction to food is a result of the response of our immune system to something we drank, ate, or breathed in. The immune system responds by making certain antibodies towards the food. These antibodies activate certain cells in the body to release chemicals called “histamines” into the blood. Histamines cause allergic reactions by targeting the nose, throat, eyes, stomach, or skin. 


    Common symptoms of a food allergy

    • Skin reactions– itching, hives/rash, redness
    • Eye reactions–Reddening of the white area of the eyes, irritated and itchy eyes, watery eyes
    • Nose–sneezing, runny nose, stuffiness
    • Stomach reactions–nausea, vomiting, diarrhea or cramps in the belly


    More severe reactions include:

    • Shortness of breath
    • Trouble swallowing
    • Chest tightness
    • Wheezing
    • Swelling of tongue
    • Coughing repeatedly
    • Scratchy voice
    • Puffiness around eyes
    • Feeling nervous, confused or fearful
    • Rapid heartbeat
    • Dizziness
    • Light-headedness
    • A sudden drop in blood pressure