Complementary Feeding For Babies

What is a complementary feed and why it is required?

Growing infants do not get enough iron, zinc, and energy from breastmilk or formula milk alone after six months of age. Children between 6-24 months are very prone to growth faltering if breastfeed is not replaced by appropriate nutrient and calorie-dense foods. So it is essential to feed these infants with food other than breast milk which is called a complementary feed.  However, breastfeeding can be continued till 12 months and beyond, as long as the will of mother and baby. 

What are the complementary foods? 

First food for the baby: Usually the first food for the baby should be the staple cereal of the family, which can be porridge with suji (semolina), Dalia, atta (wheat flour), rice flour, ragi, millet, etc, by using boiled milk. Jaggery and ghee or oil can be added to increase the energy value of the food. Porridge consistency can be made a little thinner early but as the child grows older it can be made thicker so that the nutrient value increases.

It is vital that the first foods are rich in iron, which can be made by cooking cereals with pureed meat, poultry, fish, tofu, and legumes (as per culturally acceptable food). Even we can mix pieces of half chapatti could be soaked in half a cup of milk and mashed properly.

Traditional foods for infants: Once the infant has started accepting cereal porridge well, mixed foods including cooked cereal, pulse, and vegetables like khichdi, Dalia, suji kheer, upma, idli, dhokla, bhaat-bhaji, can be started. 

Modified family food: Our families prepare a cereal in the form of roti or rice, a pulse, and or a vegetable in a balanced diet. Complimentary food can be prepared from the family pot, by separating a small amount of dal or vegetable preparation before adding spices to it. and adding pieces of chapatti in half a Katori of dal /vegetable, add ghee or oil, and mash well. 

Instant Infant Foods: Infant food mixes (sattu-like preparations), can be made at home from food grains available like, take three parts of any cereal (rice/wheat) or millet (ragi, bajra jowar), one part of any pulse, and half part of groundnuts or white til. These should be roasted separately, ground, mixed properly, and stored in airtight containers for at least a month. While feeding takes two tablespoons of this food mix, add boiled milk, jaggery and oil/ghee, and mix well. We can add cooked and mashed carrot, pumpkin or green leafy vegetables to it. We can also make halwa, burfi, upma, Dalia, from these and give to the child.

Protective foods: Milk, curd, lassi, egg, fish, and green leafy vegetables, seasonal fruits like papaya, mango, chikoo, banana, can be given in a mashed form. Rich in vitamin A and Iron.

Drinking plain water should be encouraged after six months by offering cooled boiled water and continue on-demand breastfeed or formula feeds.

Energy Density of Infant Foods

It is important to give small energy-dense feeds at frequent intervals with a view to ensure adequate energy intake by the child. Energy density in foods can be increased by adding a teaspoonful of oil or ghee, jaggery. By giving malted foods as it reduces the viscosity of foods and hence a child can eat more at a time and will provide more energy. (Malting is germinating whole grain cereals or pulses, drying it after germination and grinding). By feeding thick but smooth mixtures. Hard pieces in the semi-solid food may cause difficulty if swallowed, so can be passed through a sieve by pressing. 

HOW TO START INTRODUCING YOUR BABY TO COMPLEMENTARY FOODS?

Always give fresh and clean food, which is stored correctly. Feed your baby when he/she is happy and you can focus on your baby. It is vital to supervise each feed of your baby. Check and record your baby’s growth regularly as a guide that they are getting enough. 

Feeding on around 6 months to 8 months: Start with a single pureed food like baby rice cereal or khichdi or dalia. Offer 1 to 2 teaspoons initially and slowly increase this to 2 to 3 tablespoons. Initially give once a day and then slowly build up to 3 times a day up to half of a 250 ml cup per feed. Offer more food as your baby grows. Normally babies can refuse new foods. Sometimes it can take 10 to 

12 times of offering a food before a baby will accept it. When your baby will be full he/she may turn their head away. Do not force feed. 

 Feeding on 9 to 11 months: 

The texture of foods should vary from smooth fine mash to a lumpy mash, to minced food, to finger food (soft), which is good for jaw and mouth development. Give 3 times per day, at routine mealtimes. Infants will create a mess, we should accept it. If you eat nonvegetarian dishes ensure boneless fish/meat is cooked. Give 3-4 meals per day, each feed half of a 250 ml cup. One should offer 1-2 nutritious snacks of fruits. Cooled boiled water, expressed breastmilk or formula can be offered from a cup. Make your baby sit with the family at mealtimes to watch and learn. Provide your baby with a variety of foods and let them decide how much they want to eat.

Feeding on 12 to 23 months: 3–4 meals and three fourth of a 250 ml cup. Offer 1-2 nutritious snacks of fruits.

Foods that should be avoided?

• Avoided to reduce the risk of choking: Small, hard foods such as whole nuts, seeds, corn chips, 

raw carrot, and chunks of apple. 

• Do not add sugar or salt to foods. They can cause tooth decay and can make extra work for your baby’s small kidneys. 
• Cow’s milk should not be given as a drink until 12 months of age. 
• Honey is not needed and can cause illness in infants.
• Soft drinks, fruit juice, tea, and coffee are not suitable drinks for babies. 
• Breastmilk (or formula) and water are the only fluids your baby needs.