Complementary feeding

1
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

2
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

3
Why 6 months

• Energy 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 doesnt 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

4
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

5
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

6
Balanced Diet
Energy Jaggery Butter Sugar Paneer Ghee Oil Chee
se
Staple Cereals Wheat, Rice Millets Ragi,
Bajra
Breastmilk
Proteins LegumesMatki Dals Moong, Masoor Nuts
Almonds Dairy items Butter, Paneer
Vitamins Minerals Fruits Vegetables
7
Foods to enrich staple

• Oil , butter , ghee
• Pulses use in ratio of 13
• 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

8
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
• Dont force feed

9
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

10
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

11
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

12
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

13
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

14
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
  

15
Thank You