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EARLY YEARS EVENT- Nutrition & Weaning
Nutrition plays a very important role throughout an individual’s life. Early eating habits are inculcated in early years. Children need to be nurtured and protected. It is important they eat right and grow into having healthy lifestyles. While you were pregnant you tried to give your baby the best possible nutrition through the foods you consumed. Again, when your baby was born you provided her with optimum nutrients through breast feeding. Now you are at a stage where you will be building your baby’s tastes, food habits, likes and dislikes. Hence this is a crucial phase in both your and your baby’s life. Experts also agree that a well balanced diet from a young age lays the foundation for the future of an individual. Childhood is a crucial period involving enormous amount of growth and all round development.
Weaning as the word indicates is the process of transition from a purely milk based intake of the baby to a semi solid diet.
It is like a long goodbye!
How should I begin to introduce a mixed diet?
Introducing a baby to solid foods is one of the most exciting moments of parenthood. But it can also be daunting. Wean slowly, never stop Breastfeeding abruptly as it can be traumatic for your baby and very uncomfortable for you (engorgement of breasts).
A good way to just begin is by offering your baby your usual breast milk of formula and when she is nearly satisfied give her about one to two tea spoons of dry cereal mixed with enough bm/fm or pureed fruit to make a soupy solution. Give this to your baby on a soft rubber tipped spoon once a day and then finish with her milk feed. This way she won’t be so hungry that she is too frustrated to try the new food and not too full to be not interested. It doesn’t necessarily have to be the morning feed. Pick a time suitable to you and your baby.
At first, your baby will seem to eat very little, and it may take a while to get even that small amount into her. Do be patient with your little one and remember it may take a little time for her to learn these new skills. When your baby is eating two to three tablespoons of cereal a day, try adding another food. As she begins to eat and develops more of a side-to-side grinding motion, add a little less liquid so the texture becomes thicker. This allows your baby to work on chewing (gumming) and swallowing. Your baby's appetite will vary from one feed to the next, so watch for cues that she's full. A baby who refuses to open up for the next bite, turns away, or starts playing with her food is probably full.
First foods at 4 – 6 months
At this stage you should be giving your baby 70% of her nutrition still from BM and only 30% from other foods.
Those who have a family history of allergies or pre mature babies for them it is recommended to wait until 6 months before weaning as the incidents of adverse food reactions, allergies and celiac disease decreases if you delay weaning until this time. Also it is advisable to check with your doc before you start weaning.
Infants advance from swallowing only fluids to pureed soupy foods at 4 to 6 months. At this point they can only move their tongue from side to side. Now one of the first thing your baby has to learn while weaning is how to swallow non fluids so that your baby doesn’t have to cope with new flavours as well as using different muscles --- make the weaning foods into sloppy watery consistency.
Weaning foods such as - dal pani, rice kanji, strained fruit juice, strained soups are poor choices of weaning foods and not recommended.
Instead there are two main food groups introduced as first foods.
Fruit – banana, chikoo, stewed apple. When giving fruits it is important to remember wash, peal the fruits and remove any seeds.
Cereal – At this stage ground/mased rice is the most preffered cereal. No gluten containing food should be given till 6 months. Start with 20 to 30 ml (2 to 3 tbl spoons) of any of the above foods. The foods should always be in a mashed/soft form.
New foods should be introduced slowly, one at a time. Your baby needs time to get used to each new taste and texture. Also, careful introduction of different foods will allow you to watch for signs of a possible allergic reaction, such as diarrhoea, tummy aches, or rashes. Try adding one new food every few days, starting with yellow fruits and vegetables, which are easy for babies to digest. Some experts advise beginning with green veggies, as babies can sometimes get fixed on the sweeter taste of fruits and yellow vegetables and may not give peas and beans a fighting chance!
Once in the 5th month, food of slightly better consistency can be given such as watery versions of rice gruel, suji upma, suji kheer, dalia, khichri are other options to choose from. Coconut water, fruit and vegetable juices, may also be introduced one at a time. Try to limit the number of sweet or cereal purees to one a day and always include a veg puree. Gradually make the food of a thicker consistency.
The second stage from 7- 9 months:
No single food can give your baby all the nutrients they need so variety is the name of the game to make sure they get the right balance of vits & minerals as well as eng they need for all that growing & exploring.
By now they are ready for the next stage of weaning with lumpier but soft textured foods with more tastes & textures to help them elicit munching & jaw movements & develop chewing skills.
By the time your baby is about seven months old, she should be eating semi-solids three times a day. From now your baby's ability to join in with family meals increases enormously. You should offer him a wide range of foods to fulfil his nutrient requirements, and to get him used to eating different flavours. There are also fewer foods to avoid now.
Nows the time to introduce: • Mashed or minced food, not purées. Be sure to include some lumps. • A wider range of starchy foods -- khichri, suji upma, suji kheer, sabutdaana kheer, dalia, bread, baby breadsticks, iron fortified breakfast cereals, oats, in addition to cornmeal, potatoes, rice and millet. Around the 8th month you can try & give lapsi (using wheat or nachni) to your child. Give two to three servings a day of cereals & starchy foods.
Once lapsi is introduced and the infant has accepted it well, soft boiled Eggs (yellow first), well cooked chicken and fish (de- bone well) can be added to the other protein-rich foods in her diet -- lean red meat, poultry and lentils. Start with small amts & one at a time. Aim for one serving of protein-rich food a day.
Dairy products, such as fromage frais, yogurt and cheese. Although you should wait until one year to introduce cow's milk as a drink, it can be used in cooking or in your baby's breakfast cereal, so make a cheese sauce to add to vegetables or pasta. Cheese can be tried, but in very little amounts to start with as it can make the child constipated. No mouldy cheeses, brie or soft cheese as can cause allergic reaction.
Give your child plenty of vegetables especially the greens. Include potatoes, sweet potato, broccoli, cauliflower, spinach, pumpkin etc. • Cooled boiled water from a sipper with a soft spout, when she is thirsty, in addition to her daily breastmilk or 500-600 mls of formula. If you do choose to give fruit juice, keep it to mealtimes only and dilute it 1 part juice to 10 of cooled boiled water, and use a beaker or feeding cup, not a bottle. Keeping juice to meal times helps with iron absorption and reduces the risk of damage to emerging teeth. • Citrus fruits, such as oranges and sweetlime (mausambi)
This is also the time to introduce finger foods!
• cooked pasta shapes • hard boiled or scrambled eggs • bite sized steamed vegetables - peas, beans, sweet potato, cauliflower • breads (avoid granary or multigrain breads for now because the hard pieces may increase the risk of choking) • bite sized pieces of paranthas and chappatis • besan cheela, moong daal cheela • cheese and whole wheat sandwich • small cubes or pieces of cheese • mini idlis or rice cakes • chunks of ripe pear, banana, musk melon, watermelon and mango • soft, cooked lean meat • fish (carefully de-boned) • poultry (you can also use boneless chicken). • Chicken nuggets
Stage for lumpier foods at 10- 12 months: By the time your baby is 10 months old, nearly half her daily diet would be from solid foods, while the balance would still come from BM/FM.
Meals should become more adult like now. They should be chopped or minced & follow a 2-3 meal/day pattern along with 1-2 snacks & 500-600ml of BM/FM coming in.
At this stage your baby should be having –
3-4 servings of starchy cereal foods as khichari (mix of rice/ daliya + dal), dal, daliya or potatoes / day.
1 serving of protein rich, meat, fish & eggs or 2 servings of pulses (lentils, beans) or nut butters.
1-2 servings of cheese, yogurt as well as BM/FM
Word of caution on:
FAT:
It is imp to remember that your baby’s growth is maximum in the 1st 2 yrs if his life. They are growing in every sphere – physically & mentally.
There shud be no fat restriction for a baby until she is at least 2 yrs of age. Fat is not only an imp source of energy for your baby it also carries essential Vits- A & D.
When your baby is two & only if she is growing well & eats a well balanced diet, you can gradually introduce lower fat versions. By the time your child is 5 yrs, only about 1/3 rd of her energy should come from fat.
FIBRE:
Be cautious about introducing too many wholegrain foods and pulses for babies and young children. These tend to be bulky and can fill up a small tummy, leaving little space for other higher energy foods. So give your baby and toddler a mixture of white and wholegrain cereals and breads. If your toddler regularly eats pulses and lentils as part of a vegetarian diet, make sure that she has some chapathis, rice, bread, and pasta as well. Also do not add bran to your baby’s food as it prevents absorption of some essential vitamins.
Follow the “Golden Rule” to feed your child –
YOU DECIDE-
what food shud be served to your child-
Offer a variety of foods from each food grp
When food is served –
Make meal times fun & pleasant. Food is to be enjoyed and shud not be like a chore. Serve meals & snacks every 2-3 hrs including bed time.
Imp to set a good example at family meals.
How it is served-
Make it interesting; let your baby watch while you prepare her food.
Use different colours & shapes.
Be ready for the mess- keep bibs. This is part of learning & don’t stop them.
YOUR CHILD DECIDES-
Whether to eat –
Saying “NO” to food is a way of showing independence. Occasionally it is OK for a child not to eat a meal or snack.
Never force feed or punish a child for not eating.
How Much to eat-
Let babies develop their own sense of when they are done or full. At times children will be hungry & eat a lot other times they won’t eat very much.
When to Introduce certain foods:
Wheat, oats and other foods containing gluten
The risk of developing coeliac disease is reduced by avoiding foods containing gluten, such as wheat, rye and barley-based foods. That includes bread, flour, pasta, some breakfast cereals and rusks until six months.
Eggs
Cooked eggs can be safely introduced into your baby's diet when he is six months old. You should avoid using raw eggs in your baby's diet as they sometimes contain salmonella bacteria, which may cause food poisoning. When cooking eggs for your baby, the yolk and white should be firm. For the same reason, it is a good idea to avoid giving your child anything that may contain raw egg, such as uncooked cake mixture, home-made ice cream or mayonnaise, or desserts that contain uncooked raw egg, such as mousses.
Nuts:
It's true that you shouldn't give whole nuts to children who are under five years old, because of the risk of choking. Peanuts in any form must be avoided till your child is 3 yrs old. Other nuts in the form of smooth nuts butters can be given after the child is about 10 months old.
Fish and fish products
It is recommended that you shouldn't give any fish or shellfish to babies younger than six months, because there is a small chance that they might have an allergic reaction. Children should also avoid eating any shark, swordfish or marlin. This is because the levels of mercury in these fish can affect the development of children's growing nervous systems. Don't give raw shellfish to babies and children, as they are a high food poisoning risk food. Fish, especially oily fish, should form part of a healthy diet. Fresh fish such as salmon, trout, cod and haddock, canned fish such as sardines and pilchards, as well as fish products such as fish fingers and fish cakes are all nutritious foods for young children. Avoid giving fish canned in brine to babies, as it is higher in salt than fish canned in oil. Also make sure deboned properly.
Soya beans and soya-based products
Avoid for 1 yr as can cause allergic reactions – allergy similar to milk.
Honey
In many Indian homes, honey is believed to be the "food of the gods" or "amrit" and is given to the baby during teething or when introducing new weaning foods. Honey is a sugar, and giving your child sugar can encourage a sweet tooth and lead to tooth decay. Honey is not recommended for your child until he is a year old, as very occasionally it can contain bacteria which can produce toxins in your baby's intestines. This is known as infant botulism. When your baby is a year old, his intestines are mature enough for the bacteria not to grow.
Raisins
Raisins and other small dried fruit such as sultanas can make a nutritious snack for an older baby or toddler. Any small piece of food is potentially a choking risk for your baby, especially if your baby is under a year old. It is therefore always a good idea to be present when your baby attempts finger foods such as raisins and to make sure he is ready developmentally to chew and sit up properly, as well as having the pincer grasp to pick things up with.
Citrus fruits
Citrus fruits such as orange, keenu (tangerine), mausambi (nectarine) and lemons contain lots of vitamin C. Fruit juices and citrus fruits such as oranges should not be given before your baby is six months old.
Cow's milk & other sheep or goat milk.
Cow’s milk or dairy products are not recommended until your baby is six months old. From the age of six months, you can use small amounts of full-fat cow's milk in cooking, for example in cheese sauces or custards. Avoid giving cow's milk as a drink until your baby is a year old, because it is too low in iron and other nutrients.
Tea
Tea is not a recommended drink for babies or young children. It reduces iron absorption when taken with meals, it contains caffeine and it could scald your baby's mouth. If sugar is added to tea, it also contributes to tooth decay.
Salt
You should not add salt to your baby's food in the first year as this may damage her kidneys. In the first six months of life your baby needs less than 1g of salt per day, which she will usually obtain from breastmilk or formula milk. Between seven and 12 months this increases slightly to around 1g. Toddlers aged one to three years need less than 2g (this is the equivalent of 0.8g sodium per day). To stay within these recommendations you should aim to: • limit salty foods in your baby's diet • don't add salt during cooking
Tips for the fussy eater !
1. Offer a nibble tray. Toddlers like to graze their way through a variety of foods, so why not offer them a customized smorgasbord? Use an ice-cube tray, a muffin tin, or a compartmentalized dish, and put bite-size portions of colorful and nutritious foods in each section. Call these finger foods playful names that a two-year-old can appreciate, such as:
apple moons (thinly sliced)
avocado boats (a quarter of an avocado)
banana wheels
broccoli trees (steamed broccoli florets)
carrot swords (cooked and thinly sliced)
cheese building blocks
egg canoes (hard- boiled egg wedges)
little O's (o-shaped cereal)
Place the food on an easy-to-reach table. As your toddler makes his rounds through the house, he can stop, sit down, nibble a bit, and, when he's done, continue on his way. These foods have a table-life of an hour or two.
2. Dip it. Spread it. Top it. Young children think that immersing foods in a tasty dip is pure fun (and delightfully messy). They also like to smear/ spreading. They are also into toppings. Some possibilities to dip into:
cottage cheese or tofu dip
cream cheese
fruit juice-sweetened preserves
guacamole
peanut butter, thinly spread
pureed fruits or vegetables
yogurt, plain or sweetened with juice concentrate
Those dips serve equally well as spreads on apple or pear slices, bell-pepper strips, rice cakes, bagels, toast, or other nutritious platforms.
5. Drink it. If your youngster would rather drink than eat, don't despair. Make a smoothie – together. Milk and fruit – along with supplements such as juice, egg powder, wheat germ, yogurt, honey, and peanut butter – can be the basis of very healthy meals. So what if they are consumed through a straw? One note of caution: Avoid any drinks with raw eggs or you'll risk salmonella poisoning.
6. Cut it up. How much a child will eat often depends on how you cut it. Cut sandwiches, pancakes, waffles, and pizza into various shapes using cookie cutters.
7. Make Food fun & interesting. Use ure imagination. Call meals fun names- spaggetti & cheese balls – shoelaces & footballs, carrot sticks & broccoli – fairy wands to shrink big trees to small ones.
Use 5 a day chart – explain why healthy eating is imp & if they reach 5 a day target of meals or veggies give them a special treat.
8. Camouflage those veges – vege are also the biggest enemies of fussy children. Use in sauces, finger foods, slip them into their favorite foods, include in soups (best way to hide them). pizzas a fun way to experiment with new tastes using diff toppings etc.
9. Clear out the rubbish: don’t keep masses of biscuits, cookies, crisps, fried nuggets in the house. If they are not there you wont be tempted to give in to their naggings. Instead keep some healthy snacks pre prepared , like sauces, dips, cheese slices etc.