Starting Solids - First food for your baby

Complementary feeding is the process by which your baby moves or ships from having only breastmilk to consuming semi-solid or solid foods. There is a gradual reduction in the intake of breastmilk and/or baby formula and your baby more often starts taking more solid food.

Starting solids is one of the many milestones in your baby’s process of development. It is very important for your baby’s health and development.

 

NEED FOR COMPLEMENTARY FEEDING?

Breast milk alone is not able to provide sufficient amounts of all the nutrients needed to maintain growth after the first six months. Increasing needs of calories and protein of growing children cannot be met by the diminishing output of mother's milk. Milk is also a poor source of vitamin - C and supplementation with fruit juice is essential. Iron stores in the liver of the infant would last only upto 4-6 months. Hence iron rich foods should be given from six months onwards.

 

WHY START SOLIDS AT 6 MONTHS?

• WHO Recommendation: WHO recommends that infants start receiving complementary foods at 6 months of age in addition to breast milk, initially 2-3 times a day between 6-8 months, increasing to 3-4 times daily between 9-11 months and 12-24 months with additional nutritious snacks offered 1-2 times per day, as desired.
• The child is growing in size. Other activities like learning to turn, crawl, standing with support, walking, running / vocabulary/ teething/ learning to eat by himself/ grasp etc.
• Food contains complex forms of nutrients. Child is ready to digest these complex carbohydrates, Protein and fats by 6 months of age.
• Enzymes to digest complex nutrients are fully activated now.

 

POINTS TO BE CONSIDERED IN INTRODUCING SOLIDS:

1. Introduce only one food at a time.
2. Allow the infant to become familiar with the food before trying to give another [2-3days] so that if the baby is allergic to one food, it can be determined easily.
3. Give very small amounts of any new food at the beginning, for eg- 1 tsp or less.
4. Use a thin consistency when starting solid foods. Gradually the consistency is made more solid as the infant learns to propel the food back with the help of tongue.
5. If, after several trials, the baby has an acute dislike for a particular food, omit that item for a week or two and then try again. If the dislike persists it is better to forget about the food for a while and substitute another.
6. At first pureed and strained fruits, vegetables and cereals are given.
7. When the baby is able to chew, gradually substitute finely chopped fruits and vegetables usually at 9 months.
8. Infants may object to taking some foods by themselves but will take them willingly if one is mixed with another, eg: egg may be mixed with formula, cereal or vegetables. Vegetables may sometimes be made into soups with little milk until the baby becomes accustomed to the new flavor.
9. Variety in choice of foods is important.
10. The mother or anyone feeding the infant must be careful to avoid showing in any way a dislike for a food which is being given.
11. A baby's appetite varies a lot from meal to meal and day to day. During hot weather or when the child is teething or suffering from cold the child’s appetite may be less.
12. Give freshly prepared foods as much as possible.
13. Observe hygienic practices while preparing and feeding the complementary food.
14. Read nutrition label on baby foods carefully.

 

WHAT ARE THE PRINCIPLES IN PREPARING COMPLEMENTARY FOOD SUPPLEMENTS?

• First foods based on cereal-pulse-nut and sugar/ jaggery combinations will provide good quality protein, adequate calories and other protective nutrients.
• Since infants cannot consume bulky complementary food, in sufficient quantities, energy-rich foods like fats and small amounts of jaggery should be included in such preparations.
• Infants can also be fed green leafy vegetables (GLVs), which are rich, yet inexpensive, sources of vitamins and minerals. However, greens should be well cleaned before cooking lest the infants develop loose motions. Dietary fiber in green leafy vegetables can, by itself, promote the bowel movements leading to loose motions in infants. Since GLVs are rich in dietary fiber, it is advisable to initially feed only the juice of the GLVs after cooking them properly.
• Infants should be introduced to different vegetables and fruits gradually. It should, however, be remembered that these food items should be thoroughly cooked and mashed before feeding.
• At about one year of age, the child should share the family diet.

 

HOW TO FEED A YOUNG INFANT?

• Infants cannot eat large quantities of food in one sitting at a given time. So, they should be fed small quantities at frequent intervals (3-4 times a day).
• Make sure infants are fed seated on a high chair or propped up - not lying down. Also, the food should be of semi-solid consistency for easy swallowing. When such semi-solid foods are offered initially, the infant tends to spit it out. This should not be mistaken as dislike for that food.
• The fact is that the young infant cannot achieve full coordination needed for the act of swallowing and hence, brings out the food by movements of its tongue.
• Physiological maturity of swallowing semi-solid food develops when the food is regularly given every day.

 

WHAT ARE THE HYGIENIC PRACTICES TO BE ADOPTED?

• It is important to ensure that hygienic practices are scrupulously followed. All the raw ingredients should be thoroughly cleaned.
• Vegetables should be washed well to remove contaminants/ parasites/ pesticides before cutting.
• Vegetables should preferably be steam-cooked to reduce cooking losses.
• At the time of preparation and feeding of the recipes, mother should observe proper personal hygiene and the utensils used for cooking should be thoroughly washed or sterilized, wherever possible.
• A number of pre-cooked and ready-to-eat foods can be prepared for use as complementary foods. Such foods should be stored in clean bottles or tins.
• As feeding is likely to be time consuming, the cup or the plate from which the recipe is being fed to the infant should be kept covered to protect it.
• Most often, diarrhea is caused by unhygienic practices adopted by mothers. These foods which are properly cleaned and well-cooked are safe even for young infants.

 

SOLIDS: BASIC GUIDELINES

Volume 

Children have little capacity due to their small stomach size and smaller surface area. Initially they accept small amounts but as he/she increases in size, accepts larger volume.

• 5-6 months -> 30-50 g at a time
• From 6- 7 months -> 50-75 g at a time
• From 7-8 months -> 75 – 100 g at a time
• From 9- 12 months -> 100-150 g at a time

 

AMOUNT OF FOOD TO OFFER AT DIFFERENT AGES

AGE	TEXTURE	FREQUENCY	AVERAGE AMOUNT OF EACH MEAL
6-8 MONTHS	START WITH THICK PORRIDGE AND PUREES , SLOWLY MOVE TO WELL MASHER FOODS	2-3 MEALS PER DAY PLUS FREQUENT BREASTFEEDING	START WITH 2-3 TABLESPOONFULS
9-11 MONTHS	FINELY CHOPPED OR MASHED FOODS, AND FOODS THAT BABY CAN PICK UP[FINGER FOODS]	3-4 MEALS PLUS BREASTFEED. DEPENDING ON APPETITE OFFER 1-2 SNACKS	1⁄2 OF A 250 ML CUP/BOWL
12-23 MONTHS	FAMILY FOODS, HOME FOOD - CHOPPED IF NECESSARY. AVOID ALL FOODS WITH CHOKING HAZARD	3-4 MEALS PLUS BREASTFEED. DEPENDING ON APPETITE OFFER 1-2 SNACKS	3⁄4 TO ONE 250 ML CUP/BOWL

 

*Source: Infant and Young Child Feeding guidelines. IAP.

5-7 MONTHS PUREED	7-9 MONTHS MASHED	9-12 MONTHS MASHED TO CHOPPED	1 YEAR AND ABOVE NORMAL HOME FOOD
RICE PUREE + WATER OR BREAST MILK RAGI PUREE + WATER OR BREAST MILK PUREED WELL COOKED POTATO OR CARROT OR SWEET POTATO OR BEETROOT PUREED BANANA OR COOKED SKINLESS APPLE OR COOKED SKINLESS PEAR DHAL MASH PUREE STRAINED VEG SOUPS BOILED COOLED WATER GHEE- 1 TSP/ DAY	SAGO PORRIDGE  RAGI PORRIDGE RICE PORRIDGE ALL MALTED CEREAL MIXES PUREED / WELL MASHED SPINACH /POTATO/ CARROT/ BEETROOT/ SWEET POTATO/ PUMPKIN/GREEN PEAS/COOKED TOMATOES PUREED FRUITS + CITRUS JUICES LIKE SWEET LIME AND ORANGE [50% JUICE +50 %WATER] EGG YOLK- WELL COOKED [ NO WHITE] CHICKEN PUREED SOUP SHREDDED FISH WITH RICE MIXED GHEE : 3 TSP	WELL COOKED PASTA[MACARONI] OATS KANJI/ DALIYA KANJI/SAGO/ RAGI/ SEMIYA/OATS OR RAVA UPMA/ KHICHDI/ IDLI OR DOSA SOAKED IN DAL/ CURD BREAD PIECES- SOFT CURD AND PANEER BURJI- MADE AT HOME BOILED POTATO PIECES/ CARROT/ GREEN BEANS/ CHOPPED BANANAS/ MELONS/ COOKED APPLES AND COOKED PEARS/ PEACHES MINCED MEAT/ SHREDDED CHICKEN/ SHREDDED FISH/ EGG YOLK GHEE 2-3 TSP OIL : 1-2 TSP / DAY	ALL NORMAL HOME FOOD INCLUDING WHOLE MILK AND FULL EGGS AND POWDERED NUTS EXCEPT NUTS/ HONEY/ EXCESS SALT /SUGAR /SPICES AND CAFFEINE ALSO AVOID ALL FOODS WITH CHOKING RISK TILL 4-5 YEARS

FOODS TO AVOID 6-12 MONTHS

• SALT - Do not use excess salt in baby foods, as their kidneys are still developing. Also mother’s milk/ formula and other solid foods naturally contain the sodium they require. Check with your pediatrician to ensure you are not exceeding sodium for your little one.
• SUGAR - Do not add sugar to the food or drinks you give your baby till 1 year. Sugar could encourage a sweet tooth and lead to tooth decay when the first teeth start to come through.
• HONEY - Don’t give honey until your child is 1 year old, even for easing coughs. Honey can contain a type of bacteria which can produce toxins in the baby’s intestines and can cause a very serious illness (infant botulism).
• WHOLE NUTS - Whole nuts of any kind are unsuitable for children under the age of 5 years because of the risk of choking. However, powdered nuts can be used in recipes for calorie and fat needs.
• FOODS WITH CHOKING RISK - Avoid soti foods like jelly or gummy candies,  chewing gum, hard candies, whole green peas, whole beans like Chana /rajma etc cough drops, whole nuts, popcorn, peanut butter etc.
• Remember to cut fruits like grapes, cherry tomatoes into quarters before serving, and shred or cut meats and cheeses into very small pieces.
• EGG WHITES
• COW’S MILK