Supplementary feeding / Weaning

Introduction:

In the first year of life, infants undergo periods of rapid growth when good nutrition is crucial. In fact,
nutrition in the early years of life is a major determinant of healthy growth and development
throughout childhood and of good health in adulthood

Definition

Supplementary feeding means providing ‘extra’ food to people or families over and above their
home diet and has been used in populations that are vulnerable (including women and young
children; school‐aged children; people living with diseases such as tuberculosis, HIV, and
Alzheimer's disease; and older people) and food insecure (limited access to adequate and
nutritious food), to improve their health and quality of life.

For an infant temporary supplements may be required along with breast feeding, which can be
expressed milk, artificial milk or therapeutic formula.

The term ‘Supplementary feeding’ is sometimes overlappingly used for the term
‘Complementary feeding’ too. Currently, ‘Complementary feeding’ refers to giving an infant,
foods and liquids other than breast milk, after attaining 6 months of age, in addition to the breast
milk or nonhuman milk. Previously it was termed as ‘weaning’.

-Complementary Feeds provided from 6months to one year•

Principles to be kept in mind while giving Complementary feeding include—

• Must be initiated when baby displays signs of readiness like holds his/ her head straight
when sitting, Opens his/her mouth when others eat, Is interested in foods, Receives frequent
feeds but appears hungry soon.

• Must meet the following criteria: Easily available & low cost, Easy to prepare, Easily
digestible, acceptable & palatable, Well-balanced & nutritionally dense, Suited to the cultural
practice, Cooked thoroughly, soft & in right consistency, Served at safe temperatures.

• Introduce –

 With gradual change in consistency (Liquids, semi-solids followed by solid feeds as

developmentally appropriate) and gradual increase in quantity
 Carbohydrate feeds with introduction of fats and later proteins (animal proteins must be
introduced last)
 Timely: by six months of age
  In adequate amounts: i.e. it must provide sufficient energy, proteins & micronutrients to
meet the growth needs and must be given in addition to the regular breastfeeding; avoid
unnecessary dilution and
 Safe: i.e. hygienically & freshly prepared (Prepare only the required amount for one time)
& fed with clean hands & utensils (the vessels must be roll boiled for 3-5minutes) and not
with bottles & teats. Keep vessels covered. Avoid spices, sweetened or commercial
preparations
 One new food at a time, when the infant is relatively hungry. Initiate the next new feed
once the child gets adapted to the previous
 Do not force, and make feeding a pleasant experience

What are the qualities of weaning foods?

Breast milk is a complete food for the infant. Weaning foods are used as an additional source of
energy as well as to satisfy the increasing requirements for all essential nutrients. Particular
attention should be paid to proteins, iron, vitamin A and C, as these are frequently found to be
deficient in the diet of young infants.

Desirable qualities of weaning foods:

 Should have high energy content

 Should be easy to digest

 Should be semi-solid in consistency

 Should not be too thick

 Should be fresh and clean

 Should not be expensive and should be easy to prepare

Different Types of Industrially Prepared Complementary Foods

Many industrially prepared complementary foods are available, which are formulated to satisfy
the nutritional needs of infants and young children. Meat, vegetables and fruit are major
ingredients. Some are based on cereals, some on pasta. They run the whole gamut from biscuits,
rusks, and "main meals" to desserts and drinks

Main Categories of Industrially Prepared Foods:

 Ready to eat baby foods

These consist of prepared recipes that are cooked and sterilised and are normally sold in
cans, jars or plastic containers. This broad category includes baby meals, fruit or
vegetable based foods, and meat and fish based foods.
  Dried baby foods
The range of dried foods available is similar to ready-to-eat and they are prepared
according to recipes, but they are dried after cooking. Dried foods must be mixed with
water or milk before feeding.
 Cereal-based foods
Cereal foods are usually sold dried and ready for reconstitution. They are based on pre-
cooked cereals with additions of meat, vegetables or fruit. Some are reconstituted with
milk, but others are already mixed with high protein foods and should be reconstituted
with a non-protein containing liquid such as water.
 Pasta
These foods are available with different pasta shapes and are used after cooking in
boiling water or other appropriate liquid. Pasta is often used as a main ingredient in
“main meal” products.
 Biscuits and rusks
Biscuits and rusks can be offered in dried form or can be soaked in water or milk. These
products can be particularly useful for teething infants.
 Milk based desserts
Special deserts with controlled sugar content typically contain yogurt or other milk
products as a main ingredient.
 Toddler drink
Special formulations of cow’s milk or soy extracts have been developed to match the
specific nutritional needs of young children over one year of age.

Other drinks
Fruit, vegetable and herbal drinks also contain controlled amounts of sugar

DO NOT ....

o Leave your child alone while eating.

o Add solids to your baby's bottle.

o Hurry your child at mealtimes.

o Spend time persuading them to eat something they are refusing. Leave it and try
the food another day

IYCF guidelines

Age (months) Texture Frequency Average amount/ Sample foods

meal
6-8 months Start with thick 2-3 meals/day + Start with 2-3 -Cooked mashed
porridge, well frequent Breast table-spoonful potato, banana,
mashed foods feeds apple, carrot etc,
-Soft mixture of
rice & dal
 (Kichri), curd.
cerealpulse mix
porridge with
milk -Boiled egg
yolk
9-11 months Finely 3-4 meals + ½ of a 250ml -Can take
chopped/mashed Breast feeds + 12 cup/ bowl chopped finger
foods and foods snacks foods like slice
that baby can (depending on of apple, carrot,
pick up the appetite) rusk etc (with
due care as Fine
pieces/ nuts etc.
may cause
choking). -Soft
and well cooked
fish, Egg white,
meat & chicken
can be gradually
introduced by
11mths or so
(Early
introduction may
lead to food
allergies).
12-23 months Family foods -same as ¾ or more of a All kind of home
(chopped/ previous- 250ml cup/ bowl prepared foods
mashed as
necessary)