Complementary feeding

Last Updated 24 May 2013, 12:44 IST

Giving birth is perhaps the most joyous occasion in a woman’s life. Babies need warmth in the arms of the mother, milk from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three.

However, a time comes when mother’s milk alone is no longer sufficient to meet the nutritional needs of growing child. From six months of age, the baby begins to need additional sources of energy and other essential nutrients for good health, growth and development.The act of complementing mother’s milk with semi-solid and solid foods after the child has reached six months of age is called complementary feeding. However, complementary foods should not be introduced either too early or late as it may lead to health consequences later.

 The time period of 6 months to 18-24 months is a vulnerable one for the child. The most rapid growth of human body occurs during infancy, and nutritional needs are at their highest per unit of body weight. This is the time when malnutrition starts in many infants.

It is only at six months that a baby’s digestive system is developed enough to digest a range of solid and semi-solid foods. The baby attains the necessary motor skills to cope safely with these, as the digestive and kidney functions are likely to be sufficiently mature by around four to six months of age to enable her to process some complementary foods in addition to mother’s milk. That is why there is a general consensus amongst medical experts that complementary foods should be introduced at six months of age.

Feeding solid foods too early has been associated with an increased risk of obesity, diabetes, celiac disease, allergies and other disorderslike eczema later in childhood. Yet, the practice of untimely introduction of complementary feeding continues due to a lack of awareness among mothers. In fact, around 30% of infants aged 4-5 months are introduced early to complementary food, despite medical advice to the contrary.

On the other hand, introducing complementary food later than six months is also likely to impact the baby’s health, triggering nutritional deficiencies as mother’s milk alone may not be able to meet all her nutritional requirements. Nutritional recommendations for the complementary feeding period are based on the concept that mother’s milk will not meet full requirements for energy, protein and micronutrients beyond 6 months of age. Children fed only on their mother’s milk after this period face the prospects of a nutritional gap and lowered immunity against preventable illnesses such as diarrhea and pneumonia. As per the Infant and Young Child Feeding (IYCF) guidelines, this is a serious issue in India where around 40% of children remain without any complementary source of feeding till they attain eight months of age.

Complementary food for children needs to be timely, adequate, appropriate as well as safe and hygienic.Any compromise with these may impact a child’s health, not allowing her to reach full growth potential. Complementary food is considered adequate when it provides sufficient energy and other essential nutrients to meet the child’s growing developmental needs. It should also be easy to digest.

For infants starting on complementary foods, iron requires special attention because iron deficiency is the highest among children less than two years old. Providing complementary foods rich in essential fatty acids along with mother’s milk will help in ensuring adequate supply of these essential nutrients. Also important are Vitamin D for infants with inadequate exposure to sunlight and Vitamin A in areas where deficiency rates are high.

(The writer is a pediatrician)

(Published 24 May 2013, 12:44 IST)

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