What do I feed my baby after 6 months of age?

As I sit in my clinic on a regular day, I am compelled to write about one of the most common queries I come across; feeding a baby after 6 months of exclusive breast feeding after birth.

One of the many reasons I came back to Uganda after my training in Pediatrics abroad is, it’s arable land and the organic fruits and vegetables that can be grown without the use of commercialized fertilizers. While the whole world is going ga-ga about organic spinach, organic carrots…for Ugandans it is a norm!

So, when it comes to feeding our infants why do we go looking for the boxes and tins stacked neatly with the alluring labels in supermarkets?

Childhood nutrition and health is one of the areas in pediatrics that is extremely close to my heart. Interestingly, most of the research on the origin of non-communicable diseases (such as hypertension, diabetes mellitus, heart related diseases) has been traced back to nutrition not only in young children and infants but the growing fetus as well!

What is the basis of appropriate complementary feeding?

• timely– meaning that foods are introduced when the need for energy and nutrients exceeds what can be provided through exclusive and frequent breastfeeding;
• adequate– meaning that foods provide sufficient energy, protein, and micro-nutrients to meet a growing child’s nutritional needs;
• safe– meaning that foods are hygienically stored and prepared, and fed with clean hands using clean utensils and not bottles and teats;
• properly fed– meaning that foods are given consistent with a child’s signals of appetite and satiety, and that meal frequency and feeding method – actively encouraging the child to consume sufficient food using fingers, spoon or self-feeding – are suitable for age.

One of the most popular complementary foods given to infants as their first complementary food is thin cereal porridge. It can be made from either maize flour, millet flour or sorghum flour. Cows’ milk may be added to the porridge, or the cereal flour can be mixed with soya flour.

TIP: A tip to make it easier for the working mothers out there who are trying to get their head round on how it’s going to work for them.

• Get 250 grams of millet flour, 250 grams of soya flour and 250 grams of maize flour ( I would prefer you get the whole grains and get it powdered in front of you at a local grinding mill)
• Mix all of this grain powder and store this in a glass jar
• Every time to want to prepare a meal add 2 scoops of this nutritious powder with 60-70 ml of milk (until the consistency is liquid)
• Add pureed spinach, carrots or peas into this mixture.
• And finally, one teaspoon of oil or ghee to make it energy dense. (Also, I would avoid excessive salt in the initial ages maybe, less than a pinch.)

Try introducing a “new” food every week. This may be either a fruit or a vegetable. Keep in mind, no nuts, grapes basically anything that will cause choking in the baby. EVERYTHING HAS TO BE EITHER LIQUID OR SEMI-SOLID IN NATURE.

Complementary foods should be varied and include adequate quantities of meat, poultry, fish or eggs, as well as vitamin A-rich fruits and vegetables every day. Where this is not possible, the use of fortified complementary foods and vitamin mineral supplements may be necessary to ensure adequacy of particular nutrient intakes.

As infants grow, the consistency of complementary foods should change from semi-solid to solid foods and the variety of foods offered should increase. By eight months, infants can eat ‘finger foods’ and by 12 months, most children can eat the same types of food as the rest of the family.

How to feed the baby?

-feeding with a balance between giving assistance and encouraging self feeding, as appropriate to the child’s level of development;

-feeding with positive verbal encouragement, without verbal or physical coercion;

-feeding with age-appropriate and culturally appropriate eating utensils;

-feeding in response to early hunger cues;

-feeding in a protected and comfortable environment;

-feeding by an individual with whom the child has a positive emotional relationship and who is aware of and sensitive to the individual child’s characteristics, including changes in physical and emotional state.

How often to feed the baby?

• 2−3 meals per day for infants aged 6−8 months;
• 3−4 meals per day for infants aged 9−11 months and children 12−24 months
• additional nutritious snacks may be offered 1−2 times a day, as desired.

NOTE: CONTINUING BREASTFEEDING EVEN AFTER INTRODUCTION OF COMPLEMENTARY FEEDING IS ONE OF THE CORNERSTONES.

I feel like could go on typing about nutrition in infants and children and still it would not be enough. However, my next blog is going to be about: What do I feed my child when he/she is sick?

By: Dr. Shinsha Shetty, MD Pediatrics, Fellowship in Neonatology

First foodsMedical adviceRecipesWeaning