Complementary Feeding: What every mom should know

MUMBAI, India - May 10, 2013 - PRLog -- Mumbai, May 10, 2013: Giving birth is perhaps the most joyous occasion in a woman’s life. Indeed, someone called it “the most profound initiation to spirituality a woman can have.” From the very first day, the baby and the mother share an inseparable bond that is further cemented by breast feeding. As the famous British obstetrician Grantly Dick-Read said: “A newborn baby has only three demands. They need warmth in the arms of the mother, food 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. Doctors, however, suggest that complementary foods should not be introduced either too early or late as it may lead to health consequences later.

According to Dr. Rahul Nagpal, Director and Head of Department, Pediatrics, at Fortis Hospitals, 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 disorders like 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.

According to the 11th Five Year Plan’s Working Group on Integrating Nutrition with Health, about 12% of infants of up to 6 months suffer from malnutrition in the country, but this figure for children of age 12-23 months is a staggering 58.5%. The Ministry of Statistics and Programme Implementation, Government of India, says that over 38% of children below three years in India are short in height while about half are underweight and thin for their age. Medical experts are of the opinion that the steep rise in malnutrition among children less than two years of age is largely due to improper feeding practices.

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.

Dr. Nagpal says that 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.”

Dr. VV Varadarajan, Director, Division of Pediatrics, Sooriya Hospital in Chennai says, “An infant requires calories, protein, vitamins and minerals in the right quantity every day. The role of the doctor is crucial in explaining these options to parents.” Doctors say that babies should be introduced to complementary food with softer and smoother texture before gradually moving to thicker and firmer foods. The portion size should gradually be increased over the weeks.

It is well recognized that the period from birth to two years of age is the “critical window” for the promotion of optimal growth, health, and development. It is hence imperative that to give timely, safe, adequate and appropriate complementary food to a baby at the right age of six months.