Weaning Diet Saadah

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    Nurus Saadah Mohd FadzilZaini BahariNur Aqilah

    -Hospital Sultan Abdul Halim(HSAH)

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    INTRODUCTIONINTRODUCTION

    10 million children under the age of 5years old die each year. More than half of

    the deaths occur because of malnutrition. While if at all feasible breastfeeding is

    recommended during the first six months,the most vulnerable period for developing

    under-nutrition remains the transition frombreastfeeding to family foods (WHO,2001)

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    Energy required by age &the amount supplied from

    breast milk

    Brown KH et al, FNB, 2002

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    The Iron Gap

    rown KH et al, FNB, 2002

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    WEANING DIETWEANING DIET

    The process of giving an infant foodin addition to breast milk or infant

    formula, when either becomesinsufficient to satisfy the infant'snutritional requirements. (WHO)

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    ONE TWO THREE FOUR FIVE

    AIMS OFAIMS OF

    COMPLEMENTARYCOMPLEMENTARY

    FEEDING:FEEDING:

    The child cannot tolerateThe child cannot tolerate

    more than one liter of fluidmore than one liter of fluid

    per day. So, with increasingper day. So, with increasingneeds for energy solidneeds for energy solid

    foods should be added.foods should be added.

    Growing babyGrowing baby

    requires morerequires more

    minerals andminerals and

    vitamins whichvitamins whichcannot be suppliedcannot be supplied

    by milk.by milk.

    To train the childTo train the child

    on spoonon spoon

    feeding, chewing,feeding, chewing,

    and swallowingand swallowing

    of solids.of solids.

    To train theTo train the

    gastrointestinalgastrointestinal

    tract to digesttract to digeststarch and otherstarch and other

    solid foods.solid foods.

    To educate theTo educate the

    childchild

    independenceindependenceby using spoonby using spoon

    and cup to feedand cup to feed

    himself.himself.

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    WHEN TO FEED?WHEN TO FEED?

    Healthy infants reachdevelopmental readiness to begincomplementary foods between 4

    and 6 months old (Community NutritionPack Sheffield Community DietitiansApril,2009).WHY?

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    The infants intestinal tract developsThe infants intestinal tract develops

    immunologically with defenseimmunologically with defense

    mechanismsmechanisms

    to protect the infant from foreignto protect the infant from foreign

    proteinsproteins(thus, the risk of hypersensitive (aller(thus, the risk of hypersensitive (allerg

    reactions to the proteins inreactions to the proteins in

    complementarycomplementary

    foods is reduced).foods is reduced).

    The infants ability to digest andThe infants ability to digest and

    absorb proteins, fats, andabsorb proteins, fats, and

    carbohydrates,other than those incarbohydrates,other than those in

    breast milk and formula, increasesbreast milk and formula, increasesrapidly.rapidly.The infants kidneys develop theThe infants kidneys develop the

    ability to excrete the wasteability to excrete the waste

    products from foods with a highproducts from foods with a high

    renal solute load, such as meat.renal solute load, such as meat.The infant develops theThe infant develops theneuromuscularneuromuscular

    mechanisms needed formechanisms needed for

    recognizing andrecognizing and

    accepting a spoon, masticating,accepting a spoon, masticating,swallowinswallowin

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    Early introduction (prior to 4) leads to:Early introduction (prior to 4) leads to:

    Choke on the foodChoke on the food

    Develop food hypersensitivitiesDevelop food hypersensitivities(allergies)-immature GIT(allergies)-immature GIT

    Consume less than the appropriateConsume less than the appropriate

    amount of breast milk or infantamount of breast milk or infant

    formulaformulalack nutrient/mom risk forlack nutrient/mom risk forpregnantpregnant

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    BABY SIGNAL

    Baby can hold her head up Baby can sit up, supported by your arm

    or a chair back

    Baby makes munching motions whentheres nothing in her mouth Baby likes bringing her hands and toys

    to her mouth

    Baby has been feeding frequently buthasnt been gaining weight, or the rateof weight gain has significantly slowed

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    TECHNIQUE OF WEANINGTECHNIQUE OF WEANING

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    Bread, potatoes and other cerealsCooked and pureed potatoes, sweet potato, plantain, smoothcereals. Give 1-2 servings per day.

    Fruit & VegetablesSoft cooked fruit and vegetables as a smooth puree for

    example carrot, parsnip, apple, pear, and banana. Give 1-2servings per day.

    Meat & AlternativesSoft cooked meat and pulses as a puree. At least 1 serving perday.

    Commercially prepared weaning foods (stage 1) are suitablebut have no advantage over home prepared food.

    Cows milk products such as smooth unsweetened yoghurt,custard and small amounts of cheese sauce may be given atthis stage but should not be the initial weaning food.

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    A wider variety of solid foods should gradually be introducedIt is important to introduce lumpy foods by 6-7 months-they aremore receptive to changes in texture

    Bread, potatoes and other cerealsStart to introduce more cereals including wholemeal bread.

    Introduce lumpier texture finger foods for example toast. Give 2-3 servings per day.

    Fruit & VegetablesCooked fruit and vegetables coarse, mashed texture. Raw softfruit and vegetables as finger foods. Give 2 servings per day.

    Meat & AlternativesSoft cooked mince or pureed meat, fish and pulses. Hard boiledegg can be used as a finger food. Give 1 serving per day.

    Finger foods such as bread fingers, slices of peeled fruit orvegetables

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    Bread, potatoes and other cerealsGive starchy foods of a normal adult texture. Give 3-4 servingsper day

    Fruit & VegetablesLightly cooked or raw fruit and vegetables. Give chopped as

    finger foods. Give 3-4 servings per day.

    Meat & AlternativesMinced or chopped cooked meat, fish and pulses. Give aminimum of 1 serving per day from animal source or 2 servingsfrom vegetable sources.

    Aim for 3 meals per day plus snacks.

    Discourage high fat and high sugar snack foods and food givenasrewards as this can lead to poor eating habits.

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    Bread, potatoes and other cerealsGive starchy foods of a normal adult texture

    Fruit & VegetablesGive fruit and vegetables of a normal adult texture.(a childshandful/d). If unsweetened fruit juice is given it is best given at a

    meal time to prevent dental decay and increase iron absorptionfrom food.

    Meat & AlternativesEncourage lean meat and oily fish. Give a minimum of 1 servingper day from animal sources or 2 servings from vegetable

    sources.

    Avoid adding sugar to drinks.Avoid snacking on foods high in fat, sugar and salt.Parents should be encouraged to eat with their children toencourage good eating habits.Infants have a high requirement for energy relative to their small

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    FEEDING FREQUENCYFEEDING FREQUENCY

    6-8 months: Feed 2-3 times a day 8-12 months: Feed 3-4 times a day 12 months and above: Feed 1-2 times a day,

    with nutritious snacks added (bread/soft

    fruits)

    When baby is ill: Breastfeed more frequently.

    Give soft, appetizing foods that baby likes. Encourage baby to eat more until he regains

    any weight lost.

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    IS COMMERCIAL BABYIS COMMERCIAL BABY

    FOOD OK?FOOD OK?

    Check the label on the packaging tomake sure that it contains noartificial additives, flavourings,

    colourings, added salt or sugar.When buying fruit juice, choose100% juice with no added sugar.

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    6 months

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    8-12 months

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    1-3 years