I
can still remember my first task during my internship in National Nutrition
Council Region 7. Dr. Parolita Mission,
Nutrition Program Coordinator of NNC-7 gave me a task- to lay-out a
broadcasters’ manual with a topic about Complementary Feeding. I admit I have
no knowledge with this topic, at the back of my mind there is doubt if I could
finish this manual for 3 days. During my working hours I started browsing the
internet and the files which was given to me for my reference. If there’s one
thing I learned with this task it is about the whole complementary feeding
topic.
Complementary
feeding should be focus since malnutrition is very rampant nowadays. Based on
the Social Weather Station January 31, 2012 latest survey- hunger affects 22.5%
or an estimated 4.5 million families. According to the results of the 7th
National Nutrition Surveys (2008) 8.2 % of infants, 25.4% of 1-year old, 31.8%
of 2-year old, 37.9% of 3-year old, 34.4% of 4-year old and 38.2% of 5 year-old
children were undernourished. The first two years are considered the most
critical in the life of the child. This is the “critical window” for the
promotion of optimal growth, health, and development. Insufficient quantities
and inadequate quality of complementary foods, poor child-feeding practices and
high rates of infection have a detrimental impact on health and growth during
these important years. Even with optimum breastfeeding, children can become
stunted if they do not receive sufficient quantities of quality complementary
foods at six months of age (Lancet, 2008).
1. What
is Complementary Feeding?
Complementary feeding is the giving of foods to
infants starting at six months, in addition to breast milk. The additional
foods and liquids are called complementary foods because these are only
additional or supplemental to breastfeeding, and not sufficient on their own as
a diet. Complementary foods used to be more commonly called "weaning
foods". However, some experts advise that the use of the term
"weaning foods" should be avoided so as not to imply that
complementary foods are meant to be given to infants as they are weaned or
“removed” from the breast. Complementary feeding should not displace breast
milk or initiate the withdrawal of breastfeeding.
2. When is the right time to start complementary
feeding?
From six months and older, there is a gap between
the total energy needs of the baby and energy and nutrients provided by breast
milk. As the baby grows, the energy and nutrient gap increases. Thus, the sixth
month is the best time to start giving complementary foods. Exclusive
breastfeeding from birth up to six months and starting complementary feeding at
six completed months while continuing breastfeeding up to two years and beyond
will help a child to grow healthy.
In addition, at six months, the baby’s digestive
system is mature enough to digest a range of foods. The baby also begins to
develop the coordination skills to move solid food from front to back of the
mouth for ingestion. The control of the baby's head is improved and the baby is
able to sit with support. These are important skills in eating solid foods. A
6-month old baby who looks and grabs at foods is a clear sign that he/she is
ready to eat.
3.
What are the
risks of starting complementary feeding too early or too late?
Starting
complementary feeding before the sixth month may:
a.Reduce
breast milk production or intake. The early introduction of other foods into
the infant's diet decreases the frequency of breastfeeding and intensity of
suckling and as a consequence breast milk production also decreases. When this
happens, the additional food may take the place of breast milk, making it
difficult to meet the child’s nutritional needs.
b.Contribute to increased rates of infant mortality
and morbidity. The early introduction of complementary foods increases the risk
of illness, diarrhea, wheezing and other allergic conditions because a child
receives less of the protective factors present in breast milk. Studies have
shown that the incidence of diarrhea is 3 to 13 times higher when breastfed
infants are given complementary foods between 4 to 6 months than when they are
exclusively breastfed. Furthermore, babies fed early with restricted diets and
living in unsanitary environments suffer from more frequent diarrheal episodes.
The incidence of diarrhea is attributed to the lack of potable water, the use
of water contaminated with Escherichia coli, and improper food storage.
c. Increase the risk of mothers becoming pregnant.
Breastfeeding mothers are protected from getting pregnant because breastfeeding
is considered a natural contraceptive.
d. Interfere with iron absorption. Studies have
also shown that the early introduction especially of cereals and vegetables can
interfere with the absorption of breast milk iron, which is normally low in
concentration at the age of six months. Unless the child is fed with iron-rich
food preparations, a child may be at a greater risk to iron deficiency or
anemia.
On the other hand, delaying the giving of complementary
foods is not beneficial and is dangerous because the child will not get the
energy and nutrients required to meet his/her growing needs. As a result, the
child's physical and mental development is affected and may lead to growth
faltering and eventually malnutrition.
4.
What are recommended
complementary foods?
Breastmilk is considered the
complete food for the baby from birth up to six months. This means that
breastmilk alone is what a baby needs for the first six months of life. At the
sixth month, the baby should be given additional foods in the recommended
amount for his/her age that will provide sufficient energy, protein,
micronutrients and other essential nutrients to meet the growing child’s
nutritional needs. Parents should choose and prepare foods from the different
food groups: energy-giving, body-building, and body regulating foods or
what we know as GO, GROW and GLOW foods.
what we know as GO, GROW and GLOW foods.
Energy-giving (GO) foods:
The
main nutrients in this food group are carbohydrates and fats. Carbohydrates and
fats are chief sources of energy. Examples of foods in this group are: rice,
corn, root crops, bread and bakery products, noodles, cooking oil, butter,
margarine and other fats, and sugars.
Body-building (GROW) foods:
These
foods are high in protein and minerals needed for growth and repair of body
tissues. Protein also gives energy, but it is important as a body-building
nutrient. The foods in this group are: meat, fish, poultry, eggs, organ meats,
milk and milk products, and dried beans like mongo and nuts. These foods are
also high in vitamin A and iron that can be used readily by the body.
Regulating
(GLOW) foods:
Included in this group are fruits and vegetables high in vitamins, minerals and fiber. Vitamins and minerals are essential for growth, for healthy eyes, for strong bones and teeth and high resistance to infections. Fiber is important for regular bowel movement.
Included in this group are fruits and vegetables high in vitamins, minerals and fiber. Vitamins and minerals are essential for growth, for healthy eyes, for strong bones and teeth and high resistance to infections. Fiber is important for regular bowel movement.
5.
How do we know
that the child is getting enough breast milk and complementary foods?
Regularly
monitoring the growth (weight and height) of the child is a useful and
important way to know if he/she is taking enough breast milk and complementary
food and is healthy. Measure his/her height and weight regularly and plot these
on a growth chart.
With
sufficient breast milk and food of good nutritional quality, the child's weight
and height will continue to increase correspondingly with his/her age. The
growth chart can also be used as a tool for teaching mothers and caregivers if
they are feeding the child properly. A decrease in the weight of the child is a
signal that she/he is not properly fed and or cared for.
Source:
clinicanutrition.page