WEANING A GUIDE

A babys first introduction to solid food is an important milestone. Advice on how it should be done and what to use may come from friends, relatives, books and magazines. However this advice can often be inconsistent. This information sheet is aimed at answering some of your common queries and at guiding you to do the best for your baby.

What is weaning? Weaning is a gradual process that begins when you start to introduce solid foods. It is also called mixed feeding or starting solids. Gradually the amount, variety and consistency of foods offered increases and by the first birthday your baby will be able to eat most of the food that the rest of the family eats. Breast milk however continues to be an important constituent of babys diet.

Why do babies need to be weaned? As babies get older there is an increasing requirement of certain nutrients such as iron. This can be provided for by commencing solid food. Moving on to solid food also helps develop the muscles necessary for chewing and later on for speech.

When should I start? Weaning usually commences between 4 to 6 months of age but the exact time depends entirely on the individual baby. There is no advantage in commencing weaning earlier than this, as the babys digestive system may not be able to cope with it. It may also increase the incidence of food allergies.

What about milk? During the early stages of weaning, solids are given in addition to the normal quantity of breast milk. As mixed feeding progresses the requirement for breast milk will be reduced, although milk remains an important part of the infants diet. Up to the age of 5 years children should have about half a litre of milk per day.

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Dr. Kishore Das

INTRODUCTION OF SOLIDS

Stage 1 (4 months): What food? The first foods introduced need to be pureed to give a thin smooth consistency e.g. thin porridge made with ragi or rice pureed fruits or vegetables e.g. Bananas or carrots When? Choose a time of the day when you are both relaxed and your baby appears most hungry. You may find that your baby prefers to be held on your lap at first or you can use a baby chair. How? It may take your baby a little while to get used to the idea of taking food from a spoon. You may offer the solid feed after breast-feeding or interrupt breast-feeding to give the solids. If he refuses the food, dont worry, continue with breast-feeding and try again in a few days. Choose a small shallow plastic spoon and allow baby to suck the food from it.

Stage 2 (6 months) By about 6 months your baby should be having foods with a thicker consistency and a lumpier texture. By now your baby may be taking solids at 3 meals each day. Baby may be given a combination as follows: Mashed rice with dal Chapatti softened with dal Mashed seasonal fruits Mashed vegetables Cooked green vegetables, carrots, potatoes (mashed) Grated cheese

The aim is to get your baby used to feeding from the family pot.

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Stage 3 (7-8 months) Now baby can progress to minced or finely chopped foods. Your baby may spit out the lumps at first but slowly she will learn to chew. Foods to try: Finger foods: chunks of fruit e.g. peeled apple/banana Toast, chapatti (ensure pieces are not too small as these could choke your baby) Pieces of cucumber, chunks of cheese, celery sticks Feeding can be a very messy business. Dont wipe babys face constantly. Clean her up after the meal. * At this age babies start to learn that refusing food is a good way of getting attention, so dont let them see that this worries you. Be relaxed and try again later. * Babies should be supervised at all meal times.

Stage 4 (9-12 months) By this stage your baby will be able to eat a more varied diet, providing everything is chopped. Try to give plenty of variety. Try to include foods from each of the food groups shown below. Group Group Group Group I: Meat, pulses (peas, beans, dal etc) II: Fruits, vegetables (apples, bananas, fruit juices, potatoes, carrots) III: Bread, chapatti, cereals, rice IV: Milk, milk products (yogurt, cheese)

Up to 5 years of age children require up to half a litre of milk a day. Continue with breast feeds even as long as 18 months to 2 years of age. Cows milk should be avoided till your baby is a year old although small amounts may be used after 6 months for addition to solids. There is no need to add sugar or salt to babys food.

Hygiene: Young babies can easily pick up infections so it is particularly important to follow good hygiene practices when handling food. Always wash your hands with soap and water before handling food. Wash all feeding equipment thoroughly. Foodstuffs should be freshly prepared. Any leftover food should be covered and stored in a fridge for not more than 24 hours.

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Frequently asked questions Is a vegetarian diet suitable for young children? A vegetarian diet can provide all the nutrients a baby needs for growth and development, but you should make sure it is a balanced and varied diet.

My child refuses food and meal times have become very difficult. What do I do? After a year children begin to grow more slowly and their appetite gets smaller. Also children become a bit more independent and start refusing certain foods. Children often make a fuss about food to get their mothers attention. It is very important that you dont let them see that their not eating worries you. Forcing is likely to make the problem worse. If your child refuses a certain food simply clear it away without comment, but dont let the child fill up on junk food between meals. A childs appetite may vary during the day. Try to offer food to your child when he seems to be hungrier. Also try not to let your child fill up on milk or drinks alone.

Should I give multivitamin supplements? Vitamin drops can be given to all babies up to the age of 2 to 5 years.

When should I start brushing my childs teeth? Good dental hygiene should start early. Start brushing your babys teeth as soon as they begin to appear, using a small soft toothbrush. Foods or drinks taken frequently during the day are particularly damaging to teeth and should be limited to meal times. Also do not dip pacifiers in to sugar or honey as this may spoil the developing teeth.

My baby was born premature. When should I start weaning? Premature babies are weaned at the same age as other babies. However you should ask your doctor for advise.

Dr. Kishore Das FRCPCH(UK),FRCPI,MRCP, DCH Consultant Paediatrician

110, 9th Cross, I Block, RT Nagar, Bangalore 560032 Phone: 23530621. Copyright Dr. Kishore Das

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Dr. Kishore Das