NAME : MUNDOH AUSTINE

CLASS : NURSING 100

CONTINUOUS ASSESSMENT

1. What is weaning ?

Weaning is the transitional phase in infant’s diet when mother gradually

begins to introduce foods other than breast milk or formula.

WHO Recommends, exclusive breast feeding for first 6 months with continued
breastfeeding along with appropriate complementary foods up to two years of
age or beyond.
Mothers define weaning in various ways:

In some cultures, weaning refers to the termination of breast feeding.

In other cultures, it refers to the addition of solid foods to the milk diet.

Weaning also signifies the beginning of a social detachment of the Child from
the Mother.

Health Professional define weaning as :

The period when the breast feeding or formula feeding is gradually

supplemented with other foods in the infant’s diet.

Cereal based foods are usually the first weaning food offered to the infant.

2. When to wean a child

Weaning is a transition form breast milk or formula milk to solid foods. It is

divided into the following stages:
- Stage 1: Babies are usually ready to start on solid foods between 4-6 months.
- Stage 2: 6-9 months.
- Stage 3: 9-12 months.

Begin with smooth textures, mashed, minced, chopped, finger foods and finally
family foods.

Stage1: From 4-6 Months

During the first couple of weeks of weaning, your baby needs to learn that foods
have different textures and taste, and that it doesn't come in continuous flow.

You can start off with:

- Baby should be still having 600ml of breast or infant formula milk daily.
- Starchy foods: Initially cereal is used such as baby rice
- Mashed, starchy vegetables are also suitable e.g.- potato, carrot, sweet potato,
yam.Try combining some of these foods together.
- Vegetables and fruits: soft cooked pureed vegetables and fruits are suitable
e.g.: apple, banana, pear, mango (Do not add sugar)
- Non fibrous vegetables e.g. cauliflower, pureed spinach

Remember:
1. The aim is to get the baby used to taking food from a spoon-Start with
teaspoonful (quantities will be small) and milk will still be major sources of
nutrients)
2. Foods should be not be salted or sweetened.
3. Don't press food on your baby-If the food doesn't seem to be wanted, wait
and try again another day.
4. To try the food after a milk feed or in the middle of one
5. If food is hot, you make sure you stir it and test it again

Stage2: From 6-9 Months

- Gradually increase amount of food you give either before or after milk feed.
- Continue 500-600ml breast or infant formula milk
- Dairy products: Cow's milk may be used to mix solids. Cheese may be given
as finger foods.
- Starchy foods-2-3 servings daily: introduce wheat based cereals
- Vegetables: 2 servings
Raw soft fruits and vegetables may be given as finger foods e.g. -soft cooked
strips of carrot, Cooked green beans, soft banana and pear, Apple stew, Spinach
and tomato soup. Other cooked vegetables and fruits may now be coarser in
texture.
- Meat and alternatives- 1 serving.
Meat, fish, pulses may be coarsely pureed. Chopped hard cooked egg may be
used as finger foods.

Remember:
1. Introduce lumpy foods by 6-7 months
2. Introduce feeding from the cup.
3. Encourage different textures and stronger tastes.
4. Food should not be salted or sweetened
5. Encourage a savoury preference to sweet
Some meals to try:
Breakfast: porridge of rice mashed banana
Lunch: minced chicken with vegetables and potato or soft ripe peeled pear or
apple.
Dinner: mashed boiled sweet potato with carrots with cauliflower.

Stage3: From 9-12 Months

- Continue 500-600ml-breast milk or infant milk formula daily.
- Dairy products: To continue to use cow milk to mix with solids. Hard cheese
used as finger foods.
- Starchy foods: 3-4 servings daily
May be normal adult texture.
- Vegetables and fruits: 3-4 servings
Encourage lightly cooked or raw foods. Chopped or finger foods is suitable, e.g.
pear, apple, banana and melon.
- Meat and alternatives: to try mixture of different vegetables and starchy foods,
rice and chicken or rice cheese.

Some meals to try:

Breakfast:
- Stewed apple with curd/yoghurt
- Mashed banana with milk

Lunch:
- Mashed rice with yoghurt
- Mixed seasonal vegetables soup (carrot, spinach, tomato) and potato
- Stewed fruits with custard.

Dinner:
- Same as for lunch

After 1 Year
Minimum of 350 ml milk daily or 2 servings of dairy products e.g. curd, paneer.
- Dairy products: Whole cows milk may be now used as a drink.
- Starchy foods: minimum 4 servings daily.
- Vegetable and fruits: minimum 4 servings daily

Remember: Your child may now take almost all that you cook for your regular meals

3. How to wean a child

 There are a variety of different methods, but experts say that you shouldn’t
stop nursing cold turkey. Bourne recommends trying these practical baby-
weaning methods below.

1. Postpone feedings
This is a simple yet effective tactic: Just lengthen the time between feedings.
Bourne recommends that you extend the period between feedings by 30 minutes
each week. If your little one gets hungry, you can offer solids. If she is less than
a year old, give her formula, but if she is over a year, give her whole milk in a
sippy cup.

2. Shorten feedings
For this method, you would shorten your feeding sessions. Bourne suggests
cutting each of them down by one minute per week. “You go at a slower pace
so that your baby realizes that she isn’t getting everything she needs and has to
get it someplace else,” he says. If your baby gets hungry and fussy, you can
supplement with formula or expressed breastmilk in a bottle. If your baby is
over a year, you can offer whole milk.

3. Skip feedings
To avoid shocking and upsetting your baby, gradually eliminate one
breastfeeding session at a time and replace it with breastmilk in a bottle.

4. Conditions to take when weaning a child

 Breastfeed the child when he asks, and don’t offer when he doesn’t. This
simple technique known as “don’t offer, don’t refuse” may help
accelerate the weaning process when used with other methods.
 Change daily routines. Instead of heading home after picking him up
from daycare, head to the grocery store or elsewhere instead. Try to avoid
the “nursing chair” or other usual “nursing station” in your home as much
as possible at the times when he usually would ask to nurse. Stand up as
much as possible!
 If possible, get help from other family and household members. If he
usually nurses upon waking, try getting up before him and have your
partner or someone else do all the morning routine.
 Anticipate nursing sessions and offer substitutions and distractions. Try
offering a snack or drink at that time. Take him to his favourite place at
 the usual nursing time. Other distractions: reading, bike rides, visits from
friends, a new toy, walking/singing to the child.
 Shorten the length of nursing or see if he accepts a postponed nursing.
Telling him he will be done when you are finishing singing a certain
song, or counting to 20 may help with the transition. If he doesn’t
understand the concept of waiting or of time, this may not be helpful.

5. Consequences of improper weaning

Breast milk is highly beneficial to your child as it contains all the essential
nutrients that your child needs for the first few months of his life. There are
some important antibodies that your baby will miss out on if weaned too
early as well. Here are some consequences of weaning too early:

 Weaning early can make a baby prone to illnesses like ear infections,

upper respiratory problems, and diarrhoea.
 High risk of sudden infant death syndrome.
 Early weaning and allergies go hand in hand and babies also face a higher
risk of developing diseases such as eczema.
 Weaning too early can also cause digestive issues resulting from
the formula or solid foods.
 Early weaning risks a baby being more prone to childhood obesity,
meaning your child will also be prone to developing the problems that go
along with it such as high blood pressure, diabetes and heart disease.
 Weaning too early also puts a baby at the risk of accidentally sucking the
food into the airway.
 It can cause a baby to either get too much or too little of the right kind
of nutrition.

6. How to wean a child breast feeding from:

 HIV mothers
 World Health Organization (WHO) recommends that HIV-
infected mothers breastfeed exclusively for the first 6 months of
life and continue breastfeeding for at least 12 months, with the
addition of complementary foods. These mothers should be given
ART to reduce the risk of transmission through breastfeeding.

 Hepatitis B positive mothers

  Although World Health Organization and US Advisory
Committee on Immunization Practices postulate that chronic
HBV infection of the mother could not be an argument against
breastfeeding  many clinicians do not encourage HBV carrier
mothers to breastfeed their babies  since HBV DNA can be
detected in breast milk  and breast lesions such as cracked or
bleeding nipples may increase exposure of infants to HBV.
Recent studies reported that many HBV-infected mothers tend to
formula-feed their infants to prevent mother-to-child transmission
of HBV , although there are studies suggesting that breastfeeding
does not add risk for the mother-to-child transmission of HBV .