COMPLEMENTARY FEEDING

and WEANING

Prof. EKRAM M. HELMY

Definition:
‡ Weaning is a word derived from Anglo-Saxon
language and meaning ³to accustom´.
‡ It is used to define the process of separation
from the breast or bottle feeding; meanwhile
adjusting the baby to a mixed diet.
 Aims of Complementary Feeding:
‡ To cope with increasing energy
requirements while the child cannot tolerate
more than 1 liter of fluid/ day
‡ To supply items like minerals & vitamins
that cannot be supplied by milk alone
‡ To train the GIT to digest starch & other
solid food
Aims of Complementary Feeding
(cont.):
‡ To train the child on spoon feeding,
chewing and swallowing of semisolid
and solid food items

‡ To educate the child independence

and feeding himself
V
 A B
STAPLE PROTEIN

BREAST
C MILK D
VITAMINS,MINERALS ENERGY

OIL
 A B
STAPLE PROTEIN
Cereals
Tubers Legumes
Roots Animal Foods
BREAST
MILK
C D
VITAMINS,MINERALS ENERGY
Vegetables Sugars
Fruits Fats & Oils
 A B
STAPLE PROTEIN
Rice, Wheat, Corn Beans, Peas
Potatoes Milk Products
Sweet Potato Chicken, Fish, Egg
BREAST
C MILK D
VITAMINS,MINERALS ENERGY
Dark green leaves, Sugar, Honey, Molasse
Carrot, Squash Oils (Olive, Corn, etc)
Tomato,Citrus,Apple,etc Butter, Cream, Ghee
When Can Baby Chew Foods?
At 8 weeks:
‡ The infant begins to make chewing
movements

At 12 ± 16 weeks:
‡ Chewing movements are usually well
developed
When Should We Start
Comple-mentary Feeding ?
‡ Exclusive breast-feeding is SUFFICIENT
for most infants until the age of 4 ± 6
months
‡ There is NO EVIDENCE that
introduction of other foods before 4
months is of any benefit to a normal
breast-fed baby
(Arneil and Stroud, 1978)
When Should We Start
Comple-mentary Feeding ?
Most infants will need additional food by
the
age of 6 months:

‡ To complement breast-feeding
‡ To provide enough elements required
for growth, like proteins, minerals, and
other nutrients
 End of 6th Month (or ? 4th month)
‡ Strained or pureed fruits
(apple, pear, banana)
End of 6th Month (or ? 4th month)
‡ Sieved of pureed vegetables:
carrots, potatoes, tomatoes, squash

‡Given by Spoon
 Mixer Blender Strainer

Ò Òü
‡Do not use mixer/ blender in preparation of vegetable as
it transforms it into a liquid form unsuitable for training
the baby to swallow semisolid foods
‡Better use strainer in preparation of baby¶s food
End of 6th Month(or ? 4th month)
‡ Iron-fortified cereal gruels:
mehalabia, rice pudding,oats, etc
‡ Unsweetened tomato juice given by cup
‡ Soft cheese
 End of th
8 (or th
?6 ) Month
‡ Soft cooked vegetables in strips or slices
‡ Minced chicken, chicken liver, fish, rabbit,
lamb or veal (calf meat)
‡ Hard-boiled egg yolk (in winter)
 End Of 11 th (or ? th
9 ) Month
‡ Custard, Cheese
‡ Beans, Peas
‡ Bread, biscuits, toast, crackers
‡ Sliced fruits (apple, pear, apricot, peach)
 At 1 Year of Age
‡ Whole milk, Yoghurt, Cubed cheese
‡ Whole eggs
Milk
‡ Red meat, Liver
‡ Cooked rice, noodles Yogurt

‡ Cookies, Ice-cream
At 1 ½ - 2 Years of Age
‡ Ordinary family diet
‡ Baby should better eat
with family members
‡ Baby should better have
his own plate and spoon
‡ Let him play with his
spoon
Until End of 6th Month:
7am 10am 1pm 4pm 7pm 10pm
7th Month: A
7am 10am 1pm 4pm 7pm 10pm

Ò
7th Month: B
7am 10am 1pm 4pm 7pm 10pm
8th Month: A
7am 10am 1pm 4pm 7pm 10pm

Ò
8th Month: B
7am 10am 1pm 4pm 7pm 10pm
9th Month: A
7am 10am 1pm 4pm 7pm 10pm

Ò
9th Month: B
7am 10am 1pm 4pm 7pm 10pm
10 th ± 11 th Month: A
7am 10am 1pm 4pm 7pm 10pm

Ò
10 th ± 11 th Month: B
7am 10am 1pm 4pm 7pm 10pm
1-1.5 Years: A
7am 10am 1pm 4pm 7pm 10pm

Ò
1-1.5 Years: B
7am 10am 1pm 4pm 7pm 10pm
2 Years: A
7am 10am 1pm 4pm 7pm 10pm

Ò
2 Years: B
7am 10am 1pm 4pm 7pm 10pm
1- Foods that may cause choking:
‡ Nuts
‡ Potato chips
‡ Popcorn
‡ Fruits with seeds
‡ Fish with bones
‡ Tough meat
‡ Small hard candies
2- Common Allergy-producing
foods:
‡ Fresh milk, Yoghurt
‡ Products made with milk
‡ Eggs (particularly egg-white)
2- Common Allergy-producing
foods:
‡ Fish and Sea fruits
‡ Chocolate and Cocoa
‡ Berries, tomato, citrus fruits
 - Junk Foods:
‡ Sweets
‡ Candies
*

‡ Pastry, cookies
‡ Soft drinks
‡ Artificially-flavored fruit drinks

May prevent the child from taking more

nutritious
food and encourage the desire for sweets
 4- Salted Foods:

‡ High sodium load on the infant¶s kidneys

‡ May predispose to hypertension later on
5- Foods Hard To Digest:
Sausage, highly spiced food
Fatty or fried foods, etc.
 6- Other Foods
Food additives: artificial colors & flavors
(??toxic)
Honey: Clostridium botulinum spores in some
regions
ë





Read Food Labels Carefully !!!
Principles of Complementary
Feeding:
Gradual:
‡ To prevent GIT disturbances
‡ To avoid psychological trauma to the baby
Timing:
‡ Better start at the beginning of winter
‡ Start when baby is well
‡ Better not to start during convalescence
Technique of Complementary
Feeding:
‡ Encourage exclusive breast-feeding for
the 1st six months provided the growth
is satisfactory

‡ If weight gain is not satisfactory, we

can start complementary feeding at the
age of 4 months
 Technique of Complementary
Feeding (cont.):
‡ New food items should be introduced
one at a time
‡ Start by replacing one milk feed by
another new foreign food
‡ Gradually replace milk by foreign foods
until all milk feeds are replaced at the
age of 2 years
 Technique of Complementary
Feeding (cont.):
‡ Start by small amounts (1-2 spoons
only) of vegetable puree or cereal given
after a breast-feed

‡ Put a little food on the tip of a spoon

and place it near the middle of the
tongue
 Ä

1. Put a little food on the tip of a spoon and place it

near the middle of the tongue
2. Food on the tip of tongue will dribble out
. Too much food will cause gagging
 Technique of Complementary
Feeding (cont.):

‡ If the baby accepts the new food,

increase the amount gradually until it
can replace a breast or bottle feed

‡ Once new food is accepted, give it fairly

frequently until it becomes familiar
Technique of Complementary
Feeding (cont.):
‡ Amounts are determined by baby¶s
appetite. Many parents tend to overfeed
their babies
‡ Maximum tolerated volume is 200- 00 ml
per feed
‡ Appropriate energy concentration is:
1.5 ± 2 kcal / gram
Technique of Complementary
Feeding (cont.):
‡ Never force the infant to take a new food
‡ The presentation of food is important;
so better use colorful attractive spoons
and plates to stimulate baby¶s interest
and appetite
‡ Let the baby have his own spoon and let
him play with it.
 Technique of Complementary
Feeding (cont.):
‡ During meals, the baby will certainly
want to join in with his hands as well as
his mouth.

‡ Let him dip his fingers in the dish and

suck them and try to find out what a
spoon is for.

‡ It is messy, but is vitally important

 Technique of Complementary
Feeding (cont.):

When the baby feels that what he eats is

under his own control:
‡ the more he will enjoy eating and,
‡ the less we will have trouble with food
refusal later on
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 Technique of Complementary
Feeding (cont.):
FINGER-FOODS:
‡ Foods that are meant for fingers are good for
morale.
‡ They make eating easy and fun
‡ Hard foods are good for the baby¶s jaws
‡ They will keep the baby busy during the feed,
thus allowing you to feed him adequately
‡ They will train the baby to feed himself later on
Begin with a raw carrot or an apple
slice; he will deal with it like a toy,
but nicer-tasting than plastic
With practice, the baby learns that he can
get food from a bread crust or a hard dry
toast
Later, the baby will discover that feeding
himself with cut up finger-foods is much
nicer and easier than spoonfuls of lumpy
food
ë