complment feeding chart for infants india
- 2. Optimal Feeding Norms as per Optimal Feeding Norms as per National Guidelines on Infant and National Guidelines on Infant and Young Child Feeding Young Child Feeding Introducing appropriate and adequate Introducing appropriate and adequate complementary feeding after 6 months along complementary feeding after 6 months along with Continued breastfeeding for two years or with Continued breastfeeding for two years or beyond beyond
- 3. Definition of Complementary Definition of Complementary feeding feeding The process of giving an The process of giving an infant other foods and infant other foods and liquids along with breast liquids along with breast milk or non-human milk milk or non-human milk as breast milk alone is no as breast milk alone is no longer sufficient to meet longer sufficient to meet the nutritional the nutritional requirements. requirements. These foods should These foods should complement rather than complement rather than replace breastmilk. replace breastmilk.
- 4. Appropriate Complementary Appropriate Complementary Feeding Feeding Timely: Timely: Introduced when need for energy Introduced when need for energy and nutrients exceeds that provided by BF and nutrients exceeds that provided by BF Adequate: Adequate: Should provide sufficient Should provide sufficient energy, protein, and micronutrients energy, protein, and micronutrients Properly Fed: Properly Fed: Active feeding method and Active feeding method and proper frequency according for age proper frequency according for age Safe: Safe: Should be hygienically prepared, Should be hygienically prepared, stored and fed stored and fed
- 5. Timing of Complementary Timing of Complementary Feeding Feeding Soon after completing 6 months of age Soon after completing 6 months of age Breast milk sufficient to promote growth and Breast milk sufficient to promote growth and development till 6 months development till 6 months Energy and nutrient gap appears after 6 months Energy and nutrient gap appears after 6 months and widens thereafter and widens thereafter Infant’s development and behavior makes him Infant’s development and behavior makes him ready for other foods ready for other foods Holds objects (e.g. biscuit) and takes everything to Holds objects (e.g. biscuit) and takes everything to mouth mouth Chewing movements start Chewing movements start Tendency to push solids out decreases Tendency to push solids out decreases Eruption of teeth and beginning of biting movements Eruption of teeth and beginning of biting movements
- 6. Age of Introduction Age of Introduction 0 0 269 451 746 0 200 400 600 800 1000 1200 0-3 mo 3-6 mo 6-9 mo 9-12 mo 12-24 mo Energy Gap Energy from breastmilk Energy Needs Energy Needs Excl. Breastfeeding Comp. feeding & continued BF
- 7. Timing of Complementary Timing of Complementary Feeding Feeding Disadvantages of adding foods too soon Disadvantages of adding foods too soon Decrease the intake of breast milk resulting in a Decrease the intake of breast milk resulting in a low nutrient diet low nutrient diet Increase risk of illness esp. diarrhea Increase risk of illness esp. diarrhea Disadvantages of adding foods too late Disadvantages of adding foods too late Growth and development slows down or stops Growth and development slows down or stops Risk of deficiencies and malnutrition Risk of deficiencies and malnutrition
- 8. Why Continue Breastfeeding? Why Continue Breastfeeding? Vital source of energy (30-40%) and nutrients Vital source of energy (30-40%) and nutrients into 2nd yr of life into 2nd yr of life Key source of Key source of Good quality proteins & essential fatty acids Good quality proteins & essential fatty acids Micronutrients: Micronutrients: 45% of Vitamin A 45% of Vitamin A 40% of calcium & riboflavin 40% of calcium & riboflavin 95% of Vitamin C 95% of Vitamin C Fluids and nutrients during infection Fluids and nutrients during infection Associated with greater linear growth Associated with greater linear growth Linked to lower risk of chronic diseases & Linked to lower risk of chronic diseases & obesity obesity
- 9. Key Message-1 (Timely) Key Message-1 (Timely) Complementary feeding should begin Complementary feeding should begin soon after completing 6 months of age soon after completing 6 months of age along with continued breastfeeding along with continued breastfeeding
- 10. Adequacy (Quality) Adequacy (Quality) Staples: Staples: Cereals (Rice, wheat, maize, millets) Cereals (Rice, wheat, maize, millets) and Legumes and Legumes Fats Fats (Vegetable oils/butter/ghee; 1g ~ 9 Kcal) (Vegetable oils/butter/ghee; 1g ~ 9 Kcal) and and sugars sugars to improve energy density and taste to improve energy density and taste Foods of animal origin Foods of animal origin (Milk,, eggs, meat, fish) to (Milk,, eggs, meat, fish) to provide good quality proteins, vitamin A and provide good quality proteins, vitamin A and calcium. calcium. Vegetables and Fruits Vegetables and Fruits to provide micronutrients to provide micronutrients e.g. iron and vitamins. e.g. iron and vitamins.
- 11. Other Attributes of Other Attributes of Complementary Foods Complementary Foods Right consistency Right consistency Soft Soft Easy to digest Easy to digest Inexpensive Inexpensive Locally available Locally available Culturally acceptable Culturally acceptable Easily prepared at Easily prepared at home home
- 12. Variety of Foods Variety of Foods Start at 6 month with small amounts of food; Start at 6 month with small amounts of food; increase quantity with age, maintaining frequent increase quantity with age, maintaining frequent breast feeding. breast feeding. Increase food consistency & variety with age Increase food consistency & variety with age Can feed mashed & semi-solids (e.g. porridge) at 6 Can feed mashed & semi-solids (e.g. porridge) at 6 month month Can feed finger foods by 8-9 month Can feed finger foods by 8-9 month By 12 month, family foods can be eaten By 12 month, family foods can be eaten Combine foods (e.g. rice and legumes) to Combine foods (e.g. rice and legumes) to provide good mixture of amino acids provide good mixture of amino acids
- 13. Foods to Avoid Foods to Avoid Tea & coffee: Tea & coffee: interfere with iron interfere with iron absorption absorption soft soft beverages: beverages: No nutritional value No nutritional value Too much sugary drinks & Fruit juices: Too much sugary drinks & Fruit juices: cause decreased appetite for other cause decreased appetite for other nutritious foods . nutritious foods . Nuts: Nuts: may cause choking may cause choking
- 15. Adequacy (Frequency and Amount) Adequacy (Frequency and Amount) 6-12 months 6-12 months Give at least(150-200 mL) serving* at a time of Give at least(150-200 mL) serving* at a time of Mashed r/rice/bread mixed in thick dal or sweetened Mashed r/rice/bread mixed in thick dal or sweetened undiluted milk undiluted milk Add cooked/pureed vegetables or meat also in the Add cooked/pureed vegetables or meat also in the servings servings /biscuits prepared in milk or any cereal porridge cooked /biscuits prepared in milk or any cereal porridge cooked in milk in milk Mashed boiled/fried potatoes Mashed boiled/fried potatoes Mashed banana/mango/ Mashed banana/mango/ *3 times per day if breastfed; *3 times per day if breastfed; 5 times per day if not breastfed 5 times per day if not breastfed
- 16. Frequency and Amount (1-2 yrs) Frequency and Amount (1-2 yrs) Offer food from the family pot Offer food from the family pot Give at least 1½ (250 mL) serving* at a time of: Give at least 1½ (250 mL) serving* at a time of: Mashed rice/bread mixed in thick dal with added Mashed rice/bread mixed in thick dal with added oil/ghee. oil/ghee. Add cooked vegetables/meat also in the servings Add cooked vegetables/meat also in the servings Mashed rice /bread/biscuit mixed in sweetened Mashed rice /bread/biscuit mixed in sweetened undiluted milk undiluted milk Egg preparations/ soft meat pieces without bones Egg preparations/ soft meat pieces without bones - Fruits (banana/apple/orange/mango/) - Fruits (banana/apple/orange/mango/) * 5 times per day. * 5 times per day.
- 17. Amounts of foods to offer Amounts of foods to offer Age Age Texture Texture Frequency Frequency Amount of each Amount of each meal meal 6 months 6 months Soft porridge, well Soft porridge, well mashed vegetable, meat mashed vegetable, meat fruit fruit 2 times per day plus 2 times per day plus frequent breastfeeds frequent breastfeeds 2-3 tablespoonfuls 2-3 tablespoonfuls 7-8 months 7-8 months Mashed foods Mashed foods 3 times per day plus 3 times per day plus frequent breastfeeds frequent breastfeeds Increasing gradually Increasing gradually to (150ml) to (150ml) 9-11 months 9-11 months Finely Finely chopped chopped or or mashed foods, and foods mashed foods, and foods that baby can pick up that baby can pick up 3 meals plus 1 snack 3 meals plus 1 snack between meals plus between meals plus breastfeeds breastfeeds (200ml) (200ml) 12-24 months 12-24 months Family foods, Family foods, chopped chopped or mashed or mashed if necessary if necessary 3 meals plus 2 3 meals plus 2 snacks between snacks between meals plus meals plus breastfeeds breastfeeds (250ml) (250ml)
- 18. Ensure Adequacy Ensure Adequacy Growth Monitoring: Growth Monitoring: Measure weight and Measure weight and length periodically and length periodically and interpret by plotting in interpret by plotting in growth curves. growth curves. Investigate causes of Investigate causes of poor growth: Dietary poor growth: Dietary history; evaluate for any history; evaluate for any illness. illness. Counsel Counsel mother/caregivers on mother/caregivers on growth, feeding and growth, feeding and caring practices caring practices
- 19. Key Message-2 (Adequacy) Key Message-2 (Adequacy) Complementary foods should be of right Complementary foods should be of right consistency, energy dense and the variety consistency, energy dense and the variety to provide all nutrient demands of a to provide all nutrient demands of a growing child. growing child.
- 20. Feeding Techniques Feeding Techniques Feed infants directly & assist older Feed infants directly & assist older toddlers eat; toddlers eat; be sensitive to hunger & be sensitive to hunger & satiety cues satiety cues Feed Feed patiently patiently; encourage, but don’t force ; encourage, but don’t force If child refuses, experiment with If child refuses, experiment with different different food combinations food combinations, tastes, textures , tastes, textures Minimize distractions during meals Minimize distractions during meals Talk Talk to child during feeding; maintain to child during feeding; maintain eye eye contact contact
- 22. Suitable Feeding Situation Suitable Feeding Situation
- 23. Key Message-3 (Properly Fed) Key Message-3 (Properly Fed) Child should be fed patiently giving Child should be fed patiently giving adequate attention and time adequate attention and time
- 24. Safe Safe Unhygienic feeding Unhygienic feeding the risk of infectious illness (esp. the risk of infectious illness (esp. diarrhea) compromising nutritional status diarrhea) compromising nutritional status
- 25. Ensuring Food Hygiene Ensuring Food Hygiene Washing caregiver’s and child’s hands before Washing caregiver’s and child’s hands before preparing, handling and eating food preparing, handling and eating food Clean water and raw materials to cook food Clean water and raw materials to cook food Storing foods safely: Keeping food covered and Storing foods safely: Keeping food covered and serving shortly after preparation serving shortly after preparation Use clean utensils to prepare & serve food Use clean utensils to prepare & serve food Use clean bowls & cups when feeding child Use clean bowls & cups when feeding child No feeding bottles No feeding bottles
- 26. Key Message-4 (Safety) Key Message-4 (Safety) Foods should be prepared, stored and fed Foods should be prepared, stored and fed hygienically to the children. hygienically to the children.
- 27. Feeding the child who is ill Feeding the child who is ill Encourage the child to drink and to eat - Encourage the child to drink and to eat - with lots of patience with lots of patience Feed small amounts frequently Feed small amounts frequently Give foods that the child likes Give foods that the child likes Give a variety of nutrient-rich foods Give a variety of nutrient-rich foods Continue to breastfeed Continue to breastfeed
- 28. Feeding during Recovery Feeding during Recovery Feed an extra meal Feed an extra meal Give an extra amount Give an extra amount Use extra rich foods Use extra rich foods Feed with extra patience Feed with extra patience Give extra breastfeeds as often as child Give extra breastfeeds as often as child wants wants
- 29. Key Message-5 (During Illness) Key Message-5 (During Illness) Continue feeding during illness and Continue feeding during illness and increase during convalescence. increase during convalescence.
- 30. Key Messages Key Messages Complementary feeding should begin soon after Complementary feeding should begin soon after completing 6 months of age along with continued completing 6 months of age along with continued breastfeeding breastfeeding Complementary foods should be of right consistency, Complementary foods should be of right consistency, energy dense and the variety to provide all nutrient energy dense and the variety to provide all nutrient demands of a growing child. demands of a growing child. Child should be fed patiently giving adequate attention Child should be fed patiently giving adequate attention and time and time Foods should be prepared, stored and fed Foods should be prepared, stored and fed hygienically to the children. hygienically to the children. Continue feeding during illness and increase during Continue feeding during illness and increase during convalescence. convalescence.