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Stage of weaning (complementary feeding) with maintaining proper nutrition

WEANING (Complementary feeding) :

The weaning is a transitional period and process of introducing foods other than breast milk to an infant and gradually increasing the amount, so that eventually the infant becomes accustomed to the full adult diet.

Weaning before 4 months is called early and after 9 months is called late weaning. Early weaning is associated with obesity, atherosclerosis and influence the severity of celiac disease. The late weaning put the child at risk of developing under nutrition and to accustom the child to solid foods.

The human milk in reasonable quantities alone cannot provide all the energy and protein required for maintaining an adequate velocity of growth for the infant after the age of 4-6 months. It is, therefore, necessary to introduce more concentrated nutritional supplements beyond this age.

Stages of weaning:

Stage-1: This lasts for one month starting from 6 months. At this stage a small amount of foods, such as cereal gruel, followed by a basic mix, is introduced and the food is offered after the breast-feeding.

Stage-2: In this stage, the weaning foods are offered gradually in increasing amounts, switching to the multimix, along with the breast-feeding. The aims are to accustom the child to the family foods by the first birth day.

Stage-3: There is decreasing amount of breast milk from partial to token breast feeding with increasing amount of family foods, ultimately to a meal to complete weaning.

Age at weaning :

It is recommended to start weaning from 4-6 months of age as:

i) Nutritional: There are evidences that exclusive breast feeding no more sufficient for the growth and development of the baby.

ii) Transition from the neonatal extrusion reflex by which the infant pushes against the given spoon to the acceptance of spoon-feeding occurs at 4-6 months. The tongue is depressed; food is accepted in the posterior part of the mouth and swallowing follows.

iii) Acceptance of weaning foods concerns chewing skill. By 7-9 months, rhythmic biting movements occur even if no teeth have erupted. There seems to be a "critical period of development" in which chewing is learned. Further, texture, taste, smell and the appearance of food may stimulate chewing.

iv) The gastric acid secretion approaches to adult values around 6 months.

v) Alfa-amylase activity becomes pronounced by the age of 4 months.

Weaning foods:

The characteristics of weaning foods should be-

i) Balanced food - that a diet based on a mixture of a staple (carbohydrate), and a legume with a animal proteins (protein) and a dark green leafy vegetables (vitamins and minerals) with added oils (fat) will be nutritionally well balanced and energy dense. The adding of oil and sugar are the best way to make the weaning food energy dense and less bulky,

ii) Consistency - soft can be achieved by adding fats and oils. The consistency of gruel becomes solid when cool and difficult to eat by infant. When oil is added to the gruel it stays soft, even when cool,

iii) Locally available and low cost,

iv) Culturally acceptable.

v) Clean and safe - the hands and utensils should be clean and prepared foods must be covered to protect from insects and dirt. Freshly prepared food should be served and leftover should be discarded.

Development of recipes for weaning foods:

The foods suitable for weaning vary from one place to another, depending on availability, cost, culture, food preferences, palatable, provide a sense of satiety, energy, nutritious and so on. A meal is usually made from several foods; each food
supplies some energy and different nutrients. It is important that the foods are in the right proportion so that there is an adequate balance between the nutrients and energy.

The simplest recipe for weaning food is one, which has only two ingredients, and called basic mix, for example cereal mixed with a legume. A multimix has four ingredients such as a staple, a protein supplement, an energy supplement and a vitamin and mineral supplement. When these four ingredients are used together in suitable proportions they form a complete meal. One way in which this can be illustrated is as a Food Square .

Introduction of weaning foods:

• A single weaning food is added at a time in small quantities followed by the second weaning food after some time.
• Start with basic mixes for about two weeks and then multimix. To train an infant to chew and become accustomed to new foods give 1-2 tea spoonfuls of cereal gruel (e.g. rice), boiled and mashed tubers (e.g. potato) or freshly peeled mashed fruits (e.g. banana).
• Gluten-containing foods (wheat & wheat products) better not to introduce before six months and may delayed further.
• Wait a few days until the infant is used to one food before introducing a new one.
• Once a new food is accepted, give it fairly frequently, so that it becomes familiar.
• Gradually increase the frequency and quantity.
• Use spoon initially and allow handling the food and encouraging to feed himself.
• During the first year give the breast feeding first and during the second year give the complementary foods first.
• Never forced the infant to eat. Keep trying daily until takes the food well.
• The whole process of weaning should be gradually completed by 9-12 months of age.

Example of a multimix:

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