HOW SHOULD I FEED MY CHILD?

The optimal feed for first 6months is breastmilk.  We give only milk not even water for the baby and label it as exclusive breastfeeding.you continue breastfeeding till 2yrs

From 6months onward you start complimentary feeds. It  should contain. 0.9calorie/ml

As the child grows the qty and frequency are incresed

 

What is the advantage of breast milk?

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Benefits to the Baby

1. Breast-milk is a complete food and it provides all the nutrients a baby needs during first 6 months of life.

Breast-milk is more easily digestible due to presence of special enzyme lipase and high quality of whey proteins.

Healthy term breastfed babies do not need any supplements of vitamins and iron during first 6 months of life (except vitamin Kand vitamin D).

What are the antiinfective properties of breadtmilk?

Breast-milk contains a number of anti-infective substances, protective antfbodies and friendly lacto-bacilli, which protect the baby against development of diarrhea, respiratory illnesses (cough and cold) and other infuctions (especially ear infection).

Breast-feeding has been shown to reduce the risk of death due to diarrhea by 14 times, acute respiratory infections by 4 times and other infections by 3 times.

There is reduced risk of acute otitis media and necrotizing enterocolitis in breastfed babies.

 

What are the other keybenefits of breast  milk?

Breastfed babies are less likely to suffer from allergic disorders like asthma and eczema. Rarely breastfed. babies may develop an allergic disorder if mother consumes allergenic foods like cow’s m.ilk; eggs, nuts and citrus fruits.

 

4. Breastfeeding provides immunological benefits to the baby throughout the life time. Breastfed babies have been shown to develop better protective response to various vaccines com.pared to bottle fed babies.

 

5. Breastfeeding provides emotional security and promotes close bonding between moth.er and her baby. Breastfeeding provides maternal warmth, physical closeness and comfort to the baby.

6. Breastfeeding stimulates all the five special senses of the baby, i.e. touch, sight, smell, hearing and taste.

 

7. Breastfed babies are smarter and.have been.shown to have 8 points higher intelligence quotient (IQ) and enhanced visual development. High concentrations of two key long chain fatty acids (arachidonic acid and docosahexaenoic acid), lactose and sialic acid promote brain growth.

8. Breastfed babies are less likely to suffer from caries teeth, type 2 diabetes mellitus, obesity, high blood pressure, heart attacks and certain cancers during adult life.

 

What are the benefits to mother?

Benefits to the Mother

1. During breastfeeding there is a release of oxytocin to eject the milk. Oxytocin promotes involution of the uterus so that there is reduced risk of bleeding and anemia after delivery.

2. Breastfeeding delays ovulation and onset of menstruation which provides natural means to ensure spacing of children. It has been estimated that in India universal and prolonged breast-feeding prevents more pregnancies than all other reversible methods of contraception currently practiced. Protection is not fool proof and mothers who are breastfeeding must seek proper contra-ceptive advice.

When should a newborn be fed?

For all normal newborns (including those by caesarean section) skin-to-skin contact should be initiated in about 5 minutes of birth in order that baby initiates breastfeeding in an hour of birth. The method of ‘Breast crawl’ can be adopted for early initiation [5].

In case of operative birth, the mother may need extra motivation and support. Skin-to-skin contact between the mother and new born should be encouraged by ‘bedding in the mother and baby pair’. Mother should communicate, look into the eyes, touch and caress the baby while feeding. The new born should be kept warm by promoting Kangaroo Mother Care and promoting local practices to keep the room warm [6].

How should a newborn be fed?

Baby should be fed “on cues”. The early feeding cues include sucking movements and sucking sounds, hand to mouth movements, rapid eye movements, soft cooing or sighing sounds, lip smacking, restlessness etc. Crying is a late cue and may interfere with successful feeding. Babies should be breastfed at least 8 to 10 times in 24 hours till lactation is established (1 to 2 weeks) indicated by frequent urination, stooling and adequate weight gain. A sleepy baby can be easily woken up by removing blankets, removing clothe changing loin cloth if wet, skin-to-skin contact in kangaroo position and gently massaging the back and the limbs. Periodic feeding is practiced in certain situations like in the case of a very small infant who is likely to become hypoglycemic unless fed regularly, or an infant who ‘does not demand’ milk in initial few days. Adequacy of breastfeeding in this critical period should be monitored by clinical parameters complemented by weighing on digital weighing scale (minimum sensitivity of 5 g) on Day 1, 4, 7, 14 and 28.

How do we know a baby got enough milk after feeding?

Gain in wt, void 6 times or more,stooling,  mother feelof letting out are some of the parameters which can suggest adequate milk

Complimentary feeds

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The minimum number of times a child should eat solid, semi-solid foods is 2 times per day from 6-8 months and 3 times per day from 9 – 24 months.

Continue frequent, on-demand breastfeeding until 2 years of age or beyond. Foods should have proper consistency according to age.

At 6 months, the consistency should be a purée (or mash) – cooked vegetables or fruits, that have been ground, blended and strained to the consistency of a creamy paste or liquid.

At 7-9 months, the food should be lumpy and beyond 9 months, the finger foods (foods meant to be eaten directly using the finger and the thumb) can be introduced.

How to give complementary feeds?

 

During Complementary feeding ensure that: Choose a time when your baby isn’t tired and you’re not in a rush. It may take a while for your baby to get used to taking food from a spoon, so patience is a must. Allow them to use their own fingers, even if they make a mess.

The baby is fully alert and shows early signs of hunger. A vigilant mother can pick up the hunger cues easily. This is the best time to introduce new foods.

Make the baby sit upright with no distractions, like TV, mobiles or tablets

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Which all food item to be given?

The food should be a balanced diet consisting of various (as diverse as possible) food groups / components in different combinations.

Easily available, cost-effective seasonal uncooked fruits, green and other dark colored vegetables, milk and milk products, pulses/ legumes, animal foods, oil/ butter, sugar/ jaggery may be added in the staples gradually

What is responsive feeding?

 

Practice responsive feeding. Self-feeding should be encouraged despite spillage. Each child should be fed under supervision in a separate plate to develop an individual identity. Forced feeding, threatening and punishment interfere with development of good/ proper feeding habits [17].

Along with feeding, mother and care givers should provide psycho-social stimulation to the child through ordinary age-appropriate play and communication activities to ensure early childhood development.

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About Dr. Jayaprakash

Asst. Prof. of Pediatrics, ICH. Institute of Child Health. Gov. Medical College Kottayam. Kerala, India.

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