Solid foods: How to get your baby started

Exclusive breastfeeding is recommended until a child is six months old. After this time, the mother should introduce other foods (complementary feeding) to fill the nutrition gap left because as the child grows, their nutritional demands also increase.
Unless there are medical complications that call for giving a child other foods before six months, the child should never be fed on solid foods besides milk according to Julian Eyotaru, a nursing officer at Mwanamugimu Nutrition Unit at Mulago hospital.

Six months to two years
Infants in this age are advancing toward an adult diet. “Food preferences are set at this time of your child’s life. Therefore, keep introducing new flavours and textures of healthy foods to their diet. Give them foods rich in nutrients they need to grow healthy and strong and limit their intake of processed foods such as sweets,” Eyotaru says.
Dr Eyotaru says milk is important in a child’s diet because it provides calcium and vitamin D, which help build strong bones. Most children under two years should drink whole milk to get the dietary fats needed for normal growth and brain development.
If an infant is at risk of becoming overweight or has a family history of obesity or heart problems, speak to a doctor about switching to reduced fat milk.
After two years
After two years, the child must continue eating a balanced diet because they are still developing, warns Bridget Kezaabu, a freelance nutritionist. Meals and snacks are likely to supply enough vitamins and other nutrients for the growth and health of your child.
“If your child has a feeding problem that lasts for several weeks or if you are not sure about your child’s nutrient intake, before supplementing their diet, get expert advice,” Kezaabu advises.
A supplement should only be given to a child after a recommendation from a medical personnel. Multivitamins are no substitute for healthy foods but dairy products, fresh fruits, vegetables, nuts and grains are healthy.
“Parents should be mindful of claims that supplements help children fight colds and cough and poor appetite, among others. The ailments must instead be treated,” Kezaabu says, adding: “If possible, in one sitting, the child should have both plant and animal protein, grains for carbohydrates, a fruit for vitamins and other foods rich in nutrients.”

How much food?
Give your child three meals and two healthy snacks a day, but keep in mind that it is common for infants to skip meals. Maintain a regular schedule of the meals so that the child separates feeding time from time to play or engage in other activities.
“Do not force a child to eat if they are not hungry and do not let them demand for food all the time,” Kezaabu remarks adding: Your child should respond to internal cues for hunger and fullness but as a parent, you must set the boundaries.”

Challenges
Doctor Edward Mugisha, a pediatrician at Keserena Children’s Hospital in Bukoto, warns mothers to expect some challenges while transitioning their babies to solid foods.
“The baby will experience some constipation, diarrhea, vomiting and flatulence mainly as a reaction of their digestive system towards the new foods,” he warns. This, he says, is caused by an absence or undeveloped spectrum of enzymes responsible for digesting particular nutrients.
“It is common to find children experiencing constipation or diarrhea when they are first introduced to milk. This is because the enzyme that digests lactose, a type of sugar mainly found in milk, is either absent or it is undeveloped,” Dr Mugisha explains.
Another prevalent challenge is hygiene and handling of the baby’s food which can easily lead to contamination and food poisoning.
“You have to remember that the mothers themselves are transitioning from breast feeding which does not require much. The milk is safely manufactured internally, all they have to do is clean the breast. But here, they are handling the food, cooking and preserving it which exposes it to external contamination,” Dr Mugisha observes.
Mothers are, therefore, advised to pay extra care while preparing and storing the baby’s food. If possible a special shelf should be gazetted for the baby’s utensils to avoid random use.

HIV positive mothers
Dr Mugisha adds that while these challenges can be overcome with time, they are extremely dangerous for an HIV positive mother trying to wean her HIV negative baby.
“There is a high risk of mother to child transmission of the virus since the baby’s immune system has been weakened by other infections caused by the introduction of solid foods,” Dr Mugisha says.
He advises mothers living positively to avoid breastfeeding again once they have introduced their children to other foods.

Common foods
Various cultures have specific foods they have designated for supplementing their babies food. The most important is that the foods are mild and can be easily digested. Most Ugandan mothers swear by Irish potatoes, cooked, mashed and sieved.
Dr Mugisha recommends adding different soups such as fish or vegetable to the irish potatoes to increase the nutritional value. Pumpkin is another favorite weaning food. It is cooked, mashed, sieved and mixed with available nutritious soups. Depending on how the baby’s stomach handles the transition, fruits can be introduced at this stage but only as juices.
The baby’s food does not have to be another extra expense for the family, just feed them on what the rest of the family is having but adjusted in preparation. For example if the family is eating fried Irish potatoes, get a few, before frying and prepare for the baby.

Nutrient deficiencies

Childhood is a critical time for growth and brain development, so any deficiencies are likely to retard a child’s mental and physical ability to grow.
The World Health Organisation (WHO), estimates that 190 million infants, especially in Africa, suffer Vitamin A deficiency.
WHO, therefore, recommends bi-annual Vitamin A supplementation for infants between six to 59 months to reduce morbidity and mortality caused by vitamin A deficiency.
Dr John Mukisa, a medical officer at Mulago Hospital, warns that the most common symptom of Vitamin A deficiency is the inability to see in dim light, night or colour blindness, swelling of the eyes, dry eye syndrome, abnormal tolerance of light and complete blindness if not treated. Dr Mukisa says: “Vitamin A helps to shorten or reduce complications of diseases such as malaria, HIV, measles and diarrhea in children by strengthening their immune system. It is also essential in regulating the immune system by helping in the formation of white blood cells which fight off infections.”
Iron Deficiency
According to Dr Mukisa, some children suffer from iron deficiency and this is a serious condition that can lead to anemia.
“The condition limits the ability of the blood to carry oxygen because the red blood cells will lack enough oxygen. In some cases, the problem is dietary and you will find some children craving for clay just like adults with the same condition,” Dr Mukisa says. “Increase iron-rich foods such as meat, poultry, fish, beans and iron-fortified foods from your child’s diet,” he recommends.

Vitamin D
Rickets is a disease associated with inadequate Vitamin D intake and decreased exposure to sunlight which leads to softening of the bones.
Kezaabu warns: “Having a healthy baby starts with having conscious parents and guardians. Parents must ensure that their children get the required nutrients and when in doubt, visit a doctor or health professional who will offer advice.”