According to World Health Organisation, the transition from exclusive breastfeeding to eating solid foods, referred to as complementary feeding, typically covers the period from six to 18-24 months.
It is recommended that all infants start receiving foods in addition to breastmilk from six months onwards and these foods should be given in amounts, frequency, consistency and using a variety of foods to cover the nutritional needs of the growing child while maintaining breastfeeding. While that is supposed to be the case, Joan Rwot was not only weary but also not sure of how to start feeding her first born on anything other than breastmilk. “In the beginning, he refused the food and continually cried for breastmilk. However, he would never get satisfied,” she says adding that she only managed to make progress at nine months.
Introducing the food
Dr Zabina Nabirye, an Infant and Young Child Feeding (IYCF) specialist at The Diet Clinic in Bukoto, says the way you feed a child depends on their age. For example, a seven-month-old child will not have the same needs as one of two years. “At six months, you need to supplement your child’s diet with other foods in addition to breastmilk since on its own, breastmilk does not have enough nutrients to sustain the growth and development the child,” Dr Bertha Tendo, a nutritionist with CORSU, advises.
“Since they have been breastfeeding, their tongue thrust is very strong and thus, they push out food easily. Instead of getting frustrated, start by stopping bottle feeding to develop your child’s oral movement much quicker,” Dr Tendo advises. You could start by giving the liquids using a spoon. Then with time, they will realise that the spoon gives them little thus adapt to the cup.
This was Rwot’s dilemma coupled with the piercing cries that she gave up the first time she tried. “But when my friend urged me to keep trying, my baby started to willingly eat some porridge,” she says. For children who refuse to eat, the issue could be that you are always around them and they know your scent and will always want to come to you for breastmilk. In this case, ask a maid or relative to feed the child.
Dr Tendo also advises mothers with such children to set boundaries and stick to them. For example, you could decide to only breastfeed at night so that the baby eats some food during the day. “However, frequent meals are necessary here to prevent them from getting too hungry leading to frustration and rejecting the food,” she advises.
You also need to follow the food ratios by age because sometimes you give a child too much which might have adverse effects. “For example, despite being a nutritionist, I gave my son a mashed potato everyday in his first week of weaning and made sure he finished it. By the end of the week, he had constipation,” Dr Tendo shares. So when starting out, give small amounts.
Parents should also remember that babies have favourite foods. To deal with the issue of refusing some foods, Dr Tendo says, “Mix the foods they do not like with what they like. For example, if your child does not like vegetables but loves groundnut paste, combining the two will enable him to eat it all with little or no struggle.”
Dr Tendo says your child needs to have not less than five meals a day. The main meals are breakfast, lunch, supper but in-between these, there should be a mini-meal. For example give them a fruit between breakfast and lunch and then a fruit or water between lunch and supper. Breakfast, lunch and supper should be balanced to include carbohydrates, proteins and vegetables.
“The measurements before were not easy and costly as one needed a scale,” Dr Nabirye says. However, there are ‘kitchen’ measures in place that make it easy for anyone to quantify what to give the child. Dr Nabirye and Lillian Nyanzi, a nutrition research associate, suggest the measure of the palm explaining that a palm is equivalent to 90 calories.
How to prepare
“Food for children should not be prepared together with that of adults as it must be devoid of spices and have very little salt, and oil,” Dr Nabirye explains.
Besides that, the amount of proteins must double that of carbohydrates. After measuring, put the food in a metallic container since it is not damaged by heat. Add water according to the kind of food you are preparing. There are foods that emit water such as potatoes. To these, add water below the level of the food. Others such as cassava absorb water. For these, add water until the food is covered. Also, to maintain the nutrients in the food, steam rather than boiling it directly on fire.
“While food prepared this way seems to take a lot of time and requires attention to detail, it saves you a lot,” Dr Nabirye discloses, For example, your child will not fall sick frequently and even when illnesses attack, recovery is fast and the child is not hit hard.
“Hygiene is important to keep your child from developing illnesses such as diarrhoea,” Nyanzi explains. The person preparing the food must wash their hands and keep nails short and clean. Food should also be kept in a clean place and should always be covered.
Dr Nabirye says feeding time should be consistent. It would also be better to feed the child before your feeding time so that you can give them full attention. Feeding them from the same portion of food as yours is not good as your food is not good for the baby and you will not be able to know how much your child is consuming. Besides that, do not bring water at the time of feeding as they love water more than food.
Nyanzi also advises parents to get involved in feeding the children. Sometimes parents leave the baby to feed themselves yet they just play with the food. It is better that you feed the baby and when there is a little left, you can let them play.
To control constipation, make sure your baby is eating different types of fruit and vegetables, such as apples, pears and grapes. Also keep your baby well hydrated. Give your baby a little water in between feeds, but do not dilute formula milk if you are bottle feeding.