A Complementary Feeding Guide

The development of every child, from infancy to adulthood, relies heavily upon good nutritional intake. The period from birth till the age of two is the most critical phase in a child’s life and good nutrition is essential to support optimal growth and development.

Studies have shown that poor breastfeeding and complementary feeding practices, as well as infectious diseases, are the key causes of malnutrition and poor growth during those two critical years of life. To help prevent this from occurring, the World Health Organization (WHO) has produced a set of guidelines and recommendations on the complementary feeding of children who have been breastfed. These guidelines may also be applied for non-breastfed children. Follow these 10 guidelines to supplement your baby’s nutritional needs.

1. Exclusively breastfeed your baby until 6 months of age, and introduce complementary foods after 6 months, in addition to breastfeeding. Exclusive breastfeeding during the first 6 months will protect babies from gastrointestinal infections and improve their motor development. After 6 months however, human milk is no longer sufficient to meet the nutrient needs of a baby and complementary foods should then be introduced.
2. Breastfeed your baby on demand until he reaches 2 years of age or beyond. Breast milk can prevent dehydration and provide micronutrients to fight off infections. Infants below the age of 6 months who are fully breastfed fulfill all their energy needs from breast milk. Breastfed children between the ages of 12 – 23 months who have started complementary feeding receive 35 – 40% of total energy needs from breast milk.
3. Practice responsive feeding by taking into account not only what is fed but also how, where, when and by whom your child is fed. Infants should be fed directly while older children should be assisted when they feed themselves. Be patient and encourage your child to eat, without forcing the issue. If your child rejects the normal foods given, try different combinations of foods.
4. Practice good hygiene. Always wash your hands before preparing foods and before eating. Use clean utensils, cups and bowls. Avoid using feeding bottles that are difficult to clean. Lastly, store foods in suitable and safe places, such as air-tight containers, refrigerators, or kitchen cabinets.
5. Start feeding your baby small amounts of foods at 6 months of age and increase the amount, as he grows older. In addition to breastfeeding, your baby needs to obtain energy from complementary foods every day: a 6-8 month old infant needs an approximate intake of 200 kcal, a 9-11 month old infant needs 300 kcal, and the need of a 12-24 month old infant increases to 550 kcal. This gradual increase of calories can be achieved by serving additional portion of rice porridge and vegetables at each mealtime. Note: 100 kcal is approximately 1 cup of plain rice porridge, 1 slice of bread or 1 medium banana.
6. Increase the consistency and variety of your baby’s food gradually as he grows older. Infants at 6 months of age can be fed pureed, mashed or semi-solid foods. At 8 months, infants can eat finger foods or snacks. Most children by the age of 12 months can start to eat family foods. Foods that can cause choking like nuts, raw carrots, whole grapes, rambutan and oddly-shaped foods should be avoided.
7. Gradually increase the number of times your baby is fed. Between the ages of 6-8 months, feed your child 2-3 times a day. Then, increase it to 3-4 times a day between 9-11 months, and additional nutritious snacks given once or twice a day for those aged 12-24 months.
8. Feed your child a variety of foods with high nutrient content. Foods such as meat, chicken, eggs or fish should be eaten daily or as often as possible. Vegetarian diets are not suitable for children this young age unless nutrient supplements are given as well. Feed your child vegetables such as carrots, spinach or broccoli and vitamin A-rich fruits such as papaya, mango, or watermelon daily. Drinks with low nutrient value, such as tea, coffee or sugary drinks such as syrup or carbonated soft drinks should be avoided.
9. Intake of vitamin-mineral supplements or use of fortified food products may be necessary for both you and your child. Mothers who are breastfeeding may need to complement their diet with supplements and fortified products for their own health as well as to provide certain nutrients in their breast milk. Keep in mind that nutrient supplements should be prescribed by a doctor, nutritionist, dietitian or other medical professionals only.
10. If your baby falls ill, then increase his fluid intake and breastfeed as frequently as possible. Encourage your child to eat soft, appetizing foods. Once the illness has passed, feed your child more than usual, and as often as possible. The child needs more nutrient intake to make up for the loss of nutrients during the period of illness.

Consumption of complementary foods during the first two years of a child’s life is critical in ensuring his physical and cognitive development. Adopt these recommendations on complementary feeding to ensure that your baby’s nutritional needs are met.