Infant Feeding 9-12 months

Introduction

Qualities of weaning foods

To improve the nutritive value

Calorie dense foods

Major weaning foods

INTRODUCTION

Infants in our country thrive mainly on breast milk upto six months of age and have a satisfactory growth rate during this period. But, breastmilk alone is not able to provide sufficient amounts of all the nutrients needed to maintain growth after six months. Increased needs of calories and protein of growing children cannot be met by the mother’s milk.

Milk is a poor source of vitamin C and its supplementation through the diet is essential. Iron stores in the liver of the infant would last only upto 4-6 months. Hence iron rich foods should be given from six months onwards. Milk is also deficient in vitamin D. If the baby is to maintain the expected rate of growth and remain healthy and well nourished, supplementary feeding has to be resorted to at six months.

This is the task we are happily performing by telling you how to make food sufficient, attractive, appealing and acceptable to your little darling. You are invited to send in your experiences about weaning foods and practices helping other mothers like you.

QUALITIES OF WEANING FOODS

What are the desirable qualities of Additional (Weaning) Foods?

Breast milk is the only “standard” food for the infant. At the onset, with the infant still predominantly breast-fed, weaning foods are used as an additional source of energy as well as to satisfy the increasing requirements for all essential nutrients. Particular attention should be paid to proteins, iron, vitamin A and C, as these are frequently found to be deficient in the diet of young infants.

Keep in mind that you are feeding an infant with a small stomach capacity that has been used to liquid/semisolid diet only.

Desirable Qualities of Weaning (Additional) Foods

  • Should have high energy content
  • Should be easy to digest
  • Should be semi-solid to mashed in consistency
  • Should not be too thick
  • Should be fresh and clean
  • Should not be expensive and should be easy to prepare

 

TO IMPROVE THE NUTRITIVE VALUE OF WEANING FOODS

We are told about 5 different food groups. How to mix them while planning a menu for young children?

Besides the basic staple food, which is generally a cereal such as wheat, rice or jowar that provide energy, items from the following groups must be added to the diet.

  • Proteins: are beneficial for the growing child. Animal milk and milk products are good sources. Where feasible eggs, meat and fish can be used to provide high quality protein. However, pulses and beans are good alternatives, especially in vegetarians.
  • Oils and fats are rich sources of calories and make the weaning food softer and tastier. Vegetable oils should be preferred over ghee. A little oil should always be added to the weaning diet to increase the nutritive value.
  • Vegetables and fruits supply vitamins and minerals including iron. Seasonal, readily available and economical options should be used. The vegetables can be easily cooked with ‘dals’.

Fortunately the diet pattern in India consists of a mixture of cereals and pulses, like idli, dosa and pongal in south, and khichri and missi roti (mixture of wheat and gram flour-besan) in the North.

Iron stores in the liver of the infant would last only upto 5 – 6 months. Hence iron rich foods like dark green leafy vegetables, cereals, wheatflour, rice flakes, legumes, jaggery liver, meat, organ meats, poultry, egg yolk. (iron is in readily available form i.e. heme iron) in appropriate forms should be given.

GUIDELINES DURING WEANING

Stomach capacity has never been given much importance while telling a mother how to feed her baby. This results in mothers either force feeding or getting unnecessarily worried about baby not taking enough.

The stomach capacity (6 – 9 months): 130 –190 ml (26 –38 tsp.)

We offer few guidelines to help you wean your darling child better:

What points should be considered while feeding weaning foods?

  1. Introduce only one food at a time to permit the infant to get used to it.
  2. Allow the infant to become familiar with the food before trying to give another.
  3. Give very small amounts of any new food at the beginning, 1-4 tsp.
  4. If, after several trials, that baby has an acute dislike for a food, omit that item for a week or two and then try again. If the dislike persists it is better to forget about the food for a while and substitute another.
  5. Food should be only slightly seasoned.
  6. Child should be encouraged to try new flavors.
  7. Infants may object to taking some foods by themselves but will take them willingly if when one mixed with another, e.g. egg may be mixed with formula, cereal or vegetable. Vegetables may sometimes be made accustomed to the new flavor.
  8. Variety in choice of foods is important.
  9. The mother or anyone feeding the infant must be careful to avoid showing in any way a dislike for a food that is being given.
  10. A baby’s appetite varies a lot from meal to meal and day to day. During hot weather suffering from cold the child’s appetite may be less.
  11. The quantity of each feed should be increased as the number decreases.

Supplementary feeding at 6 months

  • Encourage gradual progression to 3 – 4 meals/day.
  • Continue breastfeeding along with cows milk.
  • By 6 months, lumpy foods should be introduced.
  • Consistency gradually changes to mashed foods.
  • By 6 – 7 months: add salt to cooked food.
  • Sugar in the form of honey, syrup, juices and jams should be controlled as harmful to erupting teeth.

CARE DURING PREPARATION

Should any special care be taken during preparation?

The nutritive value of many weaning foods can be improved by taking due care during preparation. The porridge or for that matter any other weaning food should not be excessively watered down or thinned in the belief that it will be easier to ingest and digest. A classic example of this is the thin ‘dal’ water. Even small babies can easily tolerate semi-solid foods and over dilution results in loss of valuable calories.

Unnecessary loss of nutrients should be avoided. For instance, it is better to wash vegetables whole before cutting them into small pieces. The smaller the piece, the greater is the loss of nutrients. Use the minimum amount of water for cooking and mash the food with the water used for cooking. Adding excess water and draining it off later results in loss of water-soluble nutrients and should be avoided.

Husks, bean skin and vegetable fibers can cause indigestion, so everything must be thoroughly mashed in the beginning.

SUMMARY

When the baby starts cutting his teeth, it is time to start changing him over to chopped and lumpy foods. Cooked cereals, pulses and vegetables can be given to the child.

Vegetables may be chopped into small pieces, and boiled. Cooked potato can be given. Leafy vegetables can be given well boiled and soft. A slice of raw carrot or fruit segments with all skin and seeds removed are also a good exercise for his gums. As the child grows, it is better to give fruit segments instead of juice. Fruit provides bulk in the diet and is good for bowel movement.

The aim is that child should get used to the food eaten by the family members. Mashed rice with dal, khichri or mashed vegetables normally cooked at home. Add a little oil. Green leafy vegetables can be given separately or added to dal and khichri, or stuffed in roti or Paratha.

Babies at this age should be fed 4 to 6 times a day as the stomach capacity is less and can take only little at a time.

Various food

  • Cow’s milk( not as drinking milk but in products like cereals), curds
  • Meat, chicken, fish (bone free), eggs, nuts (ground thoroughly), pulses.
  • Breads, rice, wheat, potatoes.
  • Fruit, unsweetened fruit juice, vegetable salads
  • Finger foods at 7 months – toast fingers, vegetable sticks.
  • From 6 months at least 1 food from each of 5 groups should be incorporated.
  • Homemade foods are preferable as most dishes eaten by family can be used.

Sample feed: � of a bowl of mashed dal, rice, chicken/mutton broth can be added to the rice, mashed fruits (� a fruit)

By 9 months: � a bowl of the above foods (little sugar/ salt/ghee/oil)

Food note

  • Keep breast feeding the child till 1 years of age at least, and even during illness.
  • Drinks during weaning –boiled and cooled water according to thirst.
  • During illness feed the child as normal, even if the child resists.
  • During diarrhea – give lot of fluids to the child, in fact replace each bout of stools with a glass (250 ml) of clean boiled water

CALORIE DENSE FOODS

Malting

To meet the increased demands of calorie and protein, well cooked mashed cereals mixed with milk and sugar can be given. Calorie dense cereals can be prepared by malting; also, sprouted pulses and beans can be used. Cereals like wheat, bajra, ragi, jowar, and pulses like moong (whole) can be malted.

How is the food malted?

  • Soak overnight.
  • Remove the water and tie in the moist cloth and keep in warm place (Sprouting).
  • After 48 hours when sprouts come out dry in sun or roast it.
  • Make into flour.

Advantages

  • During the process of malting, starch is converted to maltose due to increased production of enzyme amylase. Thus, this is also called Amylase Rich Food. Due to the conversion of starch into amylose, thinner gruels are made. With this either the infant can consume more gruel or more flour can be added to make thick gruel. This way calorie consumption can be increased.
  • Also, 1/2 to 1 teaspoon of malted cereal, added to porridge, khichri and other weaning foods, will reduce its viscosity and child will be able to eat a larger quantity of it. This is a very good way of increasing energy density of weaning foods.
  • The malting process increases the riboflavin, niacin content. Sprouting various pulses and beans increase the content of vitamin B group and vitamin C.
  • A major advantage of preparation of these energy dense foods is that they are pre-cooked. Thus, these cereals in powdered form can be stored in airtight bottles. They can be mixed with boiled water, cooked for a few minutes and fed to the baby.

However, these foods should not form the major feeds throughout the day, but given 1-2 times in the whole day. This is because the child should become familiar with various common foods and develop a taste for all foods and not reject them later.

As the shelf life is short, malting has to be done every three or four weeks.

Various food preparations from these malted foods

Foods:

  • Cereals like wheat, bajra, jowar, can be malted. Ragi malt is a common weaning food in the southern parts of India where ragi is commonly eaten.
  • Other cereals like rice, rice flakes, corn flakes, can also be roasted and powdered and given in the form of porridge.
  • Pulses like moong (whole) can be malted, as it is easy to digest. Roasted and powdered moong dal can be used in porridge.
  • Vegetables: boiled and mashed soft vegetables can be added to the porridges. For e.g. tomato, gourds, spinach and other green leafy vegetables.

Egg: Hard cooked egg yolk can be added to the various porridges.

  • Little sugar and oil / butter (1tsp.) can be added to the porridge to increase the calorie content.

How is the food malted?

  • Soak overnight.
  • Remove the water and tie in the moist cloth and keep in warm place (Sprouting).
  • After 48 hours when sprouts come out dry in sun or roast it.
  • Make into flour.

Advantages

  • During the process of malting, starch is converted to maltose due to increased production of enzyme amylase. Thus, this is also called Amylase Rich Food. Due to the conversion of starch into amylose, thinner gruels are made. With this either the infant can consume more gruel or more flour can be added to make thick gruel. This way calorie consumption can be increased.
  • Also, 1/2 to 1 teaspoon of malted cereal, added to porridge, khichri and other weaning foods, will reduce its viscosity and child will be able to eat a larger quantity of it. This is a very good way of increasing energy density of weaning foods.
  • The malting process increases the riboflavin, niacin content. Sprouting various pulses and beans increase the content of vitamin B group and vitamin C.
  • A major advantage of preparation of these energy dense foods is that they are pre-cooked. Thus, these cereals in powdered form can be stored in airtight bottles. They can be mixed with boiled water, cooked for a few minutes and fed to the baby.

However, these foods should not form the major feeds throughout the day, but given 1-2 times in the whole day. This is because the child should become familiar with various common foods and develop a taste for all foods and not reject them later.

As the shelf life is short, malting has to be done every three or four weeks.

Suggested recipes from energy dense foods:

Add all ingredients and cook for a few minutes by adding water or milk to a thin / semisolid consistency

  1. Plain porridge
    Bajra 1 tbsp.
    Chana dal 1 tbsp.
  2. Riceflakes porridge
    Rice flakes 1 tbsp.
  3. Fruit porridge
    Rawa 1 tbsp.
    Add a banana/fruit after boiling
  4. Apple porridge
    Rice 1 tbsp.
    Apple boiled � no.
  5. Veg porridge
    Bajra 1 tbsp.
    Moong 1 tsp.
    Carrot/Veg.1 tbsp.
  6. Tomato porridge
    Bajra 1 tbsp.
    Rice powder 1 tsp.
    Moong 1tsp
    Tomato (boiled, seedless) 1 tbsp

MAJOR WEANING FOODS

What are the main categories of Indian Foods that can be used for weaning?

Cereals

Cereals contain 7 to 12 % proteins and about 75% carbohydrate. They form an important source of energy, iron and protein in the Indian diet and also supply a certain amount of fat, which is referred to as invisible fat.

A thick creamy porridge made from cereals in water/ milk/ milk-water mixture is a good weaning food for babies. Cereals are cheaper than most other foods and are usually consumed by the family. When given alone, especially after being cooked in water, most cereals are too low in energy. The porridge should be thick (too thick to be given in a bottle) and concentrated but soft. Some oil or fat (or sugar) should be added to the porridge to make it richer in calories and easier to swallow and digest. Care should be taken to ensure that the porridge is not watered down or made unduly thin which will further compromise the energy content.

Pulses

The Indian diet consists of several kinds of legumes – lentils, Bengal gram, red gram, black gram, horse gram, rajma etc. Red gram is mostly eaten in the southern, western and central parts of India. A wider variety of pulses are eaten in the northern parts. Their protein content is 20-25%. Dry legumes that are a much richer source than the immature legumes, are also a good source of vitamins and minerals.

The legumes need to be cooked thoroughly and mashed to make them easily digestible for babies. It should be thick (too thick to be given in a bottle) and concentrated but soft. Some oil or fat (or little sugar) should be added to make it richer in calories and easier to swallow and digest.

When given with cereal staples, they are just as nutritious as animal foods (meat, fish, and milk).

Fruits

Commonly consumed fruits are banana, guava, melon, mango and citrus fruits. Pear, apple, plum, peach are abundantly available in the hilly regions. Banana is rich in carbohydrates and supplies about 80 calories per 100 gram. It is easily digestible and is very good as the first semi-solid food for the baby. Guava and citrus fruits are rich in Vitamin C while mango and papaya are good sources of vitamin A. Before giving any fruit to your baby, be sure that it is washed in clean water, peeled carefully, deseeded and then mashed.

Juice of fresh fruits:

Oranges, tomatoes, sweet lime, grapes serve to supplement the protective nutrients not present in sufficient amounts in breast milk as well as in animal milk. It is advantageous to start feeding small quantities of fresh fruit juice by the 4th month of life.

In the early stages, the fruit juice is strained and diluted with an equal amount of boiled water and only a couple of teaspoonfuls are fed. The amount of fruit juice fed is gradually increased and at the same time the dilution with water is cut down.

Oil Seeds and Nuts:

Roasted groundnut is recommended in winter. In Maharashtra and Gujarat, green boiled groundnut is popular.

Tubers and Starchy Roots

These are mostly eaten in addition to cereals and include potato, sweet potato and colocasia (arwi). In parts of Kerala, tapioca or cassava is eaten instead of rice. These are rich in carbohydrates but if given alone, especially after being cooked in water, are too low in energy.

Fish Liver Oil:

Fish liver oils are good sources of vitamin A and D. Infants can be given a few drops to � tsp. per day mixed in small quantity of milk.

Oils and Fats

Oils and fats should preferably be added to the weaning foods since they increase energy value, make the food softer and easier to swallow and help in absorption of vitamin A. Many kinds of oils are used in different parts of India – mustard oil in Bengal, Assam and Kashmir, and groundnut, sunflower, palm and til (sesame) oil in other parts.

Sugar and Jaggery

This can be used as an alternative to oils to increase the energy value of the weaning foods. However, care should be taken that excess of sugar is not added as it may result in dental decay and osmotic diarrhea.

Foods of animal Origin

Nearly all foods of animal origin are nutritious since they provide high quality protein, vitamin B12 and iron and are easily digestible.

Cooked, ground and strained fish and meat may be given at five to six months of age. Egg yolk can be given to the infant between the age of four to six months of age. The yolk contains protein, iron and vitamins, which are valuable additions to the baby’s diet. Hard cooked egg yolk seems to agree well with the babies.

Soft custard is also a suitable way in which to introduce egg yolk. Egg white, because of the frequency of allergic manifestations, is not given until the infant is 8 to 10 months old and then it is given very cautiously

Milk and Milk Products

All types of milk provide high quality protein, mostly in the form of casein, in contrast to human milk, which has mainly lactalbumin. The fat content of buffalo’s milk is almost double than that of human or cow’s milk. Milk is a rich source of B6 and calcium, and has some amounts of vitamins A and C, however it is a poor source of iron. Goat’s milk does not have vitamin B12. Instead of just being used alone, milk can be used to cook porridge or added to other weaning foods to enhance their energy content and soften them. Several milk products like curd, cottage cheese (Paneer), khoya, etc. are available and can be used. All of them have good nutritive value.

Oils and fats

Oils and fats should preferably be added to the weaning foods since they increase energy value, make the food softer and easier to swallow and help in absorption of vitamin A. Many kinds of oils are used in different parts of India – mustard oil in Bengal, Assam and Kashmir, and groundnut, sunflower, palm and til (sesame) oil in other parts.

Vegetables

Vegetables are poor in calories and protein but are good sources of vitamins (especially A, B and C) and minerals (esp. iron). The dark green or yellow vegetables are particularly good sources of vitamin A. Generally, darker the color, better the food value.

Cooked, mashed vegetables like potato, green leafy vegetables, carrots etc. can be introduced to get vitamins and minerals in the diet.