Complementary Feeding: A solid start

 

     The annual celebration of World Breastfeeding Week gives us occasion each year to explore and promote an important facet of infant and young child feeding. This year’s theme, set by the World Alliance for Breastfeeding Action (WABA) is Breastfeeding and Family Foods.

 

     Attaining the highest achievable standard of health is the right of all children as stated in the Convention on the Rights of the Child. The World Health Organization’s (WHO) Global Strategy for Infant and Young Child Feeding recommends supporting and promoting the best possible feeding practices for children and describes how governments and health care systems can be active in achieving these goals.

 

 

What does "complementary feeding" mean?

 

     Complementary feeding means giving other foods in addition to breastmilk. The gradual shift from breastmilk to solid foods is a transition period that begins after an infant reaches six months of age and continues until the age of two years or more.

 

 

When starting solids after six months, an infant’s:

  • enzyme system and gastrointestinal wall have adequately matured to digest a variety of foods,

  • head and neck muscles are strong enough for head control and the coordination of tongue, lip and swallow,

  • oral reflexes have developed to swallow semi-solid and solid foods, immune system is ready to handle other foods and to protect against pathogens and allergies,

  • kidney system will not be overloaded.

     The complementary feeding phase is a fun learning time for infants. Listening to their baby’s messages is all parents need to do to develop a responsive feeding relationship. Babies are highly curious and want to explore, taste and touch everything, and that includes food. When food is prepared in the home, babies will exercise their excellent communication skills and become excited and animated at the sight and aroma of it. They want to touch, feel, smell and taste the great variety of healthy foods available. When introducing foods, choose ones that provide plenty of opportunity for exciting tastes, textures and colours. When baby has had enough, a turn of the head or a spitting out is saying, "I’m full!"

 

 

What do parents need to know about feeding family foods?

  • Exclusive breastfeeding is all a baby needs for the .rst six months of life. Breastmilk provides all the nutrition, growth factors, security and protection against illness that a baby needs for growth, development and health.

  • It is normal for breastfeeding to be continued for two years or longer.

  • Complementary feeding can be started after six months. When starting solids, breastfeeding can be done as often as before – on cue – and as long as a baby wants. Breastmilk remains the most important food.

  • After six months a baby’s digestive system can handle a diversity of foods. A baby now has the capacity to munch down on food, may have some teeth, and can control tongue and swallow.

  • This is a fun time of exploration and new learning for a baby. Babies want to explore the tastes, colours, aromas and textures of new foods.

  • Babies need foods that are rich in energy and nutrients and prepared to be safe and suitable.

  • The order of food introduction is not important as long as the foods are healthy and nutritious for infants.

  • The amount and the number of times per day infants are fed solid foods can be increased gradually. 

  • It is important to spoon-feed from a plate or bowl. Babies should not be given pureed foods through a bottle.

  • When a baby is sick, it is important to continue breastfeeding. A baby will want to be breastfed more often and can catch up on solid foods by feeding more frequently when feeling better.

Do babies need vitamin and mineral supplements?

 

     A full term, healthy and exclusively breastfed baby will have adequate nutrient stores and will have all nutrient needs met, including iron. The iron from breastmilk is very efficiently absorbed compared to that of infant formula, commercially fortified cereals and cow’s milk, because it comes with lactoferrin, lactose and vitamin C in the perfectly required amounts. When babies start solid foods, breastmilk remains an important source of iron for infants. After six months additional iron from iron-rich foods such as meats, fish, beans, lentils and egg yolks, is needed.

 

     Vitamin D, the "sunshine vitamin" is a nutrient (hormone) that is marketed as a supplement for breastfed infants. Health Canada has decided that this should be recommended as a population policy because they claim it is not practical to counsel pregnant women and new mothers on their nutrient status. This arbitrary endorsement means that the majority of infants will be receiving this supplement needlessly. The vitamin D requirements of breastfed babies can be easily be assessed. Babies who may need supplementary vitamin D:

  • are not exposed to sunlight,

  • have darker skin pigmentation that screens out more sunlight,

  • are born to mothers who so not consume vitamin D fortified milk,

  • live in higher latitudes.

     For lighter skinned babies living in lower latitudes, giving the mother a vitamin D supplement during pregnancy and lactation, and safely exposing baby to sunlight for 5 to 10 minutes, several times a week, along with sustained breastfeeding will help maintain a baby’s vitamin D status.

 

     The  question must be asked whether babies are being set up for delayed vitamin D inadequacy by denying the normal, sunlight source of vitamin D. Will this negatively impact on an infant’s development of biochemical pathways to convert ultraviolet light to the nutritional form of vitamin D in later life? Science has demonstrated how the lack of certain nutrients in infant formulas can influence a person’s capacity for full development, such as the ability to manage cholesterol in later life. Cholesterol is missing from infant formula, and present in breastmilk. Research is now appearing that demonstrates the greater risk for high blood pressure and cardiovascular disease in adults who were not breastfed as infants. Can similar biochemical abnormalities develop when infants are slathered with sunscreens, given an artificial source of an artificial source of vitamin D and denied the normal biochemical development of vitamin D synthesis from sunlight?

 

 

Are commercial baby foods necessary?

 

  Cereal foods commercially produced for babies are heavily promoted on the fact that they are "fortified" with iron. The most commonly fed "first" food is rice cereal fortified with "elemental" or "reduced" iron and with three of the B vitamins. These cereal foods are highly refined and the iron is not readily absorbed. As well, many of these cereals now come with added skim milk powder or powdered infant formulas. Both the Canadian Pediatric Society and Health Canada recommend that babies not consume cow’s milk before the age of nine.

 

     Jarred baby foods have a pureed consistency and are diluted with water to create a semi-solid state. After six months babies will prefer the tastes, textures, colours and aromas of family foods and will not need pureed, watery foods.

 

     Food interests are developed at an early age and exposing a baby to the taste, texture, appearance and smell of real food during the first years of life helps to establish important lifelong food preferences.

 

     British researchers at Birmingham University have noted that babies weaned on "beige" coloured diets and processed foods are more likely to favour "beige" carbohydrates such as white bread, doughnuts, biscuits and potato chips later in life. Dr. Gillian Harris, a clinical psychologist  notes, "children develop a visual prototype of their preferred foods early in life." They tend then to reject foods inconsistent with the prototype.

 

     Interestingly, babies become used to the foods of their mother’s diets and have a preference for the foods she eats during lactation.

 

     Parents armed with a food processor, blender or mashing fork can easily prepare family foods that are fresh and of higher nutritional value, often at a fraction of the cost and with much less of the waste generated by jarred and packaged baby food. In the US alone, the average baby will have

consumed, smeared or spit out 600 jars of baby food by the time they reach twelve months of age. That’s a lot of unnecessary expense and waste.

 

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