So if you are a parent and reading this, then I must congratulate you for a job well done! You can give yourself a small pat on the back for getting the first 6 months of feeding down. Like with everything in paediatrics, it changes with time. Developmental milestones roll arond every few months and your paediatrician assesses these at each wellness visit. One of those milestones for the child and also the parent is the initiation of solid foods, after a pure milk diet over the first 6 months of life. Today I will discuss some tips on the introduction of food in an infant's diet. We shall look at when, what and how it should be done?
1. First 6 months- NO SOLIDS!
No food, no additional water, no flour pap, no "sego"- a local food that is served in Trinidad culture; should be given to a child in the first 6 months of life. The only source of nutrition should be mother's milk or a suitable formula as discussed with your paediatrician.
2. How to know when my child is ready?
Solids should be started at 6 months of life and as long as the infant has good head control, can sit comfortably and have a normal swallowing reflex. Additionally, your little one should be showing signs of wanting to eat such as leaning towards the food and putting food to mouth. Of course if a child has any neurological impairment then these signs may be delayed and you would need to discuss feeding options with your paediatrician.
3. How it is done?
Any introduction of solid for the first time, must be done by itself for 3 days at a time to ensure any allergic reaction or food intolerance can be easily identified.
4. Cereals-
Rice cereal should be done first for 3 to 4 days by itself. This can be given by spoon in a feeding chair at a pureed consistency in the beginning. Once this is tolerated, then keep at it before moving on to oats.
Bear in mind that wheat, rye and barley can trigger gastrointestinal symptoms and failure to thrive in children who have coeliac disease or gluten sensitivity. Coeliac disease is an autoimmune disease that can run in family and is only seen on starting gluten solids. Some manufacturers of oats place a disclaimer of possible gluten contamination. So read labels once starting oats and be cautious with wheat. Once diagnosed, treatment is simply a gluten-free diet for life.
5. Fruits and Veggies.
The same principle of three days per fruit should be carried out before combining any fruit or vegetable. A simple way to remember is use colours. Start with clear- yellow- orange- green-red. So this could be like this- banana puree for 3-4 days, then applesauce for 3-4 days, then local fruits like mango for 3-4 days once in season, pumpkins/squash for 3-4 days, avocadoes for 3-4 days and kale/spinach for 3-4 days. Once one fruit is tolerated well then you can combine with the food ate the previous day. The sole purpose is to identify any potential allergenic foods as your little one grows.
6. Milk.
So although you have started solids, it does not mean that we will forget about milk. In fact the WHO recommend that children can continue to be breastfed for up to 2 years whilst on solids. Those mothers who may be working then expressing breastmilk can allow for the infant to get mother's milk even in her absence. For those mothers who are unwell or may not producing any milk, then a substitute formula should be introduced. The amount of fluid would need to be worked out based on your child's weight in consultation with your paediatrician. Obviously, the more solids your child consumes, the less milk he/she would want.
7. NO salt and No sugar in the first year of life.
8. Eggs should be tried after 9 months in preparation for yellow fever vaccine.
9. Your infant can eat from the family pot from one year.
These are some general guidelines. Of course all children are different and they may have a preference or dislike for a certain food. In fact, it can take up to 20 attempts in some children before they begin to like a new food group, so don't give up after the first attempt.
Good luck with feeding!!
Dr. Zafir Latchan
Disclaimer: The information in this article is meant for educational purposes only and not meant to diagnose or treat any condition. If you are concerned about your health or that of your child please visit your paediatrician or health care practitioner for advice and treatment.