Guiding Principles for Diversifying Complementary Feeding: Ensuring Optimal Health and Development

Complementary feeding is a critical stage in a child's development, especially for infants older than six months. This period marks the transition from solely relying on breast milk or formula to incorporating a variety of nutritious foods. Diversifying complementary feeding is not just about quantity but also quality, ensuring that infants receive the essential nutrients necessary for their growth and development.

Importance of Complementary Feeding in Various Settings

The practice of complementary feeding extends beyond hospitals and homes. It is also crucial in nursing homes and schools. Diversifying complementary feeding in these settings can play a significant role in promoting better health outcomes. For instance, in hospitals, it ensures that infants receive optimal nutrition while in care. In nursing homes, it supports the dietary needs of older adults. In schools, it contributes to the overall well-being of children by providing them with necessary nutrients that support their academic and physical development.

Key Nutritional Requirements for Complementary Feeding

To ensure good health and development, infants older than six months should consume a variety of nutrient-rich foods. These include animal products such as eggs, beef, chicken, lamb, milk, cheese, and butter, as well as fruits and vegetables. The World Health Organization (WHO) recommends starting complementary feeding at six months of age. Initially, infants should receive complementary foods 2-3 times a day between 6-8 months, and this should increase to 3-4 times daily between 9-11 months and 12-24 months.

Best Practices for Complementary Feeding

Feed infants directly, and assist older children when they feed themselves. Be sensitive to their hunger and satiety cues.

Feed slowly and patiently, and encourage children to eat but do not force them.

If children refuse many foods, experiment with different food combinations, tastes, and textures to encourage acceptance.

Preparing Complementary Foods

Complementary foods can be made using a variety of ingredients, including:

Rice, sweet potato, or taro Fish, meat, liver, egg, or beans Peanut, mungbean, or other legumes Vegetables such as morning glory, ivy gourd, leaves, star gooseberry leaves, ngub, amaranth leaves, pumpkin, squash, or moringa leaves

The Indian Academy of Pediatrics (IAP) is celebrating COMPLEMENTARY FEEDING DAY on 6 June 2023, with a theme of C4GP (Complementary Feeding for Growth and Prosperity). This initiative is expected to promote better infant nutrition and prevent stunting and wasting among children.

Timing and Nutritional Needs of Infants

Around six months, an infant's nutritional needs cannot be met solely by breast milk or formula. This is why complementary foods are introduced. This is particularly important for iron and zinc in breastfed infants. The introduction of solid foods also aids in other developmental aspects such as enhancing a child's social skills.

Safe Feeding Practices

Milk and other drinks should be offered in a cup rather than a feeding bottle. All foods given to infants must be nutritious and safe. Foods must be free of pathogens, of appropriate quantity, size, and texture. Infants should always be supervised during feeding.

Historical Context and Research

Dr. Jundell, a Swedish pediatrician, first reported in 1921 that starting complementary feeding at six months of age was associated with better growth and resistance to infections. Complementary foods include infant cereals, vegetables, fruits, meat, and other protein-rich foods, modified to suit the infant's developmental readiness.

Infant Feeding Skills and Development

The term "complementary feeding" or "weaning" refers to all solid and liquid foods other than breast milk or infant formula. This guide will help you ensure proper feeding skills and infant development. See Figure 1 for more detailed information on feeding skills and infant development.

Diversifying complementary feeding is a crucial aspect of ensuring optimal health and development for infants. By following these best practices, caregivers can help infants thrive in various settings, from homes and hospitals to nursing homes and schools.