From breast to all that’s best

Proper nutrition in childhood is the key to lifelong eating habits that contribute to your children's overall health and help them to grow to their full potential. Healthy eating habits begin at birth, and are largely the result of parental influence, says Consultant Paediatrician Dr. Dilrukshi Ruberu, stressing the importance of inculcating good nutrition in the early years of life.

The first six months

Infants should be exclusively breastfed for the first six months. Even water is not necessary, since breast milk contains sufficient water for their needs. The value of breast feeding has been constantly reiterated - breast milk contains all the necessary nutrients for their development during this period, and since the milk is always pure, babies can't catch infections from it.

Infants should be put to the breast as soon as possible after birth, if not immediately, at least within half an hour. Colostrum - or the initial fluid that comes in before the real milk - has been shown to provide babies with immunity from a variety of infections. Even mothers who have to return to work can continue breastfeeding by expressing and storing their milk. Expressed breast milk can be stored for two hours at room temperature and about eight hours in the refrigerator. This milk can be fed to the baby with a spoon or in a feeding bottle.

If, for unavoidable reasons, the baby has to be bottle-fed, there are a variety of commercial formulas available in the market. Price is not necessarily indicative of quality and your paediatrician can recommend a suitable formula for your child.

It is also possible to combine breast and bottle feeding - a bottle of formula may be given when the mother is away and she may continue to breastfeed when she is at home. A multivitamin supplement during this time is beneficial, though not essential.

The first solid foods are usually introduced after six months - in formula-fed babies, perhaps a little earlier. Rice conjee or cereal is typically given first - it is preferable to let the baby get used to natural, homemade foods before introducing commercial cereals.

Rice Conjee: Start with 2 tablespoons of red rice and 6-7 oz of water. Boil together until the water is thick. Feed the thick water for two weeks. After two weeks blend the rice with the water and feed. Breast milk or formula can be added to the conjee or cereal. Fruit Juices and Fruit Pulp can also be started around this period.

Fruit Juice: 3-4 teaspoons of Papaw, Orange, Mandarin or Thambili may be given.
Fruit Pulp: 3-5 teaspoons of Papaw, Plantain of any kind, Avocado, Beli and Grape may be given.
Vegetables: Vegetables may be added to the rice conjee, one at a time. A single slice of the new vegetable should be added first before gradually increasing the quantity, and a space of one-two days should be allowed before introducing a new vegetable.

This is because babies may develop allergies to certain vegetables. If there is any adverse reaction such as a rash, vomiting or diarrhoea, that vegetable should be stopped and introduced again only after several months. Good vegetables to start with are carrots, pumpkins, potatoes and dhall. Green beans, peas, and leafy vegetables such as spinach and gotukola may gradually be added.

Fish and meat: White fish such as Thora, Paraw or Mullet and chicken may also be introduced after six months. Chicken liver may be added after nine months and beef and beef liver, only after a year.

Eggs are usually given after eight months. The egg should be ¾ boiled and half a teaspoon of the yolk given first, then half a teaspoon of the egg-white. The quantities are gradually increased until the baby is taking the whole egg by the end of a week. Again, if there is any sign of allergy such as a rash, vomiting or diarrhoea, it should be discontinued and given again only after a year or so.

Salt and sugar: Salt is only added after nine months, since infants' kidneys are too immature to handle salt before this. It is not necessary to add sugar to their milk at all.

Between nine months and one year

At this time, babies may be introduced to adult foods such as curries without chillie powder and pepper, bread, kiribath, green gram and chickpeas, stringhoppers pasta and noodles and mashed potatoes with butter and milk.

Although it is recommended that they continue to have three 6-8 oz bottles of milk a day, some children may reduce their milk intake with the increase in solids. This doesn't matter, if they continue to gain weight and develop normally. Also, other milk foods such as cheese and yoghurt can be given instead. Parents can try replacing powdered milk with fresh milk.

One to five years

After one year, children should be taking a largely adult diet. Their meals should comprise a variety of foods including plenty of grain products, vegetables and fruits. While they need a certain amount of fat, this fat should come from foods that contain plenty of other nutrients like meat, oily fish and full-fat milk, rather than from high-fat foods that contain few nutrients such as cakes, biscuits and chocolates. Red rice is preferable to white rice.

Since children of this age-group often have small appetites and are fussy eaters, small, nutrient dense and frequent meals are more suitable than three regular meals. Their diet should include a variety of foods from the following food groups:

Bread, other cereals and potatoes - these starchy foods, which also include pasta and rice, provide energy, fibre, vitamins and minerals
Fruit and vegetables - these provide fibre, vitamins and minerals and are a source of antioxidants.
Milk and dairy foods - these provide calcium for healthy bones and teeth, protein for growth, plus vitamins and minerals.
Meat, fish and alternatives - these foods, which include eggs and pulses, provide protein and vitamins and minerals, especially iron. Pulses also contain fibre.