SUPPLEMENTARY FOOD DURING THE FIRST YEAR OF LIFE

At no other time in life is food as important as in the first year. The kind, amount,
and sanitation of the food, as well as the manner of feeding, require particular
attention, which pays dividends in the form of a healthy, happy baby. Nutrient
requirements are high per unit of body weight because of rapid growth. In fact, at
no other period of life is growth as rapid as in infancy, i.e., the first year of life.

Every mother is aware that foods prepared for adults are not always suitable for
infants. However, most mothers do not realise that suitable foods can be easily
prepared for them. They often opt for expensive baby foods that are sometimes
beyond their reach. Satisfactory foods can be planned and prepared for infants and
children at home without using much expensive food.

We all know that breast milk is the best food for the baby. But after 6 months,
breast milk alone is not sufficient to meet the growing needs of infants. Certain
other foods need to be provided along with breast milk to supplement the
shortfall in nutrients. The right time to start supplements is between four to six
months. Starting too early increases the risk of diarrhoea, and if started too late,
there is a constant fear of malnutrition. Therefore, supplementary foods should be
introduced after 6 months but along with breastfeeding, which should be
continued alongside supplementary foods.

The texture and consistency of the supplements can be modified according to the
age of the infants, providing them with liquid supplements between 6 months,
semisolid between 7-8 months, and solid supplements between 8-12 months.
Liquid supplements include fruit juice, vegetable soups, thin dal, and other animal
milk. In the early stages, we can start with half an ounce, gradually increasing this
amount up to 3 ounces per feed. As the child grows, there is a gradual transition
from liquid supplements to semisolid foods. Semisolid foods are mostly porridges
made from the staple foods of the community (wheat, rice, maize, jowar, etc.).

These cereals are generally cooked with milk and sugar. Some commonly used
porridges are 'SUJI KHEER', 'RAGI KANJI', 'DALIA', 'RICE KHEER', 'SABUDANA
KHEER', etc. The porridge should be such that the child can swallow it easily. To
ensure that the porridge is not too thick and to reduce its thickness, ARF (Amylase
Rich Food) is added to porridges. ARF is flour obtained from germinated grains like
wheat, barley, jowar, maize, etc. Germinated grain flour contains a lot of amylase,
which makes the porridge soft, thin, and easy to eat. Grains can be germinated,
dried in the sun, powdered, and then stored in airtight containers. One-fourth to
half a teaspoon of this ARF powder can be added to the cooked porridge while it is
still hot (70°C).
Other than porridge, boiled and mashed potatoes, sweet potatoes, carrots, and
green leafy vegetables can be given to the baby. Among the fruits, banana,
mangoes, papaya, and other soft fruits could be mashed and given as such,
whereas fruits like apple, pineapple, peaches, etc., need to be first stewed and
mashed before being served. Boiled dals, egg yolk, boiled fish, and meat can also
be given along with a little salt and butter.

When the baby starts teething around eight months, it is the right time to
introduce thick solid foods. Foods that were boiled and mashed earlier should now
be simply boiled and cut into small pieces. Boiled rice and small pieces of chapatis
may also be given. Hard and crunchy foods are liked by infants during teething.
Biscuits, toast, rusk, raw carrot, apple, and cucumber are ideal food items for the
child to chew.

Various food mixtures prepared from cereals, pulses, fruits, nuts, milk and its
products, and vegetables can be given to infants during this period. It has been
noticed that children who are brought up on a variety of foods are healthier and
have much healthier tastes than those brought up on just milk and biscuits, fruit
juice, and vitamins. A mixed diet will not only upgrade the protein quality but also
prevent the development of vitamin and mineral deficiencies.

By the age of one year, the baby can consume all solid foods. In fact, the child can
eat all the foods prepared for family meals. The only modification required is to
keep the food free from irritant spices. The food can simply be dressed with lime
juice and salt. Roti/chapati can be crumbled into pieces, softened with dal, curd, or
milk, and served to the child. Rice can be served with dal and vegetables, all mixed
well. Attempts should be made to gradually transition the child onto the family
pattern of eating.

Along with these foods, breastfeeding should be continued. If breast milk has
ceased, then the child should be given 500 ml of either cow's or buffalo's milk. Milk
can be given as such or in the form of curd, cottage cheese, pudding, custard,
kheer, or porridge.

Fermentation and sprouting are processes that can make cereals and pulses more
suitable for children. Idli, dosa, uttapam, khaman, dholka are some of the
preparations that can be easily given to children of this age. Sprouted legumes can
substitute for dals ordinarily used in fermentation.
The table below depicts the meal pattern of infants of various age groups.

6-7 months 7-8 months 8-12 months

On Waking Breastmilk Breastmilk

08:00 Fruit Juice Egg Yolk/Paneer

10:00 Breastmilk Mashed Fruit

12:00 Mashed papaya/banana/mango/cheeku/apple Milk

14:00 Thin Dal Khichdi/Dalia/Porridge

16:00 Suji Kheer/Dalia in Milk/Veg Soup Mashed Fruit

18:00 Breastmilk Porridge

20:00 - Breastmilk

Most of the problems with food acceptance in children arise around one year of
age. The problem actually starts with the mother, who thinks that the child should
be well-fed and tries to feed the child more food than it needs. The mother should
have patience and help the child develop good food habits gradually. Learning is a
slow process, and here the child is learning to eat new foods one after another. So,
have patience, be supportive, and the result will be a happy, healthy baby.

With best compliments,

Dr. A.K. Jain, MBBS, MD Pediatrics Aayushman Paediatric Clinic, Mainpuri (U.P.)
Contact: 94-1234-3099
Dr. Ujjawal Jain, MBBS, MIMA, PIYCF (USA), Healthy Lifestyle Clinic, Mainpuri (U.P.)
Contact: 906-8855-349
Insta: @healthylifestyleclinic