COMPLEMENTARY FEEDING

OF THE BREAST FED CHILD

DEFINITIONS: COMPLEMENTARY
FEEDING

• Period of complementary Feeding (CFg): when

other foods or liquids are given along with breast milk
(previously “weaning period”)
• Complementary Foods (CFs): food or liquids other
than breast milk given to young children during the
period of complementary feeding
• Transitional Foods (TF): nutrient dense CFs
designed meet nutritional needs of child
 Definitions: Breastfeeding

Exclusive (or Full) Breast feeding (EBF):

 Exclusive breastfeeding means that the infant receives
only breast milk. No other liquids or solids are given – not
even water – with the exception of oral rehydration solution, or
drops/syrups of vitamins, minerals or medicines.
 All healthy infants should be breastfed exclusively for the first
six months of life.
RISKS TO STARTING COMPLEMENTARY
FOODS TOO EARLY

Adding complementary foods too soon (before six months) may:

 take the place of breast milk, making it difficult to meet the child’s
nutritional needs
 result in a diet that is low in nutrients if thin, watery soups and porridges
are used because these are easy for babies to eat
 increase the risk of illness because less of the protective factors in breast
milk are consumed
 increase the risk of diarrhoea because the complementary foods may not be
as clean or as easy to digest as breast milk
 increase the risk of wheezing and other allergic conditions because the baby
cannot yet digest and absorb non-human protein well
 increase the mother’s risk of another pregnancy if breastfeeding is less
frequent.
RISKS TO STARTING COMPLEMENTARY
FOODS TOO LATE
Starting complementary foods too late is also a risk
because:
 the child does not receive the extra food required to meet
his/her growing needs
 the child grows and develops slower

 might not receive the nutrients to avoid malnutrition and

deficiencies such as anemia from lack of iron.
 29/2

ENERGY REQUIRED BY AGE AND THE

AMOUNT SUPPLIED FROM BREAST MILK

1000 Energy Gap

800
Energy (kcal/day)

600
Energy from
400 breast milk

200

0
0-2 m 3-5 m 6-8 m 9-11 m 12-23 m
Age (months)
 29/4

STOMACH SIZE •The stomach of a young

child is small. At eight
months of age the stomach
can hold about 200 ml at one
time. Thin foods and liquids
fill it quickly.
•The consistency or thickness
of foods makes a big
difference to how well that
food meets the young child’s
energy needs. Foods of a
thick consistency help to fill
the energy gap.
 29/5

KEY MESSAGE
 Foods that are thick
enough to stay in the
Just right
spoon give more energy to
the child

Too thin
 29/6

FATS AND OILS

butter / margarine / ghee

coconut
 30/2

GAP FOR IRON

Absorbed iron needed and amount provided
1.2 Iron gap
Absorbed iron

0.8 Iron from

(mg/day)

birth
stores
Iron from
0.4 breast
milk

0
0-2 m 3-5 m 6-8 m 9-11 m 12-23 m
Age (months)
 30/3

KEY MESSAGE 4
 Animal-source foods are especially good for children, to help them
grow strong and lively

poultry fish

meat
liver

cheese

eggs
yoghurt
 30/4

KEY MESSAGE 5
Peas, beans, lentils, nuts and seeds are also good for children

seeds

Groundnut
lentils paste

beans

peas nuts
 30/5

GAP FOR VITAMIN A

Vitamin A needed and amount provided
400
Vitamin A
gap
Vitamin A (µg RE/day)

300
Vitamin A
from birth
200 stores
Vitamin A
from
100 breast milk

0
0-2 m 3-5 m 6-8 m 9-11 m 12-23 m
Age (months)
 30/6

KEY MESSAGE 6
Dark-green leaves and yellow-coloured fruits and vegetables
help a child to have healthy eyes and fewer infections

carrot

pumpkin yellow sweet

potato

mango
papaya spinach
GAPS TO BE FILLED BY 31/2

COMPLEMENTARY FOODS FOR A 12-23

MONTHS OLD CHILD
Percentage of daily needs

% 100

75

Gap
50

25 Provided by
550 ml breast
milk
0
Energy Protein Iron Vitamin A
 31/6

KEY MESSAGE 7
 A growing child 6 – 8 months needs 2 – 3 meals a day
 A growing child 9 – 24 months needs three to four meals a day
 Plus additional 1 – 2 snacks if the child is hungry:
 Give a variety of foods
 31/8

RECOMMENDATIONS FOR FEEDING

THE NON-BREASTFED CHILD
The non-breastfed child should receive:
 extra water each day (2-3 cups in temperate
climate and 4-6 cups in hot climate)
 essential fatty acids (animal-source foods, fish,
avocado, vegetable oil, nut pastes)
 adequate iron (animal-source foods, fortified
foods or supplements)
 milk (1-2 cups per day)

 extra meals (1-2 meals per day)

RECOMENDATIONS
 Continue frequent, on-demand breastfeeding, including
night feeding for infants.
 Introduce complementary foods beginning at six months
of age.
 Increase food quantity as the child ages-while
maintaining frequent breastfeeding.
Provide 6-8 month old infants approximately 200 kcal per day from
complementary foods.
Provide 9-11 month old infants approximately 300 kcal per day from
complementary foods.
Provide 12-24 month old children approximately 550 kcal per day
from complementary foods.
Local research is needed to determine the best combinations of
foods and practices to achieve these levels of energy intake.
  Increase feeding frequency as the child ages

Feed 6-8 month old infants complementary foods 2-3 times per
day.

Feed 9-11 month old infants complementary foods 3-4 times

per day.

Feed 12-24 month old children complementary foods 3-4 times

per day.

Offer nutritious snacks 1-2 times per day, as desired.

 Gradually increase food consistency and variety as the child
ages, adapting the diet to the infant’s requirements and
abilities.

Feed mashed and semi-solid foods, softened with breast

milk, if possible, beginning at 6 months of age.

Feed energy –dense combinations of soft foods to 6-11

month olds.

Introduce “finger foods” (snacks that can be eaten by

children alone) beginning around 8 months of age.

Make the transiti0on to the family diet at about 12

months of age.
 Diversify the diet to improve quality and micronutrient intake

Feed vitamin A-rich fruits and vegetables daily.

Feed meat, poultry, or fish daily or as often as possible, if feasible and

acceptable.

Use fortified foods, such as iodized salt, iron-enriched flour or other

staples, when available.

Give vitamin-mineral supplements when animal products and/ or fortified

foods are not available.

Avoid giving drinks with low nutrient value, such as tea, coffee and sugary
beverages.
  Practice responsive feeding

Feed infants directly and assist older children when they feed themselves.

Offer favorite foods and encourage children to eat when they lose interest
or have depressed appetite.

If children refuse many foods, experiment with different food

combinations, tastes, textures, and methods of encouragement.

Talk to children during feeding.

Feed slowly and patiently and minimize

distractions during meals.
Do not force children to eat.
 Practice frequent and responsive feeding during and after
illness

During illness, increase fluid intake by most frequent

breastfeeding, and patiently encourage children to eat favorite
foods.

After illness, breastfeed and give foods more often than usual,
and encourage children to eat more food at each sitting.
  Practice good hygiene and proper food handling

Wash caregivers’ and children’s hands

before food preparation and eating.

Store foods safely and serve foods immediately after preparation.

Use clean utensils to prepare and serve food.

Serve children using clean cups and bowls, and never use feeding bottles.
COMPLEMENTARY FOOD
1. Multimix khichri
2. Qima ki khichri
3. Egg khichri

KHEERS:
Recipies with breast milk, peanut kheer, phirni,
rice kheer, suji kheer, porridge, potato & milk
Banana kheer, custard, saonwin ki kheer,
family foods
FRESH FRUITS
Banana, apple, plum, fresh juices

FINGER FOODS
French fries, buiscuits, roti-chicken, boti
COMPLEMENTARY FOODS
AGE RECIPY
6–8 Yakhni with rice – pulao
Months
Multimix khichri, rice, vegetables mix with yakhni
Banana, plum, stewed apple
All kheers in breast milk

9 – 12 Multimix khichri with chicken / fish / qima

Months
Egg full boiled yolk first can mix butter, finger foods

13 Months Family food

onwards
FORTIFIED COMPLEMENTARY
FOODS
 What are the main contents or ingredients?
staple food , cereal product, flour, vegetables, fruit and
animal source foods.
 Is the product fortified with micronutrients such as iron,
vitamin A or other vitamins?
 Does the product contain ingredients such ass sugar
and/or oil to add energy?
 What is the cost compared to
similar home-produced foods?
 Read Expiry Date
WATER NEEDS OF THE INFANT
 No need of water for Breastfed baby.
 A non-breastfed child aged 6-24 months of
age needs approximately 2-3 cups of water per day in a temperate
climate and 4-6 cups of water per day in a hot climate. Water should
be offered to the child several times a day.
 Drinks that contain a lot of sugar may actually make the child
thirstier, pure juices & Fizzy drinks(sodas) are not suitable for
young children.
 Teas and coffee reduce the iron that ;is absorbed from foods.
 When a child is thirsty during a meal, A small drink will satisfy the
thirst.
 Drinks should not replace foods or breastfeeding. If a drink is given
with a meal, give only small amounts .