In the first two years of a child’s life, optimal nutrition fosters healthy growth and improves cognitive development.
By Abha Ranjan Khanna
According to the World Health Organisation, “nutrition is the intake of food, considered in relation to the body’s dietary needs. Good nutrition – an adequate, well balanced diet combined with regular physical activity – is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity.”
Diet is the kind of food that a person/community habitually eats. In the first two years of a child’s life, optimal nutrition fosters healthy growth and improves cognitive development. It also reduces the risk of becoming overweight or obese and developing Non Communicable Diseases (NCDs) later in life. The period from birth to two years of age is a “critical window” for the promotion of optimal brain, health and behavioural development.
By six months, breast milk alone cannot meet the infant’s increased needs for energy and nutrients and complementary foods must necessarily be introduced. An infant of this age is also developmentally ready for other foods.
Guiding principles for appropriate complementary feeding are:
* Exclusive breast feeding till 6 months of age.
* Continue frequent, on-demand breastfeeding until 2 years of age or beyond.
* Practice responsive feeding (for example, feed infants directly and assist older children. Feed slowly and patiently, encourage them to eat but do not force them, talk to the child and maintain eye contact).
* Practice good hygiene and proper food handling.
* Start at 6 months with small amounts of food and increase gradually as the child gets older.
* Gradually increase food consistency and variety.
* Increase the number of times that the child is fed: 2–3 meals per day for infants 6–8 months of age and 3–4 meals per day for infants 9–23 months of age, with 1–2 additional snacks as required.
* Use fortified complementary foods or vitamin-mineral supplements as needed.
* During illness, increase fluid intake including more breastfeeding, and offer soft, favourite foods.
* Encourage finger feeding self by 7-8 months; introduce a spoon by 15-18 months and expect independent self- feeding by 24 -30 months.
Feeding is the joyous act that engages the mother and infant or toddler for nurturing development, growth and well-being. Feeding is an important time for attachment, bonding, building trust and positive well-being. Nurturance and care during feeding can alert the parent to any risk factors for feeding difficulties.
Frequent/prolonged feeds; irritable /unsatisfied post feed; dehydration; neurological impairment; inadequate weight gain and excessive sleepiness are warning signs that the child is not receiving or unable to take in adequate nutrition. Food allergies may be noted in the first years of life and the most common food allergies include cow/buffalo milk, eggs, nuts and soy proteins. It is recommended that only one new flavour/texture/food be added every 7-14 days in small quantities.
Fussy eaters may be facing certain challenges like sensitivity to smells, noise/distractions textures and tastes; low muscle strength in facial muscles and tongue.
Research indicates that parents and caregivers may require skilled support to adequately feed their infants. Based on new knowledge the WHO has developed the guide “Complementary feeding: Family Foods for breastfed children” that gives more detailed guidance on how to support complementary feeding.
(The writer is an occupational therapist.)