Nutrition in the first year of life

Article in Why Kids Magazine, Volume 6 No 3, Spring 2013

Author: Sr Ida Bester, Registered Nurse and Midwife, Boeps2Babes

The World Health Organisation (WHO) recommends exclusive breastfeeding from birth to 6 months of age with introduction of complementary foods at 6 months with continued breastfeeding.

Both ESPHGAN (European Society for Paediatric and Infant Nutrition) as well as AAP (American Academy for Paediatrics) states that solids may be started from 17 weeks of age when the baby has reached certain milestones.

 

Why solids?

About half way through the first year of life, babies begin to outgrow their liquid diet of breast milk or milk feeds which no longer supplies them with enough nutrients to support their rate of growth.

 It is very important to introduce complementary food according to growth, development needs and individual needs.

 This is a beautiful stage in a baby’s life filled with excitement, discovery and plenty of mess. As you introduce the baby to solid foods you are essentially setting the foundations for the child’s future health. What the baby learns now about taste and texture will guide their food choices for the rest of their lives.

 Healthy food for a baby will ensure that toddlers accept more food from most food groups, implicating that they will eat better as young children and later adults.

 

Signs that your baby may be ready for weaning

• The baby demands more frequent milk feeds.
• The baby takes a keen interest in what Mom is eating.
• Able to support his head and neck, good control and sit with support.
• Seems to be hungry even after regular milk foods.
• The baby weighs more than 6kg or has doubled his/her birth weight.

 

During this first stage of weaning, breast milk is still the primary source of nutrition and should be continued at the same frequency. 

At plus minus 17-24 weeks baby’s milk feeds needs to be complemented with other foods and tastes. The first week of solids is more educational than about nutrition. 

AAP and ESPHGAN recommend that all babies start with an iron fortified cereal at the age of 17 weeks. Cereal-based foods are internationally recommended as appropriate starter foods, because they are energy rich and happily accepted by babies.

An infant cereal is scientifically formulated to provide energy, protein, vitamin and minerals and other nutrition as the baby requires prime growth opportunities. B-probiotic added to cereal is a similar good bacteria found in digestive system of breastfed infants and is clinically proven to help keep babies’ intestinal flora healthy and strengthen natural defences.

 

The Explorer Eater (6-9 months)

By now your baby has realised that food is really tasty and is keen to explore new tastes as well as textures and will try almost anything.

When entering the explorer stage, your baby can:

• sit unsupported
• eat properly from a spoon
• begin to drink from a “Sippy cup”

 

Variety is the spice of life

Your baby will now be more tolerant to different textures which are vitally important for oral sensitisation and tactile development. Research has shown that babies exposed to a wide selection of fruit and vegetables at this stage will develop good eating habits for the rest of their life, reducing the risk of becoming “picky eaters”.

So parents play the most important role to introduce a wide selection of fruits, vegetables and combinations of these. Babies should taste as many new tastes as possible.

The Explorer needs extra energy and nutrition from a variety of foods in addition to continuing milk feeds. Remember, the milk is the main source of nutrition until the age of 1 year.

 He can now chew using both his gums and jaws and therefore need to be offered mince as well as mashed food that include soft lumps. These mashed foods are suitable for gumming.

For the first few days everything can be pureed together just to introduce the taste. Then slowly add 2 teaspoons of food mashed with a fork to these and gradually increase more mashed foods and the pureed part less.

• A good time to start offering mild spices and curries especially in our different culture groups. Remember the baby became accustomed to these flavours while in the uterus as well as during breastfeeding.
• Also introduce finely ground beef, chicken or pulses. Remember, to introduce only one variety at a time and wait a week between new foods to eliminate allergies.
• 2-3 ingredient foods are used to provide safe and worry free taste exploration for the baby.
• Once the chewing goes better (rotary chewing now), encourage the little one to feed him or herself.
• He must also explore textures, shapes and colours with his little fingers and experience new food sensations. A great idea is to grate some fresh apple and put it on the table of his high chair to play and touch while Mom is feeding him. He will now curl his little fingers around the food and hold it in his palm.
• Appearance of the front teeth (incisors) is a sign that your baby is ready for finger foods and fine pincher grasp also is developing now.

The Confident Eater 9-12 months

By now the mealtimes have become a contact sport eagerly anticipated by the baby. At the beginning of stage 3 the little confident eaters:

• Sits alone.
• Self-feeds with his hands.
• Drinks from a Sippy cup.
• Has 1 or 2 teeth.

Ready, steady, go! The contact sport begins!

The baby will be accepting more different textures which is vitally important for oral development. Feeling, eating and playing help to develop fine motor skills e.g.:

• tactile awareness
• helps to develop eye-hand coordination
• assists with speech development by increasing muscle strength 

How to introduce texture

Mash rice, vegetables, couscous and soft cooked pasta with a fork and mix with finely chopped meat, beef, lamb and chicken.

Introducing finger foods

• 9 month old babies usually want to feed themselves and don’t want to be fed anymore.
• They can be offered chopped or grated fruit or vegetables like carrot julienne.
• Important for parents to eat with their 9 month old babies (monkey see, monkey do).

Use house-cooked foods and form it into nugget size balls and offer 2-3 of these at a time. Remember to only offer a little bit at a time, otherwise they will play with it, throw it down on the floor and even feed the dog.

Your confident eater now needs a lot of nutrients to support his/her rapid growth as milk intake decreases.

A 9 – 12 month old baby does not need more than 750ml of breast or formula milk in 24 hours. Remember that 45% of nutritional requirement comes from milk.

A 1 year old only needs 500ml per day otherwise they won’t eat because they get: all their nutritional value from milk. 

As Health Care Professionals we play the most important role in a parent’s life to guide and empower them with knowledge to fulfill this task raising healthy babies and toddlers.