Complementary feeding Bridging the gaps TM. Complementary feeding • • • • Giving other foods in addition to breast milk Breast milk only is not sufficient To fill the gaps breast milk will replaced by family foods Complementary food should be: • • • • Rich in energy and nutrients Clean and safe Easy to prepare from family foods Locally available and affordable When should complementary foods be started? • At 6 months • The age when the digestive system is mature enough to digest a range of foods When should complementary foods be started? • Children : – Can control their tongues better – Start to make up and down munching movement – Start to get teeth – Like to put things in their mouths and are interested in new tastes Training material Project Satellite What are good complementary foods? – Rich in energy, protein – Micronutrient – Vitamin A, iron, Vitamin C – Clean and safe – Not too peppery or salty Staple food/energy giving food/feculent • Main food eaten • Cereals – Rice – Wheat – Maize • Roots – Potato – Sweet potato – cassava Pulses • Good sources of protein • Examples – Lentils – Broad beans – Chick pea Training material Project Satellite Food from animals • • • • • • Meat Chicken Fish Liver Milk + milk products eggs Training material Project Satellite Dark green leafy vegetables • Good sources of iron and Vitamin A – Pumpkin leaves – Chayote “Chouchou” leaves – Spinach – Amaranthus ( brede malbar) Orange coloured vegetables and fruits • Orange coloured vegetables – Carrot – Pumpkin – zucchini • Orange coloured fruits – Mango – Pawpaw – orange High iron food • Liver • Animal flesh – red meat • Foods fortified with iron – Fortified infant cereals • Iron absorption is increased by: – – Eating foods rich in vitamin C Animal source iron To increase energy value of food • Thin watery food will not contain enough energy and nutrients • To make food more energy and nutrient dense, – Cook with less water – make thicker porridge To increase energy value of food – Replace the water with milk – Add extra energy and nutrients • Powder milk powder, margarine, butter – Toast cereal grains before grinding them into flour • It will not thicken much Training material Project Satellite Filling the gaps • A mixture of complementary foods is the best way to fill the gaps • For the healthy growth and development • During a day, a good mixture is – Staple food + pulse + animal food + green leaves or an orange coloured vegetable or fruit Example of a day’s complementary food • 3 meals: – A morning meal of cereal porridge – A midday meal of rice + beans + orange – An evening meal of rice + fish (or liver) + green leaves • 2 snacks: – Banana – Bread with margarine How food items can fill in the gaps? Food items Gaps filled pulse Protein, small effect on iron gap, oil seeds will have an effect on energy gap fruit Improves iron absorption, little effect on vit A gap fish Fills protein gap, small effect on iron gap, improves iron absorption Dark green leafy vegetables Provides some iron, fills vit A gap liver Fills protein gap, fills iron gap, fills vitamin A gap Training material Project Satellite Good snacks • Mashed ripe banana, paw-paw, avocado, mango and other fruits • Yoghurt, milk, puddings made with milk • Bread or chappati with butter, margarine • Biscuit, crackers • Baked potatoes Training material Project Satellite drinks • Drinks for young children should be clean and safe – Boil water, wash fruit before juicing – Drinks should not replace solid food or breast milk – If drinks are given with meal, Give drinks at the end of meals – Teas and coffee reduce iron absorbtion Training material Project Satellite How much and how often? • Start by giving one or two teaspoon twice daily • Gradually increase the amount and variety (by 9 months, a child should be eating a variety of family foods Training material Project Satellite Rice pudding with peach • Rice Pudding with Peach • Preparation : 5 minutes Cooking : 15-20 minutes Time total : 20-25 minutes • Equipment : Saucepan • Shopping 1 fresh ripe peach (approximately 110g, stone removed) 30g uncooked risotto rice 60 ml (4tbsp) of baby’s usual milk* Training material Project Satellite Rice pudding with peach • Recipe details 1. Wash, peel, stone and finely dice the peach. 2. Place the diced peach, rice and milk into a saucepan with 100ml water. Heat gently and bring to the boil, then simmer for 15-20 minutes until the rice is tender, stirring occasionally. Do not add any sugar. • Suggestions/tips Good to know: To increase your baby’s milk consumption, replace the water with baby’s usual milk. *This can be expressed breast milk or follow-on formula made up as per instructions on pack. Training material Project Satellite Vegetable pilaff • Preparation : 5 minutes Cooking : 10 minutes Time total : 15 minutes • Equipment : Frying pan Food processor • Shopping 1 small onion, finely chopped (approximately 60g) 30g red pepper 50g dried apricots 15ml (1 tbsp) rapeseed or olive oil 5ml (1 tsp) mild curry powder 160g cooked basmati rice 50g frozen peas 75ml natural yoghurt (approximately half a small carton) • Training material Project Satellite Vegetable pilaff • Recipe details 1. Finely chop the onion and pepper and apricots. 2. Heat the oil in the frying pan and gently sauté the onion and pepper with the curry powder. 3. Stir in the cooked basmati, peas and apricots, heat gently, stirring until warmed through. 4. Stir in the yoghurt. Mash the mixture or blend in a food processor to make a chunky mixture. • Suggestions/tips If you wish to freeze the second portion omit the natural yoghurt, then simply freeze the remaining portion in a clean sealable container. Other delicious vegetables to include are okra, courgette, carrot, in fact, any of your child’s favourites. Training material Project Satellite