October 16, 2019
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    Nourishing the newborns

    May 10, 2019

    Very young babies are totally dependent on the parents, particularly the mother for the provision of adequate nutrition in the first year of life. It is now firmly established that exclusive breastfeeding for the first six months of life is the ideal form of initial nourishment. This implies that only breast milk should be given and nothing else.

    Mother’s milk

    Mother’s milk is the Golden Elixir that fulfils all the nutritional needs of a baby, right up to six months. Even additional water is not necessary. In addition, vitamins and western medicines are only permitted. A majority of babies grow very well and thrive beautifully just on mother’s milk. It is definitely the first step in the right direction to produce a healthy populace in our country.

    In any normal individual, the highest rate of growth after birth, in physical proportions as well as in the growth of organs and intellectual development is found in the first two years of life. Proportionately, this is even more than the growth in the pubertal growth phase of adolescence. The first two-year growth segment is especially significant and vital for brain growth. Many essential nutrients should be provided at this important stage in the life of an individual and additional foods need to be supplied in optimal quantities to the baby right throughout this rapid growth segment of life. Thus, infant feeding is a very important component of childrearing. It must, however, be stressed that all necessary ingredients for normal growth can be provided by natural foods and extra fancy articles of food are not generally necessary. This is particularly true of commercially available processed foods. Such items are not essential for adequate growth. Yet, for all that, some of them have the advantage of being so easy and convenient to prepare for the baby. This may be quite useful for some working mothers.

    Extra nutrition

    However, it is quite necessary to point out that after the first six months, breast milk alone cannot provide sufficient quantities of all necessary nutrients to the baby. There are advantages of continuing breastfeeding for even up to two years, but other foods have to be gradually introduced around six months of age. The baby needs extra nutrition and other foods from this age onwards. The selection of proper articles of food is of seminal importance for this age group. These foods should be well-balanced, nutritious, palatable and energy-dense. The old practice of giving the baby watery or thin rice congee water (kenda watura) does not suffice at all as the energy level of congee water is quite low. Complementary feeding should be started with mashed over-cooked rice mixed with vegetables and other articles of proteins and fats. The real requirement is to provide an energy-dense, appropriately mixed and palatable nutritious diet to the baby after the initial period of exclusive breastfeeding.

    The period of five to eight months is also important as it is the time during which the baby learns to chew and swallow semi-solids and solids. Although newborn babies are born with a well-developed swallowing reflex, they have to subsequently learn to chew and swallow. Adequate stimulation of this process is vital to ensure that the baby develops the ability to ingest semi-solid and solid foods as well as to develop a liking for different types of foods.

    Balanced diet

    The addition of newer and extra foods after the sixth month should be based on a balanced diet. Such a diet should supply adequate amounts of calories, proteins, carbohydrates, fats, vitamins and minerals. All new articles of food need to be introduced only gradually so that the baby gets used to them and develops a liking for them. Around this time, natural fruit juices and soft fruits too could be introduced.

    As the baby gets used to more solid foods, vegetables, lentils, fish, egg, meats and oil could also be incorporated into this mixture. There is no scientific truth in the notion that eggs should not be given before the first year. Evidence from scientific studies has confirmed the notion that the addition of eggs early does not lead to an increase in the incidence of allergies, as was thought earlier.

    The trick is to gradually make the preparation of foods more and more solid, so that the baby learns to chew and swallow. The consistency of the mashed up mixture is gradually changed over weeks of time so that in time to come the baby gets used to eat solid food.

    The ultimate goal is to get the baby to eat most of the articles of an adult diet by the time he or she is one-year-old. It is particularly important to add fish quite early as it provides some essential ingredients for brain growth.

    Different ways of preparing food and the addition of different articles of food will lead to the baby developing a taste for many different foods. It would prevent him or her getting bored by the same old thing being given day in and day out. Variety is the spice of life, even for little babies. Most importantly, then it is totally unnecessary to cook separately for the baby. The food that is cooked for other family members could be usefully employed to provide balanced nutrition for the baby too. Even vitamins and minerals in adequate quantities could be provided by such articles of food that are used day in and day out in a normal diet.

    Commercially available baby foods

    Parents of today are bombarded by a variety of commercially available proprietary baby foods in packets, jars and bottles. The marketing efforts that have gone into some of these advertisements of commercial preparations are totally unbelievable. We cannot blame the commercial establishments concerned with the manufacture and distribution of these preparations. After all, it is their ‘bread and butter’. There are subtle advertisements for these products depicting bonny babies and happy parents.

    Many virtues are extolled and the inclusion of all kinds of factors and compounds that are supposed to increase the growth of organs, especially the brain, are used by interested parties to convince mothers that these foods are superior.

    However, it must be categorically stated that there is no ‘growth factor’ or an essential nutrient that is added to these foods that cannot be provided by natural articles of foods available in all homes. True enough, the convenience of packaged pre-cooked food is attractive for busy people, but it must also be realised that there are many food additives that are used to preserve the shelf life of these products.

    Currently, there are concerns all over the world on the long-term effects of these substances on growing children.

    The saddest thing is that even non-working mothers who are there with the baby at home tend to use these foods for their babies. There is no scientific evidence that any of these proprietary and synthetic foods are that much better or for that matter, any better than natural foods.

    Sweetening food and salt

    The current recommendation that is advocated especially by the Sri Lanka College of Paediatricians is to try and avoid sweetening foods and drinks by adding sugar.

    There is a growing problem of being over-weight and obese in children and sweetening food is just one cause for this problem. Sugar may provide some calories, but is not an essential ingredient in a child’s diet. In addition, excessive consumption of sugar in the early years of life predisposes to dental problems as well. Another common article of food that is not necessary for very young babies is salt. There is accumulating evidence that salt intake in early life is probably linked to the development of high blood pressure and heart problems in later life.

    The Sri Lanka College of Paediatricians specifically requests parents to avoid adding salt to the diet of young children. Tea and coffee too are perhaps best avoided during the first year as some of the chemical ingredients in these beverages have some stimulant properties.

    Apart from these, there are no other restrictions on natural foods for the baby, but many synthetic foods with all kinds of food additives and colourings are perhaps best avoided during this stage of life. Babies generally do not like chillies, pepper and spicy food because of their irritant effects on the tender lining of the mouth and throat.

    However, there is no evidence that these are nutritionally harmful to the baby or that they lead to long-term problems such as gastric and liver disorders. If the baby likes these articles, there is no reason to avoid giving them to him or her.

    Artificial formula milk

    Many believe that it is essential to provide the baby with some artificial formula milk after the first six months.

    This is not absolutely or invariably so. If other articles of food are gradually introduced and the baby is breastfed, there is no real reason to introduce these proprietary milk foods, even up to the end of the first year.

    All types of formula milk are made from cow's milk and are not primarily designed for humans. However, if it is convenient and affordable, there is no absolute embargo on the use of these kinds of milk for the baby in the second six months of life.

    This is particularly relevant to families with working mothers. Affordability is particularly relevant in view of the escalating costs of milk powders in modern society. Unfortunately, there are parents from middle-income surroundings who spend over Rs. 5,000 a month for expensive artificial milk preparations for their children.

    Feeding a baby in the first year should not be a big hassle. It should be an enjoyable experience for both the giver and the receiver.

    A majority of babies enjoy meal times. In fact, it is absolutely essential to make it a pleasurable experience to be looked forward to by a baby. However, it is a crying shame that some unnecessarily forceful practices of shoving food down the throats of babies and children have made meal times a real hassle and a source of annoyance and distress for children.

    All it needs is some common sense, prudent selection of natural foods and a little bit of extra effort.

    By the end of the first year, the baby should be joining the rest of the family at the table during all meal times.

    There are many misconceptions, false beliefs and common folklore statements that are presented to mothers. The widespread practice of describing some foods as ‘heaty’ and others as ‘cooling’ does not have any scientific basis. Such ideas have led to unnecessary restrictions being placed on the provision of some useful natural foods to the baby. It is worth reiterating that all children would grow up like flowers provided the basic forms of nutrition are made available to them.

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