Breast feeding is the foundation of good nutrition in infancy.
Exclusive breast feeding provides adequate nutrition for the first four to six months of life and is recommended by the World Health Organization (WHO) for this period. In the normal full-term baby, there is no need for supplements of water, formula or vitamins for the first six months of life.
Breast milk production begins when the baby begins to suck after birth but full production does not come on stream until the 3rd or 4th day after birth.
Breast milk production is encouraged by putting baby to the breast immediately after birth and thereafter by feeding the baby on demand. Most normal full term newborn infants will demand the breast as often as every two hours or so.
Sustained breast milk production is almost entirely dependent on demand by the infant. Once the infant is nursed continually, milk production is geared to the baby’s appetite.
Latching on properly to the breast (placement of at least three quarters of the areola, which is the dark area around the nipple, in the baby’s mouth) is a very important factor in the establishment of breast feeding.
The first milk is called colostrum and is a watery bluish fluid that is rich in protein, the food constituent that is the building block for all the organs and systems in our bodies. Colostrum also contains other nutrients that will satisfy the baby’s needs for the first few days of life.
Breast milk contains all the nutrients that are necessary for normal growth and development (protein, carbohydrate, fat, minerals, and vitamins) in the right proportions, whenever required and at body temperature.
Breast milk also contains substances (immunoglobulins; enzymes; hormones) that protect the baby against infection.
Breast milk therefore has the advantages of ready availability, low cost, protection against infection and because of this, less demand on the health-care system. Breast feeding also promotes bonding of the baby to the mother.
INTRODUCTION OF SOLIDS
Breast milk alone is insufficient for growth and development after the first six months of life and other foods should be introduced at this time.
Babies begin to chew, an action quite different to sucking, around the age of six months. Solids should be finely crushed or pureed and offered with a spoon. The food should be placed well back on the tongue since the baby’s first response may be that of thrusting the tongue forward, an essential component of the sucking reflex which may still be operative. Drinks should be offered from a cup. Feeding bottles are not necessary at this age and have the potential of becoming contaminated with germs that can cause bowel infection (gastroenteritis).
Solids should be introduced one at a time and no other new foods offered until after a few days when the baby has got accustomed to the taste, which he or she will hopefully like. The first solid food that is traditionally offered is ready made cereal (oats, wheat, rice) or cooked porridge (oats, cornmeal, banana).
The aim of mixed feeding is to get the infant established on a diet which contains elements from the four main groups of food:
Starches & cereals
Peas, beans, legumes and nuts
Animal derived foods (meat, chicken, fish, eggs, milk, cheese & yoghurt)
Fruit & vegetables
The baby should receive five meals per day; three main meals with a mid-morning and a mid- afternoon snack, until at least the age of two years. The main meals should be taken from the family pot, before seasoning like salt and pepper is added. To encourage good eating habits, the family should have a meal together at least once and preferably twice per day. Clean water should be given to quench thirst. Natural juices with no added sugar may also be offered but sweet artificially flavored drinks, carbonated beverages and concentrated juices should be avoided. Food should not be offered as reward for good behaviour.