10 Steps to Shift Your Child to Complimentary Feeding from Breast Feeding

We suggest gradual introduction of food while continuing breast feeding. From birth up to 2 years is the time of rapid growth; health and behavioral development and this is time which is most susceptible for growth faltering; deficiency of micro nutrients and illnesses like diarrhea.
It is suggested to give up to 6 months of exclusive breast feeding to child. After 6 months till 2 years continue breast feeding and complementary feeding. It may be continued after 2 years.

Facts and guidelines about complementary feeding:

1. Exclusive breast feeding till 6 months of age and introduce complementary food at 6 month of age.
   Rationale:
   a. Till 6 months’ breast feeding is sufficient in all nutrition
   b. It is sterile and free from contamination.
   c. No need of water as water transiently fill stomach and thus child accepts lesser milk.
   d. After 6 months’ child starts wandering and one cannot avoid contact with soil and pathogens also calorie requirement increases therefore best time for complementary feeding.
   Note: Vitamin D and zinc are deficient in breast feeding; it should be supplemented if possible.
   Calcium; Iron; Viatmin a, Vitamin B2, B6 and B12 are of concern in specific populations. (eg. preterm)
2. Continue frequent on demand breast feeding till 2 years or beyond
3. Practice responsive feeding:
   a. feed infants and assist older children while they feed themselves.
   b. feed slowly and patiently; encourage children to feed but never force them.
   c. children refuse many foods; experiment with different food combinations, textures, taste and methods of encouragement but never lose your spirit.
   d. Minimal distraction of child during feeding
   e. feeding is learning and love: – talk to child while feeding with eye to eye contact.
   f. optimal feeding is not only about what is feed but also about how, when, where and by whom child is fed.
4. Practice good hygiene and proper food handling.
   a. wash hands of caregiver and child.
   b. safe storage and serving
   c. clean utensils.
   d. cup and spoon feeding
   e. Say ‘ Big No’ to bottles.
5. Start with small amount of food (along with breast feeding) and increase as the child grows.
6. Gradually increase the form food consistency (thickness) as infant grows.
   a. 6 month: pureed, mashed and semisolid food
   b. 8 month: “finger food” snacks etc that can be taken by infant on his own
   c. 1 year: same as older children

Caution: Whole or roughly crushed nuts or kernels, non-meshed or pureed raw veggies such as carrots etc. must not be given to children, it may cause chocking.

1. Increase the number of times that the child is fed complementary food as he grows.
2. Feed a variety of foods, vegan diets cannot meet requirements at this period unless fortified. Vitamin A rich meal must be taken daily. Avoid drinks with empty calories like soda, tea, coffee etc. Limit juices to avoid displacement of more nutritionally rich foods. on contrary to adult’s fat rich foods are essential (30-45% calories should come from fat)
3. Use fortified complimentary food or vitamin mineral supplements, as needed. In some people mothers are also to be supplemented.
4. In consensus with your pediatrician increase fluid intake during illnesses, including more frequent breast feeding and encourage the child to eat soft, varied, appetizing, favorite food. After illness give food more often than usual and encourage child to eat more.
5. Experience a happy and safe motherhood.