No idea if your little one is eating enough? MH speaks to the experts.
WORDS ANGEL DREWGUS
Every child is different and responds differently to feeding. This is baffling to parents because most approach feeding their children in exactly the same way – whether it's breastfeeding, bottle feeding or solids. Their eating habits and the food that they like and dislike differ even between siblings. You can have one child that eats like a horse, and the other one who eats almost nothing. As parents, it is your responsibility to ensure that mealtimes are happy and everyone enjoys their food and no one eats too much or too little.
Benefits of Breastfeeding
Breast milk gives your baby all the nutrients and water he needs for mental and physical development in the first six months of life and beyond. Mothers are recommended to breastfeed their babies for up to two years or more as the antibodies in their breast milk will protect their babies from infections and boost their immune system.
If breast milk is unavailable, then age-appropriate iron-fortified formula milk should be given to infants up to 12 months of age. Infant formulas are designed to match the nutrition as close to that of breast milk and provide the balance of carbohydrate, protein and fat as well as the essential vitamins and minerals to promote healthy growth and development, explains Dr Han Wee Meng, head and senior principal dietitian, Nutrition and Dietetics Department, KK Women’s and Children’s Hospital.
After a child turns a year old, cow’s milk (full cream/full fat) can be given. But it should never be given to infants younger than 12 months of age as cow’s milk is difficult for a young infant’s immature kidneys to process due to its concentrated content of protein, sodium, and potassium.
Low-fat milk can be considered after the child turns two years of age, advises Dr Han.
Starting on Solids
Solids can be introduced to babies when they turn approximately six months old. Weaning should not be before four months of age. This is to reduce the risk of food allergies as the digestive tract is still immature. However, some babies may be developmentally ready to start solids earlier than six months. According to Dr Han, some signs to indicate that baby may be developmentally ready include:
Sits well when supported
Disappearance of the tongue’s thrust extrusion reflex, which if still present will push food out of the mouth
Interest in food, drooling and putting objects into the mouth
Hunger, crying for feeds before his usual feeding time
It is important to follow the cues your baby gives in order to prevent feeding issues from developing later due to force-feeding of solids to your baby when he is not ready.
The Weaning Formula
Trying to wean a baby can be challenging and stressful for the parents. Some parents sail through this stage, while some parents find it very challenging.
This is an important stage of emotional and behavioural development for the baby and much patience is required. Here are some tips by Dr Han for easy weaning:
Let the baby set the pace and do not try to force-feed. Wait for baby to open his mouth when food is offered. If he refuses, try again later or on another day when he is less hungry or tired. Allow plenty of time for feeding, especially at the beginning.
Start with small quantities and increase the amount according to the baby’s preference.
Be prepared that the baby may not accept new tastes readily. He may take a few small spoonfuls and stop. However, do not confuse rejection with permanent dislike, therefore the food should be offered again. It is known that it can take up to 15 or more exposures for the baby to accept a new taste.
Do not be particular about neatness during a meal and avoid cleaning or wiping the baby too often. A mess during mealtimes should be expected.
Ensuring Your Child Gets Sufficient Nutrition
It is useful to take a look at the guidelines from Health Promotion Board (as appended below). According to Tan Shiling, dietitian, Nutrition and Dietetics Department, KK Women’s and Children’s Hospital, it details the appropriate daily portions of food (including milk) to consume for children from six months to 18 years of age.
Having the right number of servings in the daily diet will help the child get all the nutrients he needs. If your child’s intake is low in a particular food group such as fruit, you may consider offering fruit as a snack for your child to help meet his daily needs. On the contrary, if your child is overweight, you may continue to follow the guidelines, but foods that are high in fat, sugar, and salt should be consumed sparingly.
Table 1: Recommended Number of Servings from the Food Groups for Six Months to 18 Years Old
Milk remains the main source of nutrition during the early weaning stage, as the initial aim is to let the child be exposed to and gain experience with spoon-feeding. Subsequently, as the solid food intake increases, there should be a focus on iron and zinc intake, both of which become gradually depleted in the body and are important for growth and development, explains Dr Han. After a year old, children should be taking family meals, and milk becomes a supplement to meet their high energy and protein needs. For all ages, growing children need adequate energy and protein to ensure appropriate growth and development. They should be given a variety of foods to ensure they obtain sufficient nutrients, importantly vitamin A, calcium, iron, and zinc.
Recommended milk intake: children between one and two years of age need 750ml of milk while children between three and six years of age need 500ml of milk. Children from seven to 12 years of age need 250 – 500ml of milk. These recommendations apply regardless of the type of milk (goat, cow or soy) or form (formula, pasteurised or UHT).
Time for a Snack
Snacking can help build or ruin a child’s healthy diet. The key depends on the type, amount, and timing the snack is consumed.
A snack that is high in fat and sugars may contribute to empty calories leading to weight gain. Also, if a snack is consumed in excessive amounts and/or too near to meal times, it may affect the child’s appetite for the main meal. Nevertheless, one to two planned snacks that are nutrient-dense, served in appropriate portions and consumed at least an hour away from main meals can be part of a healthy diet for a growing child, advises Tan.
Fatty Food—Yes or No?
Fatty food includes fatty meat like bacon, luncheon meat, and sausages; the skin of poultry; dishes containing coconut milk/cream and deep fried food like fried chicken wings and nuggets. High intake of such high-fat foods may put the child at risks of becoming overweight or have diseases like high blood pressure, diabetes, heart disease and stroke.
While it is not necessary to avoid fatty food, it is more important to inculcate healthy eating habits from young, to prevent the risks of becoming overweight and the other diseases as stated above. As a guide, limit intake of fatty food to approximately twice a week, advises Tan.
In today’s fast food world, parents have more to worry about than before. With chronic diseases like obesity and diabetes adversely affecting children, it is essential to teach children how to appreciate healthy foods. The food choices you make for your child will ultimately impact his health and lifelong eating habits.