Complementary feeding should begin at six months of age with small quantities of food and increase the quantity as the child gets older, while continuing frequent breastfeeding. The energy requirements from complementary foods on breast milk is estimated at 200 kcal/ day at 6-8 months of age, 300 kcal/ day at 9-11 months, and 550 kcal/day at 12-23 months of age whilst the total energy needs of well-breastfed infants should approximate 615 kcal/d at 6-8 months, 680 kcal/d at 9-11 months, and 895 kcal/d at 12-23 months.
The consistency of foods is important when handling complementary foods where the transition from semi-solid to more solid foods is gradually introduced as the child develops. Begin with pureed and mashed foods while transiting to solid foods.
Factors such as hygiene and sanitation should be prioritized when handling foods reduces cases of food contamination. As the intake of complementary feeding increases after 12 months, the risk of food contamination incidences also increases. To also reduce the risk of microbial contamination, the use of fermented foods is recommended .Consuming these fermented foods also improves the nutrient value of foods so that the child is able to obtain the most of a nutrient from a food.
The early exposure of infants to energy-dense foods with high sugar content at an early age, rather than nutrient-dense ones negatively affects their development. Moreover, early exposure to high sugary foods is linked to a greater prevalence of dental caries among preschoolers. Hence, it is recommended that high energy dense and sugary foods and beverages be avoided. Coffee and tea should also be avoided by young children because they hinder iron absorption. Excessive juice consumption should also be discouraged as it causes loose stools and lowers the child’s appetite.
Micronutrient content-The rapid rate of growth during the first 24 months, requires an increase in nutrients. Breast milk contains various nutrients but at this age, it does not fully meet the nutrient requirements of the child especially for the various minerals such as zinc and iron that are low in it. Thus, complementary foods should supplement those requirements. Foods that present allergies should be avoided. Introduce foods gradually- each at a time. This should enable you to detect foods that cause allergic reactions.
This particular group is at risk of Vitamin A deficiency and iron deficiency so include a variety of Vitamin A rich foods and iron rich foods. The inclusion of vegetables and fruits daily is important in reducing the likelihood of vitamin deficiencies. Fat is also essential when introducing complementary foods. They should be approximately 30% of the total energy intake.
Fluid requirements will increase during illness, though breastfeeding should be continued and even though appetite may be low, it is recommended that complementary food intake also be continued to promote fast recovery. Nutrient intake should be increased after the illness until the child regains the lost weight.
When introducing complementary foods, the timing to start, the consistency of foods, macronutrient and micronutrients intake, and fluid requirements are important considerations.