Important Information about Complementary Feeding of Mother's Milk to Babies

Complementary feeding Mother's milk or formula milk is one of the important periods in the first 1000 days of a child's life. Research shows that during this transition period, many babies experience growth failure due to poor quality complementary foods. This period is also a critical moment for your little one to learn to eat. What's more, giving the right complementary foods can support the optimal growth and development of your little one.

Therefore, the proper way of giving complementary foods to mother's milk and other questions about complementary foods will be discussed thoroughly in the following article.

Basic Principles of Complementary Feeding

Complementary feeding Mother's milk is recommended to be given following the following 4 principles:

1. On time

Complementary foods are given at the right age, when breast milk alone is not sufficient for the baby's nutritional needs. IDAI and WHO recommend giving complementary foods to mother's milk no later than 6 months of age. However, in certain conditions, such as poor weight gain, your little one can start to be given complementary foods after being evaluated for the cause and after their food readiness is assessed by a doctor

Signs of readiness to start the provision of complementary feeding of mother's milk that must be assessed with the doctor, namely:
  • Your little one shows an interest in food.
  • The neck is straight and the little one can lift his head on his own without assistance.
  • The 'blushing' reflex (ejecting food from the mouth) is reduced.
ESPGHAN (Association of Pediatricians Specialized in Nutrition and Digestion in Europe) recommends giving complementary foods as early as 12 weeks of age, and not later than 26 weeks of age (6 months). Provision of complementary feeding of mother's milk too early has the risk of causing gastrointestinal infections, allergies, and obesity. Meanwhile, if it is too slow, it will cause malnutrition and stunting. Therefore, consult a pediatrician to assess whether your little one can start giving complementary foods to breast milk.

2. Enough (adequate)

The menu for complementary feeding is suggested that the mother's milk provided contain nutritional needs that cannot be met by breast milk, especially the amount of energy, protein, iron, and zinc. No one type of food can meet all of them. Therefore, provide complementary foods that are varied and sufficient sources of carbohydrates, animal and vegetable protein, fat, and micronutrients, namely vitamins and minerals. Menus like this are known as full menus. Introduce fruits and vegetables in small amounts by paying attention to the intake and composition of carbohydrates, proteins, and fats in complementary feeding of mother's milk. Complementary feeding of mother's milk from foodstuffs that the family usually eats. For example mackerel, which turns out to have a protein content that is not much different from salmon. And in fact, the iron and DHA content of mackerel is higher than salmon which is quite a favorite as a complementary food menu for mother's milk.

In addition, be careful with the guidelines for complementary feeding of mother's milk that are widely circulated, for example, the provision of 4-star complementary feeding. Before following this guide, it's a good idea to consult with your doctor first to ensure its safety.

Complementary feeding of mother's milk is given with an increased amount and texture according to the stages. Delay in texture recognition at the age of 6-9 months is at risk of causing eating problems in children later in life. Use a 250 ml bowl to ensure your little one's intake. The following is a guide to providing complementary feeding for mother's milk:
  • 6 months 2-3 tablespoons 2-3 times a day Thick porridge (pure), strain, until pulverized.
  • 8 months (6-9 months) Increase gradually to cup 250 ml (200 kcal/day or 30% of target calorie requirement) 2-3 times a day + snacks 1-2 times a day Coarsely filtered food, can start finger food.
  • 9-12 months - cup 250 ml (300 kcal/day or 50% of the target calorie requirement) 3-4 times a day + snacks 1-2 times a day Team rice, finely or coarsely chopped food.
  • 12-23 months cup 250 ml (550 kcal/day or 70% of the target calorie requirement) 3-4 times a day + snacks 1-2 times a day Same with the food eaten by the family.

3. Safe and hygienic (safe)

Pay attention to the cleanliness of hands, materials, and equipment for solid food during the process of preparing, making, storing and serving solid food. Separate cutting boards for raw and cooked foods. Wash your hands before preparing solid food, and before feeding your little one.

Contamination-causing bacteria can grow in food, store solids in the refrigerator at a temperature of less than 5 degrees Celsius (bottom refrigerator). Store meat and fish in plastic, and keep separate from cooked food. Food stored at room temperature (5-60 degrees Celsius), can only last for 2 hours.

Ripe solids can be stored in the refrigerator (with a temperature of less than 5 degrees Celsius), for feeding for a day after being stored in a closed container. Storage time depends on the type of food used. Frozen solids can be warmed by soaking in water with plastic wrap, and be sure to change the water every 30 minutes. Complementary foods can also be warmed using a microwave, but it should be noted that the heat generated is not evenly distributed. Keep in mind, frozen food that has been reheated is not good for refreezing.

4. Given in the right way (properly fed)

The provision of Complementary foods is given in a responsive way, meaning that the provision of Complementary foods must be consistent with the signal of hunger and satiety from the Little One. Although given in a responsive manner, complementary feeding still needs a regular schedule, namely three main meals and two small meals in between, with meals not exceeding 30 minutes.

If your child shows signs of not wanting to eat (covers mouth, looks away, or cries), offer back food neutrally, without coaxing or forcing. If after 10-15 minutes you still don't want to eat, end the eating process. Mothers must be patient and encourage the baby to eat by himself according to the stage of the child's age. Avoid forcing your little one to finish food.

In giving Complementary foods, create a pleasant eating atmosphere (no coercion), and no distractions (toys, television, electronic game devices). Always offer new types of food. Sometimes it takes 10-15 times for the food to be accepted and eaten by the little one. Serve new types of food along with foods that your little one likes.

Frequently Asked Questions About Complementary foods

Some of the questions below are often asked by mothers, especially in the early days of giving complementary foods:

What Complementary foods should be introduced first?

There are no rules about what food to introduce first. The important thing to remember is to fulfill the child's nutritional adequacy by providing adequate carbohydrates, protein and fat, as well as introducing various types of food. There is no delay in certain types of protein (meat, fish and eggs can be given from 6 months of age).

Can I give instant solid food?

Factory-made Complementary foods can be chosen because it has been fortified with iron and other micronutrients. However, it is recommended that you prepare your little one's food yourself, and make sure to choose foods with sufficient protein and iron content, such as beef or chicken liver.

Can Complementary Foods add sugar and salt?

Giving sugar and salt to complementary foods can make it easier for babies to accept food, and until now, there has been no research that has proven a relationship between giving salt to babies and the emergence of heart and blood vessel problems as adults. For babies 6-12 months, salt is needed as much as 0.9 grams per day or the equivalent of the tip of a teaspoon. While the addition of sugar is allowed up to a maximum of 5 grams per 100 kcal. By adding a little sugar to food, the sugar intake limit will not be exceeded.

Why should fruit juice for complementary foods be avoided?

The American Academy of Pediatrics (AAP) does not recommend the consumption of fruit juice in infants (aged 0-12 months), because it does not contribute to a healthy diet. Babies can eat fruit in the form of cut fruit. As for older children, a maximum of 120 ml of fruit juice can be given per day or about half a glass of bottled mineral water. Excessive consumption of fruit juices can cause children to not gain weight, because fruit juices do not contain protein and often reduce the intake of other nutritious foods. It is important to remember, that what is given is really fruit juice, not fruit-flavored drinks.

Can Complementary Foods be given by means of Baby-Led Weaning (BLW)?

Complementary feeding with the BLW method means that the baby feeds himself using his hands, without being fed by adults. This method is not recommended by IDAI, given the risk of choking. In addition, protein and iron intake may be inadequate, especially in infants less than 8 months old, because their swallowing motor skills are not yet good. It is advisable to consult a pediatrician if you want to use this method.

Now, parents need to enjoy the whole process of giving complementary foods, because apart from providing nutrition and training their little one's eating abilities, complementary foods also aim to form a close relationship between babies and parents. Don't forget, check your little one's weight gain every month and compare it to the child's growth curve according to WHO, well.