Diploma in

Nutrition
Week - 19
 TOPICS
1. Diet during Infancy

2. Major Milestones during Infancy

3. Energy requirements

4. Nutritional Concerns

5. Feeding Problem

6. Weaning
Diet during Infancy

• Children from birth to one year of age are categorized into infancy stage.
• Mother has to ensure that the baby’s physical, emotional and psychological needs
are met.
• Baby tries to adjust to a new world and the mother’s physical detachment
introduces certain psychological changes in the baby.
• Along with the baby’s physiology, the mother’s body also undergoes multiple
changes.
• Both these factors are significant and interrelated in deciding a healthy grown-up
individual.
• There are rapid changes in infants, like brain development, physical development,
neural changes and psychological adaptations.
• The infancy stage is marked by some important milestones that indicate healthy
growth like breastfeeding, the occurrence of deciduous teeth (the milk teeth),
weaning off mother’s milk and starting with supplementary foods.
• If the growth of the baby is strong then it develops into a healthy all-around
individual.
 Physiological Changes

• Infancy is a stage where the baby witnesses

changes in his/her growth with each passing
day.
• Average weight of an Indian infant at birth
is 2.5 to 3 Kg and the length of the baby is Head Growth
around 48 to 50 cm.
• Head shows a major transition in growth pat-
• Over a period of 5 months, the weight gets
tern.
doubled and triples by the end of 1 year. Also,
• In the womb, the head makes 50 percent of a
the average length becomes around 75 cm
baby’s body length.
from 50 cm.
• At birth, it becomes 25 percent of an infant’s
body length.
Weight Changes
• At last, the head forms only 15 percent of the
• Baby loses almost 5 percent of the body body’s length portion.
weight in the initial days of birth due to
multiple factors. Brain Development
• Around four months of age, the babies
• At birth, the size of a baby’s brain is usually 20
undergo good growth in the normal stages.
cubic inches and it grows to 34 cubic inches in
• Both the muscles and fat content increases to
the first three months.
a significant amount by the end of infancy.
• The hippocampus part of the brain, primarily
• Gastro intestinal acidity is low at the time of
responsible for memories, grows 47 percent in
birth and hence the infant can’t digest much
3 months.
complex foods.
• With good brain growth, the babies start dif-
• Breast milk is the best food during this time.
ferentiating their surroundings and significant
water content is 75% at birth which reduces to 60% at 1y.
others in a better way.
Kidneys

• Filtration rate of kidneys is low at the time of Vision Changes

birth and the infant is not able to excrete high
• The infants are born nearsighted and can only
concentration of solutes.
see things as blurred.
• Functional capacity of kidneys increases over
• Intially, baby can only see from 8 to 16 inches.
one year and the excretory system starts
• The infants are also sensitive to bright light
performing better.
• The infant can’t distinguish between the colors
and the complex patterns of the face.
Feeding Behavior • When an infant looks at a face, it focuses more
on the flatter parts like the forehead or chin.
• At the time of birth, the baby helps himself to
• By the end of two months, the vision starts
feed with sucking action for breast milk.
developing.
• After a few months, the swallow movements
• The eye muscles start strengthening and the
develop and by the sixth month the chewing
infant becomes comfortable around colorful
action also develops in the infant.
objects and familiar faces.
Hearing sense

• As compared to vision, the hearing sense is

quite developed at the time of birth.
• Ultrasound reports in the womb show the
Smell Sense
movement of the baby on hearing the familiar
sounds. • Newborns are highly sensitive to their moth-
• In the first three months, baby gets startled by er’s odour and feel comfortable around their
the loudness of the sound mother’s bodies.
• From four to six months, the baby starts • At birth, the infants stay very close to their
enjoying different decibel sounds. mother’s chest and feel safe as they recognize
• The baby responds to sounds, enjoys different their mother’s odour very well.
sounding rattles and toys.
• From seven to twelve months, the baby starts Emotions and Expression Development
imitating the surrounding sounds and starts
• Infants start expressing emotions at early
babbling.
stages
• Babies start learning ‘Social Smile ‘at the age
Taste Sense
of 2-3 months.
• The baby has spent a good time in the • At the fourth month of infancy, most babies
amniotic fluid in the womb and has been start laughing.
consuming the mother’s food through this, so • After four months, the infants gradually learn
the infant is also good at smell and taste buds. to express their emotions like anger, distress,
• From the sixth to twelfth month, the ba- fear, sadness and surprise.
by’s taste and smell are developed by • After 6 months, we can see the infants
experimentation. mimicking the expressions of adults.
• It depends on a wide variety of factors, • At 9 months, babies start witnessing
including genetics. something called Separation Anxiety.
• The infants have a preference for sweeter • At the 12th month, the baby is well aware of the
tastes because breastmilk is sweeter. emotions of the surrounding people and may
• By fifth month, the taste preferences get start behaving differently.
inclined towards salty tastes
• To develop a taste of a particular food, the
baby is given that particular food at least
seven to eight times.
 Major Milestones during
Infancy

• Physical changes and nutrition are interrelated and indicate a healthy growth.

• At the end of two months, the child starts smiling at the familiar voices and

tracks the movements with eyes.

• At the end of three months, the child starts grasping the objects and can roll

from side to back.

• At the end of one year, the baby starts walking and talking at least one word.

• Such is the quantum of the growth that a baby undergoes in the first year.

Recommended Dietary Allowances for Infants

• Infancy is the second fastest growth stage in a baby’s life.
• There is an astounding mental, physical and emotional growth
of the child that needs adequate nutritional requirements.
• RDA refers to a sufficient amount of average daily dietary intake
to meet the nutritional requirement of an infant.
infants need 92 kcal per kg as compared to 40 kcal per kg of adults.
 Recommended Dietary Allowances for Indians
(Macronutrients and Minerals)

Group Particulars Body Net Protein Visible Calcium Iron

Weight energy g/d Fat mg/d mg/d
(kg) (Kcal/d) g/day

Infants 0-6 months 5.4 92 Kcal/ 1.16 g/ – 500 46 µg/

kg/d kg/d kg/day
6-12 8.4 80 Kcal/ 1.69 g/ 19 5
months kg/d kg/d

Group Particulars Vit. A mg/d Thiamin Riboflavin Niaci Pyridoxine

mg/d mg/d equivalent mg/d
mg/d
Retinol b-
carotene

Infants 0-6 -- -- 0.2 0.3 710mg/kg 0.1

months

6-12 350 2800 0.3 0.4 650mg/kg 0.4

months

Group Particulars Ascorbic Dietary Vit.B12 Magnesium Zinc mg/d

acid mg/d folate mg/d mg/d
mg/d

Infants 0-6 25 25 0.2 30 –

months

6-12 45 –
months
Energy requirements

• A growing infant witnesses an overall growth in the body organs and the activeness

of the baby needs a huge intake of energy.

• The first six months these requirements can be well supplemented by mother’s milk

which has all the energy supplements in the food.

• A six-month-old infant needs 92 Kcal/Kg/d.

• The requirement slows down when the infant turns one year old to 80 Kcal/Kg/d.

Proteins

• A six-month -old baby needs a daily intake of Essential Fatty acids

1.16 g/d of proteins. • Fatty acids are one of the most important
• This requirement increases to 1.6 g/d as the sources of cell membrane structure.
baby turns 1 year old • Linoleic Acid is an important essential fatty
• In India, some special supplementary foods acid needed for a holistic infant growth
also help in completing this need of a rapidly • Infants need 3 percent of essential fatty acids
growing infant. in their diet, which is almost 10 g/day visible fat.

Fat Calcium
• The infant receives almost 30g fat / day from • For the first six months of infancy 300 mg of
the breast milk. calcium is sufficient for infants and is well pro-
• As the infant starts weaning off from the vided by the mother’s milk.
mother’s milk and consume supplementary • Calcium is very important for growing bones
food, the visible and invisible fats need to be of the infant’s body that supports the body
completed. weight.
• The infant’s weaning diet must have 25% of fat
in it for a good growth of the infant.
infants need 19g/day of visible fats.
 Phosphorus Vitamin A

• Phosphorus along with calcium is a huge • A well-nourished infant contains necessary

determinant in development of motor skills in vitamin A stores in its liver during the birth.
the infant and it can delay major milestones in • These stores may last for approximately six
a baby. months
• Ratio of calcium and phosphorus is well • Content of vitamin A in the mother’s milk is
present in sources like Cow’s milk and Mother’s largely enough for the health of the infant.
milk both. • Feeding extensive amount of vitamin A to
children can have unhealthy aftereffects.
Iron Conditions which may occur due to excessive
intake of vitamin A:
• The blood volume of a baby’s body doubles,
1. Anorexia - an eating disorder, where an
along with the fall of iron concentration in the
infant can face a reduction in appetite or
hemoglobin. This concentration decreases to
do not intend to eat at all.
about half of which was present at the birth
2. Hyper irritability in infants.
time.
3. Removal of the outer layers of the skin can
• Iron requirement for the age groups of ‘0 to 6
occur in an infant.
months’ and ‘6 to 12 months’ is 46 µg/kg/day
• RDA of vitamin A is denoted in two forms -
and 5 mg/day respectively
retinol and b-carotene.
• Infants having low birth weight need dietary
• For infants between ‘6 to 12 months’, retinol and
iron in the earlier stages of life as they are
b-carotene requirement is 350 mg/day and
highly susceptible to anemia.
2800 mg/day respectively.
Reason for the occurrence of Hypochromic
anaemia infants are:
1. Depletion in fetal stores
Vitamin D
2. Inadequate dietary supply in the body • Deficiency of vitamin D leads to rickets, a
condition in which the bone development of
Sodium children deteriorates.
• A good supply of mother ‘s milk or cow’s milk
• The small amount of sodium present in human
cannot provide enough vitamin D and hence
milk is considered to be adequate for an infant.
the prevention of rickets can be tough.
• Sunlight is the biggest and natural source
Iodine
of vitamin D, which is easily accessible to
• Maintaining an adequte amount of iodine is
pregnant women living in tropical countries.
also important. Iodine deficiency can lead to
• Extreme Vitamin D consumption
swelling of thyroid glands, resulting in a lump
should be avoided in order to prevent
in the front of the neck region. This condition is
‘hypervitaminosis D’.
called Goitre.
• Breastfed milk is the only dietary source of
iodine and must contain plenty to enrich an
infant’s body.

cretins may be caused in child if mother is thyroid or iodine deficient.

 Vitamin B

• The RDA requirement of thiamine or Vitamin

B1 in an infant of age groups ‘0 to 6 months’
and ‘6 to 12 months’ is 0.2 mg/d and 0.3 mg/d
respectively.
• RDA value of riboflavin or vitamin B2 in the age
groups of ‘0 to 6 months’ and ‘6 to 12 months’ is
0.3 mg/d and 0.4 mg/d respectively.
• The RDA intake of Niacin for the age groups ‘0
to 6 months’ and ‘6 to 12 months’ is 710 mg/kg
and 650 mg/kg respectively.

Vitamin E
Vitamin C
• Vitamin E is essential for the well-being of
preterm infants. • Deficiency of vitamin C or ascorbic acid in any

• It is found at a higher level in breast milk of a individual is the major cause behind a disease

mother, who has prematurely given birth called ‘scurvy’.

• It is better for an expectant mother to look out • Similarly, lack of vitamin C in breast milk may

for healthier options except feeding cow’s milk. develop scurvy in an infant.

because it is considered to be a poor source of • A newborn’s body will swell due to internal

vitamin E for infants. bleeding in the body and this situation might
convert into fatal consequences.
• RDA guidelines suggest 25 mg/d of ascorbic
Vitamin K
acid for the age group of ‘0 to 6 months’ and ‘6
• An infant can face danger of bleeding due to
to 12 months.
the low level of vitamin K in its body.
• Lack of vitamin K makes the newborn more
Magnesium
susceptible to haemorrhage
• In such cases, a single dose of 1 mg of water, • Magnesium helps in maintaining fluid balance

which is the miscible form of vitamin K, has of the body.

to be given immediately after the birth of the • It is involved in the many metabolic processes

infant. and helps in regulating the heartbeat of the

• It is sufficient to prevent hemorrhage in a body.

newborn. • An infant of age groups of ‘0 to 6 months’

• An infant receives deficiency of vitamin K from and ‘6 to 12 months’ must have an intake

a mother who has received blood thinners of 30 mg/d and 45 mg/d of magnesium

during the nine months of pregnancy. respectively.

Nutritional Concerns

Breast feeding

• Breast milk is known to be a ‘natural food’ for a newborn.

• An infant should be breastfed within half an hour post normal
• In cesarean delivery cases, infants must be breastfed within four hours after the delivery.
• Avoid feeding prelacteal food items like distilled water, honey, glucose to newborns.
• These foods will satisfy their thirst and will reduce their strength to suck the breast milk
• There are some important components which are available in a lower quantity in colostrum as
compared to mature milk.
• They are: Total fat content, Concentration of lactose, Niacin, Pantothenic acid, Biotin, Riboflavin.

Advantages of breastfeeding which are divided into

different factors:
• Nutritional factors
• Immunological factors
• Psychological factors
• Physiological factors

breastfeeding is advantageous to mothers as it helps reduce weight gained during pregnancy and helps uterus
return to its normal functions.
 Nutritional Factors

Carbohydrates

• Human milk is the sweetest form of milk due to the presence of

high amounts of lactose.
• It comprises of lactose, galactose, sucrose and amylase.
• Lactose facilitates processes like absorption of calcium,
magnesium and amino acids
• It is least soluble in nature and hence, it cannot be added to
the milk at home. Moreover, commercial formula will be used to
mix it with the milk prepared for a newborn.
• Galactose in the human milk is necessary for the formation
of myelin, a protective sheet surrounding the nerve fibre that
transmits nerve messages in the entire body.
• An infant can face increased gastrointestinal distress, if
sucrose is added to breastmilk.

human milk has amylase enzyme also.

Proteins

• Human milk contains 20% of ‘beta-casein’ and 80% of ‘whey

proteins’.
• Casein’ is the largest form of protein present in milk.
• ‘Whey proteins’ are known to be a complete protein because
it contains all the nine essential amino acids. They are further
composed of lactalbumin and lactoferrin.
• Lactalbumin helps in providing essential amino acids
• Lactoferrin is also a type of protein found in both cow and
human milk.
• Lactoferrin ensures proper regulation of iron absorption from
the intestines to the entire body.

lactoferrin provides immunity to infants.

 • Breast milk contains essential amino acids
Minerals
specifically required for brain development.
• Breast milk is rich in sulphur having amino • The mineral content of human milk for an

acids, cysteine, and a high ratio of methionine infant is highly dependent on immediate

which leads to development of nervous sys- intake of some minerals.

tem. • They are mainly calcium, magnesium,

• Breast milk has a large amount of taurine, a phosphorus, iron, copper, zinc, sodium and
necessary neurotransmitter and neuromodu- potassium.
lator for the brain and retina. • Breastfed infants rarely face a condition called
• Human milk is a source of binding proteins ‘infantile tetany’.

such as thyroxine, corticosteroid, vitamin D, • Sodium content in the human milk comes from
folate and B12. the mother’s diet.
human milk also has protein splitting enzymes. • It is advisable to maintain a low sodium level in
human milk because kidney’s may find it hard
Lipids (Fats)
to handle excess sodium.
• The type of fat found in human milk is • Breast milk is able to ensure good oxygen
directly dependent on the dietary fat intake of saturation in an infant’s body
the mother • Breast milk helps in increasing the trace
• Types of lipids present in the human milk: elements such as copper, cobalt, selenium,
1. Unsaturated fat iron and zinc in an infant’s body.
2. Essential fatty acids
3. Prostaglandin precursors Vitamins
4. Fat soluble vitamins
• Breast milk is known to contain more vitamin A,
5. Steroids
C and E than cow’s milk.
6. Phospholipid
• Breast milk is rich in water soluble vitamins
7. Cholesterol
and vitamin D in fat soluble fraction, which are
Advantages of human milk in terms of providing
enough to protect the infant from rickets.
lipids:
• Vitamin D content of the mother’s milk helps in
• There is an abundance of brain lipids in
determining the nutritional intake during the
breast milk. .
stages of pregnancy
• Human milk has high carnitine content.
• Chances of low vitamin K in breast milk are
• It helps in increasing the metabolism
high. Every infant should receive vitamin K
through mitochondrial oxidation and via
supplements immediately after birth.
transport of essential fatty acid.
• Dietary intake of a mother regulates the
• Cholesterol found in mother’s milk is
presence of riboflavin, pyridoxine and B12 in an
important for the synthesis of myelin of the
infant’s body.
nervous system.
• Thiamine and Vitamin C are abundantly
• Breast milk fulfills the needs of essential
present in human milk.
fatty acids in an infant.
fats in breast milk increase satiety value of breast milk and make it easier for infant to obtain high calories.
Hormone and Growth Lymphocytes

• Breast milk is a rich source for hormone • Lymphocytes are the white blood cells which
development in the body. mediate major aspects of the immune system
• Some of these hormones are thyroid and hence, are able to attack many infectious
stimulating hormone (TSH), thyroxine, growth microorganisms.
hormone releasing factor, prolactin and insulin. • Lymphocytes can produce lymphokines and
• All these hormones helps infants by acting as, other growth factors.
Growth regulating factors, Growth promoting • Lymphocytes present in breast milk play a
factors, Growth modulators. crucial role in immunity transition of an infant
• Different immunological factors bestow pas- i.e. from passive to active immunity.
sive immunity to an infant.
• This is the form of an immunity, which does not
Lactoferrin
need activation of immune system defenses
from an infant’s body part. These factors are • Lactoferrin ties the iron required for the growth

divided into various subcategories: of staphylococcus organisms and E.coli.

1. Macrophages • This process helps to inhibit the growth of such

2. Lymphocytes organisms in an infant’s body.

3. Lactoferrin • Lactoferrin creates a protective effect by

4. Lactobacillus Bifidus Factor removing free iron from the body.

presence of excess iron in infant makes prone to infections.
5. Enzymes
6. Immunoglobulins Lactobacillus Bifidus Factor
7. Fatty acids and Monoglycerides • Lactobacillus Bifidus Factor is a type of amino
8. Para Amino Benzoic acid sugar.
• It contains a substance called
Macrophages ‘N-acetylneuraminic acid’, which is known to

• Macrophages are defined as a type of white play an important biological role in the body.

blood cell which can stimulate the functions of • Lactobacillus Bifidus Factor is a nitrogen

other immune system cells. containing carbohydrates in human milk.

• Macrophages are able to provide immunity to

an infant in two ways: They have the ability to
engulf and then digest bacteria.
• These cells synthesize and help a protein,
which is involved in the creation of immunity
against infectious organisms.
Enzymes Para Amino Banzoic acid

• Breast milk imparts a certain set of enzymes to • Para Amino Banzoic acid is essential for
the infant. erythrocytic stages of malaria parasite.
• These enzymes are namely amylase, • Human milk lacking in PABA inhibits the growth
lipoprotein lipase, bile salt stimulated lipas- of malaria in the body.
es, oxidases, lactoperoxidase and leukocyte
myeloperoxidase. Para Amino Banzoic acid
• All these enzymes increase the digestibility in
• Para Amino Banzoic acid is essential for
the body of an infant.
erythrocytic stages of malaria parasite.
• Lipases are the enzymes which kill the bacteria.
• Human milk lacking in PABA inhibits the growth
of malaria in the body.
Immunoglobulins

• Immunoglobulins are defined as the Psychological factors

defensive proteins which house all the types of • An infant is nourished in the security of a
antibodies. mother.
• They are represented as ‘Ig’ in abbreviated • Whenever the child is breastfed, they feel the
form. sense of security.
• Presence of immunoglobulins like IgA and IgM • It is also good for the heart of the child.
is much lower than the IgA in the human milk. kangaroo care, skin to skin contact between parent and child.
• To balance this situation, an infant is able to
create a relatively low level of IgA and high
Physiological factors
level of IgG and an IgM in the first year of its life.
• The synthesis of ovarian hormones decreases
with the help of prolactin, which stimulates the
Fatty acids and Monoglycerides
milk production in the body of a woman.
• Human milk contains fatty acids and • Breastfeeding an infant brings back the
monoglycerides. normal size of the uterus of a new mother.
• They have potential to penetrate the • Breastfeeding can help in shedding ex-
membranes of the viruses and bacteria to tra weight which gets collected during nine
destroy them properly. months of pregnancy.
• Their function is to impart passive immunity in • It is possible because of the effect of various
the infant. hormones as well.
breastfeeding helps reduce bleeding due to increased
oxytocin levels.
Artificial feeding

• Artificial milk is much needed in some circumstances like:

• Mother is suffering from any serious illness, fever or infection.
• Breast milk stops completely or is insufficient to be fed to a newborn.
• Intervention of another pregnancy during the lactation period.
• Newborn is extremely weak to be nursed or it cannot be nursed at all because of harelip or
cleft palate
• Mother is only available to feed the child for some part of the day.
• Mother is prescribed to take anticoagulants, steroids, and radioactive drugs.
• The most common practise of artificial feeding is ‘bottle feeding’, where infants drink milk from the
tip of a bottle.

Advantages of bottle feeding

• It frees a mother from creating additional requirements for

her infant.
• It removes all the problems in the way of establishing the
milk supply.
• Parents and family members can check whether nutrition-
ally adequate amounts of milk is being fed to the infant.
• Dilution of milk can create a calcium concentration nearly
similar to human milk.
• Around 15 g of sugar is added to the milk in a day’s formula
during the first two weeks.
• A baby should have 120 ml of the formula milk at the age of
two months.
• This intake needs to be increased by 30 ml every month
until the baby is having a maximum of 250 ml of milk.
Tips for pumping the breast milk

• Check the pump before applying for milk-pumping.

• It should not be damaged or contaminated with dirt
particles, bacteria, mold etc in it.
• The tubing of the eclectic pumps can get wet soon. This
causes mold growth because the tube does get dry easily.
• Mark the number of ounces, time and date after pumping
the milk in the container.
• Make sure the baby is not drinking old breastmilk.

Tips for freezing the milk

• Freeze the pumped breastmilk immediately if a mother is

not feeding it to her infant.
• This maintains the nutritious qualities of the milk.
• Small amounts of 50 ml to 100 ml of breastmilk should
be freezed. This way, milk will not get wasted if remained
unfinished by the baby.
• Freezing breast milk at the back of the freezer will pro-
tect it from temperature changes happening inside the
refrigerator.

Tips of thawing and warming the breast milk

• Avoid using microwave to warm the milk

• Check the temperature of warmed breast milk on the wrist,
before feeding.

Steps involved in feeding techniques

• Milk, bottles and other equipment of feeding should be

sterilized.
• The nipple hole should not be too large or too small.
• Nipple should have more fluid and no air.
• The specific amount of water should be added while
making formula milk.
• The baby should be finishing only the needed amount of
formula in the bottle at each feeding.
• Over drinking formula milk might be harmful.
Feeding Problem

There are four basic feeding problems associated with an infant:

• Underfeeding
• Diarrhoea
• Constipation
• Colic

Underfeeding

The results shown by a underfed infant are:

• Restlessness
• Irritability
• Failure in sleeping
• Excessive crying

Diarrhoea

• The chances of breastfed infants facing diarrhoea are unusual.

• It causes a temporary decrease or cessation in the feeding practices
of a baby.
• he solution to this problem is to hold back all solid food items and one
or many milk feedings.
• Substitution of boiled water or balanced electrolyte solution can also
help.

Constipation

• Constipation occurs due to to insufficient amount of food and fluid.

• The other cases of infant constipation results when their diet is either
too high in fat or protein or is largely deficient.
• For the first few months, increasing the amount of fluid or sugar in the
formula will be a corrective measure
• Increase in the amount of cereal, vegetables and fruits will help to
obtain better results in an infant’s body.
Colic

• Colic means when an infant faces frequent symptoms of complex paroxysmal abdominal pain.
• In this the child typically draws his knees up against the abdomen.
• This problem is usually seen in infants under the age of three months.

Colic prevention methods

• • Improvement in the feeding and burping techniques.

• • Identifying and avoiding any allergenic foods in the infant and mother’s diet.
• • Avoiding underfeeding or overfeeding.

Disadvantages of bottle feeding are:

• Though the availability of various types of formula milk has increased in the market, there might be
chances that the infant remains nutrient-deficient after drinking bottle milk.
• Bottle milk might not be good for the digestive system of the infant. An infant can suffer from
frequent indigestion and gas issues in such cases.
• Feeding bottle milk can convert into an expensive practise for parents. Moreover, it’s not just milk but
buying costly milk bottles is not pocket-friendly for any parent.
• Proper cleaning and sterilization of bottles is very important otherwise it may lead to various
digestive issues and sometimes loose motions for the infant.
Weaning

• Weaning is the process of transitioning a newborn from breast milk

to solid foods.
• The baby simply requires a small bit of solid food once a day to
begin with.
• It helps to create a routine that works for both parents and the
baby because the baby needs time to adjust to the experience of
eating.
• Weaning is commonly known as the ‘Anna Prashashan’ ceremony
in India. It is a celebrated day where an infant begins its journey of
eating food.
• Weaning is commonly known as the ‘Anna Prashashan’ in india
• A six to eight months old infant is fed with rice or a kheer other than
breastmilk, milk or bottle milk on any auspicious day chosen by
parents
• The word ‘weaning’ comes from the Latin word ‘wemian,’ which
means ‘to accustom.’
• New flavours and textures encourage infants to explore a wide
range of foods, ensuring a well-balanced diet later in life.
• Solid meals help babies’ lips, tongues, and jaws to move.
• Weaning also allows newborns’ bodies to obtain nutrients such
as iron, protein, vitamins, and minerals from sources other than
breastmilk
• Cooked and mashed vegetables, soft fruits, and baby cereals
mixed with breastmilk or formula are few of the food items that
parents can start with once a day.
• Supplementary food should be administered to babies around six
months of age
Nutritional density of weaning foods should ideally be:

• Around 1.0Kcal/gm of food in the western diet.

• In the Asian diet, it is about 0.25-0.4Kcal/gm of food.

Supplementary foods

• Liquid supplements
• Solid supplements mashed well before feeding.
• Solid supplements unmashed

Liquid Supplements

• Transition from baby’s milk to solid foods should be as gentle as possible.

• Purées are an excellent first texture to introduce.
• The baby can be fed animal milk (preferably cow’s milk), fresh fruit juices,
soups, and other such foods.

Animal Milk

• Most parents prefer cow’s or goat’s milk for their babies.

• Parents should start with two 225ml feeds per day.
• They can add a little jaggery or sugar to enhance the flavour while also
increasing the calorific value.

Fresh Fruit Juices

• Oranges, tomatoes, sweet lime, and grapes are high in protective nutrients
that aren’t found in sufficient amounts in breast milk or even in cow milk.
• Fruit juices should be diluted with water.
• In a sippy cup, combine 2-3 tbsp of fruit juice with boiled water. The
amount of water can be gradually reduced as the baby becomes
accustomed to this diet.

Soups
• The baby can be fed strained green leafy vegetable purees like spinach,
broccoli, bottle gourd or diluted lentil soups.
• The nutritional demand for vitamin A and K can be met by adding 1/2 tea-
spoon of cod liver oil to the leafy vegetable soup, fruit purees, or milk.
Solid Supplements - Blended or Mashed Food
• The most important thing is to begin slowly; start with one solid food meal per day, such as breakfast,
and work our way up to two or three per day.
• To get started, we can puree or mash potatoes, apples, sweet potatoes, yams, or even rice in milk.
This is when a baby’s chewing and motor skills have developed to the point that they can handle soft
fruits and veggies.

Weaning foods for infants

Infant’s age Foodstuffs Form in which Amount to be Type of

given given supplement

4-6 months Fruit juices Juice mixed with a Start with 1 to 2 Liquid
little sugar spoons & increase
to about 30 to 50
ml.
Green leafy Soups in milk Start with 1 to 2 Liquid
vegetables spoons & increase
to about 50 ml.
5-6 months Cereals Cooked in water or Cook about 2 tsp Semi-Solid
milk of cereal in a cup
of milk or water, for
example suji kheer,
etc.
6-7 months Egg yolk Half boiled egg Cook about 2 tsp Semi-Solid
yolk of cereal in a cup
of milk or water, for
example suji kheer,
etc
Starchy Boiled and Start with ½ tsp & Semi-Solid
vegetables mashed potato increase to 1 yolk
and fruits with butter or milk
Mashed banana
with milk
7-8 months Vegetables & Well cooked vege- Start with small Semi-Solid
pulses tables, thin khichdi amount & increase
to 40 to 50 g

10-12 months Whole egg Soft boiled egg, One egg Semi-Solid
including the scra mbled egg,
egg white custard.
Meat, Well cooked, Starting with small Solid
vegetables, raw or cooked quantities increase
fruits (Chopped) the amount.
Cereals and starchy gruels
• Well-cooked mashed cereals mixed with milk
and sugar can be given to meet the increasing
demands for calories and proteins.
• Malted wheat or ragi can be used to make
calorie-dense cereals.

How to prepare malted cereal: What can be offered?

• Soak the cereal for at least one night. • A small portion of well-mashed hard-boiled

• Drain the water and wrap it in a damp cloth egg yolk, which is high in vitamin A, iron, and

to keep it warm for at least 48 hours. When protein. Gradually, with time, the entire egg

sprouts appear, either dry them in the sun or yolk can be fed once a day.

roast them. • Egg white is not given till the baby is 10 months

• Once the sprouted ends have dried, remove old due to hypersensitivity.

them and crush them into flour. • After 12 months of age, a poached or
soft-boiled egg can be given.
• From the 6th or 7th month cooked meat or
Vegetables
mashed fish can be fed.
• To maintain enough vitamin and mineral
intake, cooked, well-mashed vegetables such
Pulses
as potato, pumpkin, green leafy vegetables,
• Infants can also be given well-cooked puls-
and carrots are introduced into the baby’s diet.
es blended with mashed rice in the form of
‘khichdi.’
Fruits
• Malted cereal and mixed pulses can be used
• Except for bananas, the rest of the fruits must alternatively.
be properly mashed and sieved before being
fed to the baby. Solid Supplements - Unmashed Food
• To enhance the flavour of the fruit, add melted
• Soft breads, chapatis, daal-rice, idlis, and other
jaggery, honey, maple syrup, or lime juice.
foods can be added to the baby’s diet
• Half-mashed boiled potatoes and carrots can
Non-vegetarian foods
be given to the baby because they’ll be used
• Most nutritionists believe that a baby’s to grabbing foods and chewing them by now,
digestive system is ready for animal protein this would be a good exercise for their gums.
when they acclimate to solid foods during the • As they grow, it is recommended that they
weaning stage. However, others disagree. move from basic fruit juices to consuming
• A good amount and proportion of ani- whole seedless fruits.
mal protein can actually meet a baby’s iron
requirements if given around the 8th or 9th
month of age.
Key things to consider while introducing weaning foods
• Start with one food at a time. Do not combine foods or provide several supplements at the same
time.
• Start by giving tiny portions of food, like one spoonful of mashed food or one teaspoon of diluted
fruit/vegetable juice.
• Boiled egg yolks should not be given whole; instead, start with a small piece once a day.
• When introducing infants to pureed, mashed or blended foods, start with a thin consistency
• Don’t persist to feed a food item if the baby expresses a dislike for it or vomits it up
• Don’t season or spice the baby’s food.
• Fruits and vegetables should be fed to babies first and non-vegetarian foods introduced later.
• Sometimes, when given independently, babies will refuse to consume certain foods, such as egg yolk.
So you can flavour it with rice, oatmeal or pureed vegetables.
• Keep in mind that babies are always watching and observing their environs.
• So, if the people who are feeding them dislike the taste or smell of the food, the infant will react in the
same way.
• Feed them only freshly cooked food. Foods that are frozen should be avoided.
• Use clarified butter, such as ghee or handmade butter, to make your baby’s food calorie-dense.

Problems in Weaning
1. Obesity
• The first 1000 days of a child’s life is a period of great vulnerability for their growth and develop-
ment.
• An infant remains at risk of obesity or overweight if their weaning is started too early or with highly
concentrated food.
2. Underweight
• Being underweight can be caused by eating too little food or eating foods that are less concen-
trated.
• The child suffers from numerous illnesses and has diarrhoea episodes on a regular basis.
3. Allergy
• Food allergies are more likely in babies and children who come from families with a history of
allergy
• Wheat, milk, eggs, and citrus juices are the foods most frequently linked to infant allergies.
 Foods to avoid during weaning because of allergic reactions:
1. Wheat:
• It is recommended if wheat consumption is deferred until the baby is
6 months old.
2. Egg white:
• It’s a strong irritant and should be avoided until the child is 10 months
old.
3. Milk:
• Lactoglobulins and, to a lesser extent, lactalbumin cause allergic
reactions in certain infants.
4. Food protein:
• This is a temporary one. By the end of the first year, the tolerance has
usually increased to 50%, and by the third year, it has increased to
80%.
• Artificial flavours or colours might cause allergic reactions.
5. Choking:
• Peanuts, seeds, little hard sweets, crisps, and raisins can cause
choking
• Until the children reach the age of three, avoid offering them hard or
large pieces of fruit, such as apples or vegetables, or popcorn.

unfiltered fruit juices may also cause allergic reactions.