Complementary Feeding practices for parents and caregivers

Poshan Maah Special

Shivanee Harshey
Anganwadi worker Laxmi Tara visits the kitchen garden of Sheela Angati where she explains benifits of different green vegetables during COVID 19.
UNICEF/UNI365340/Panjwani
22 September 2021

The POSHAN Abhiyaan was launched in March 2018 by the Prime Minister, as the Indian government’s flagship programme to improve nutritional outcomes for children, pregnant women and breastfeeding mothers aiming for Holistic Nutrition. Every September is marked as the ‘Poshan Maah’ in India. During this time, we see several communications and sensitization efforts on maternal health, nutrition, eliminating severe acute malnutrition and much more.

In 2021, along with fighting the COVID-19 outbreak in India, the work towards securing the nutrition of our children and women must continue. Anganwadi workers have played a crucial role as front-line community workers and especially in promoting child growth and development.

Vidhya Jain, Anganwadi worker speaks to young mothers about the importance of nutritious, locally sourced food in Jethana village, Rajasthan
UNICEF/UN0392554/Kolari
Vidhya Jain, Anganwadi worker speaks to young mothers about the importance of nutritious, locally sourced food in Jethana village, Rajasthan

Nutrition is a crucial part of the development and health of children. Improved nutrition means improved infant, child, and maternal health. It also ensures robust immune systems, improved learning. For mothers it leads to a safer pregnancy and childbirth experience. It is one of the main contributors to lowering risk of non-communicable diseases and assures longevity.

Healthy children live and learn better. Individuals with optimum nutrition are more productive and can fully realise their potential. They go on to create opportunities for themselves, and their communities that, in turn, break the cycles of poverty and hunger.

In India, malnutrition presents a significant threat to child health. In India, almost 70% of all deaths among children below 5 years are attributable to undernutrition.[1]

Promoting infant and young child feeding can help in improving child survival rates. The first two years of a child’s life are the most important. Parents must conduct regular checks to assess if the child is growing well with the help of Anganwadi workers so that they can spot any faltering early on.

Anganwadi worker weighs a child at the Jethana B Anganwadi center in Jethana village.
UNICEF/UN0392558/Kolari
Anganwadi worker weighs a child at the Jethana B Anganwadi center in Jethana village.

If adequate nutrition is provided during these initial months, it lowers morbidity and mortality, reduces the risk of chronic disease, and fosters better development overall. In this regard, early initiation of breastfeeding (within 1 hour of birth) protects the baby from infections and reduces mortality. Breastmilk is also a critical source of energy and nutrients.

Patel Manisha brings her son for checkups as acitivties resume post Covid lockdown. Mamta diwas (VHND) acivities have resumed at Chanota Fadia AW, Baria, Gujarat
UNICEF/UNI340973/Panjwani
Patel Manisha brings her son for checkups as acitivties resume post Covid lockdown. Mamta diwas (VHND) acivities have resumed at Chanota Fadia AW, Baria, Gujarat

But what happens after the first six months of exclusively breastfeeding a child? Is it enough?

The answer is no.

Around the age of six months, a baby is developed enough to receive and process other foods. The energy and nutrient needs of the young one is growing and cannot be met with breastmilk alone. Moreover, as the child grows and starts to explore the world around, the nutrition requirements continue to grow. Should the child be denied this nutrition or not given food appropriately, it can adversely affect growth and development.

Therefore, at the six month mark, it is critical to start complementary feeding so that one can ensure optimal development of the child.

Seema Devi, an Anganwadi worker, feeds complementary food to SAM children during the nutrition session of Bal Poshan Satra at the anganwadi centre in Rahuniya Purwa Barwara, Chitrakoot.
UNICEF/UN0390076/Vishwanathan
Seema Devi, an Anganwadi worker, feeds complementary food to SAM children during the nutrition session of Bal Poshan Satra at the anganwadi centre in Rahuniya Purwa Barwara, Chitrakoot.

Here is a quick guide to the basics of complementary feeding. With the help of these quick tips, mothers and caregivers can understand nutrition better and safeguard the health of their child.

When to start and why it’s critical

A mother feeds complementary food to her child during the nutrition session of Bal Poshan Satra at the anganwadi centre in Rahuniya Purwa Barwara, Chitrakoot, U.P.
UNICEF/UN0390062/Vishwanathan
A mother feeds complementary food to her child during the nutrition session of Bal Poshan Satra at the anganwadi centre in Rahuniya Purwa Barwara, Chitrakoot, U.P.

- At the six month mark, baby's body and brain is growing rapidly and requires more energy and nutrients than what breast milk alone can provide.

- This is the right time to introduce complementary feeding.

- Delay in introduction of complementary foods affects the child’s growth and increases the risk of malnutrition.

What to feed and what to avoid

Home visit by AWW and Asha to Rekha ( ANC- 6 month) . They explain benefits of healthy diet (Tiranga bhojan) in Village Karnawas, District Barmer, Rajasthan
UNICEF/UN0388791/Panjwani
Home visit by AWW and Asha to Rekha ( ANC- 6 month) . They explain benefits of healthy diet (Tiranga bhojan) in Village Karnawas, District Barmer, Rajasthan

- To support physical and brain development feed a variety of foods such as porridge, mashed pulses, fruits and vegetables.

- Do not add salt or sugar

- Non-vegetarian can include egg, fish, chicken etc.

- Do not feed child junk foods such as chips, packaged juice, biscuits, sweets, or savouries.

How to feed and sustain the habit of eating

Budhe Majhi and her 1.7 year old daughter Priyanka. She still breast feeds, and also feeds her child sold food with a spoon to try to keep infection through dirty hands at a minimum.
UNICEF/UNI296812/Narain
Budhe Majhi and her 1.7 year old daughter Priyanka. She still breast feeds, and also feeds her child sold food with a spoon to try to keep infection through dirty hands at a minimum.

- Practise good hygiene and proper food handling.

- The child should be fed from a separate bowl and all utensils used should be thoroughly washed

- Look into the eyes while feeding the child. Be patient, encouraging and loving.

- Do not force feed.

- Self-feeding must be encouraged early on

- Children have a small stomach, so make every bite count

A combination of continued breastfeeding for at least 2 years along with timely and adequate complementary feeding is the most reliable option to provide optimum nutrition to the child. As the child grows, increase the number of times that the child is fed: 2–3 meals per day for infants 6–8 months of age and 3–4 meals per day for infants 9–23 months of age, with 1–2 additional snacks as required; use fortified complementary foods or vitamin-mineral supplements as needed and gradually increase food consistency and variety. Over and above the nutritional benefits, complementary feeding can strengthen the bond between children and their parents.

 

[1] Swaminathan, S., Hemalatha, R., Pandey, A., Kassebaum, N. J., Laxmaiah, A., Longvah, T., ... & Dandona, L. (2019). The burden of child and maternal malnutrition and trends in its indicators in the states of India: the Global Burden of Disease Study 1990–2017. The Lancet Child & Adolescent Health, 3(12), 855-870.