PART 3: FEEDING INFANTS, YOUNG CHILDREN AND ADOLESCENTS

FEEDING YOUNG CHILDREN

General Principles

• Your baby grows rapidly in the early months of life. In the second year, however, her growth will generally slow down, and she will be less hungry. Also, her appetite may vary from day to day. She may also be passing through a phase of negativism (15 months to 3 years), when she tends to do the opposite of what you want her to do. If she is unwell, her appetite may suffer even more, though she may continue to accept mother’s milk if still breastfed.
  
• Keeping this in mind, do not force your child to eat. Of course, you must offer her food quite often. Let her eat by herself even if she makes a mess. Let her learn to handle the spoon. You may fill up her spoon off and on or you may offer her some food with a separate spoon, but she should be encouraged to develop independence in her eating habits. Do not get upset if she does not eat ‘nourishing’ foods for a few days. Children have their moods. For some days, an infant may eat less of certain foods but if left to herself, she may start eating the same again after a gap of few days. Breastfeeding should be continued in the second year or as long as you and your child want. (See chapter on FEEDING THE NEWBORN AND INFANTS.)
  
• A child must sit while eating — first in your lap and later on her own. She should not be allowed to run around the house while eating.
  
• I do not believe that you should only feed a child when she asks for her food. Some children get so absorbed in playing that they will never ask for food, though they start becoming irritable because of hunger. Children should be offered food at regular times, but not forced if they eat less or do not eat at all at one particular sitting. 
  
• Too much milk is not recommended. Avoid giving your child more than 500 ml. a day. You can aim at giving ½ or ¾ this amount as milk and the rest in the form of milk preparations like curd, paneer, or milk pudding. Children who hate milk may be offered milk preparations instead. Do not worry if your child does not want anything made from milk; read about vegan diets in the chapter on PREGNANCY. (However, keep in mind that vegan diets, which eschew the intake of even milk and milk products, can lead to severe anaemia and brain and nerve damage due to Vitamin B12 deficiency. A study in the Netherlands has found that children with low levels of Vitamin B12 in their blood appear less able to reason, solve complex problems and process abstract thoughts. They also have poorer short-term memory. The study detected problems even in children who did not have severe deficiency and found that the effects of low Vitamin B12 intake can apparently appear years later.)
   
• I do not suggest addition of flavouring agents to milk. Similarly, the so-called nourishing drinks advertised with the help of sportsmen or sportswomen are not recommended; they offer your children little nourishment. In fact, some children may prove to be allergic to these products and others may never drink plain milk again because they get hooked to a certain taste. Moreover, such children may miss out on many other nutrients which normal food provides. If your child wants milk soon after getting up in the morning, give it to her, but this is not essential. She can be given milk with her breakfast. In such cases, many mothers give the child just plain water when she gets up. This habit, if continued, is helpful later in life. The person gets some fluid at the beginning of the day so that even if she does not get enough fluids during the day, at least some of her requirements have been fulfilled. Some children and adults also find this fluid intake helpful to move their bowels.
  
• Dry fruits are good for children, but they must also be rationed — partly because they are expensive — and more so because some of these, like dates, figs and raisins, can remain stuck between the teeth, leading to caries. Foods that may lead to choking in children should be avoided in those below 3 years. Examples of these foods are peanuts, raw carrots, other nuts, popcorn, hard candies, berries and whole grapes.
  
• Raw eggs can cause infection and should be avoided.
  
• Do not bribe or threaten your child to eat. You can give her ‘favourite food’ after her meals or in place of her meal.
  
• Children need to eat about 5 times a day — breakfast, lunch and dinner and snacks during the day — and in the evening.
  
• Do not satisfy your child’s appetite with only milk, fruit juices and soups. These liquids can form a part of the meal if required.
  
• Cooked vegetables spoil easily. They should be eaten fresh, as far as possible. If kept in the refrigerator, they should be consumed within a day or two. There is no need for the readymade foods available abroad. Natural, freshly prepared food is preferable. But if you find readymade foods convenient, remember that the saliva of your child introduced into the jar from your child’s finger or the spoon can cause the food to spoil rapidly.
  
• Do not be too anxious to teach table manners to your child below the age of 3. As a family, avoid eating food while watching television. A family meal is a very important time for the family, for getting together and enjoying each other’s company. Moreover, children who are given to the habit of eating while watching television are likely to become fat because they may get so absorbed in the programme that they may eat more than what their system needs. Such habits also cut down on their normal activities.
  
• It is better to avoid discussing controversial issues at mealtimes. Time for sharing or for discussing disturbing events can be set after dinner.
  
• There is no need to sterilise the utensils used for older children. Clean, dry utensils are quite safe. Drinking water should be boiled.
  
• Teach your child about hygiene. Hands should be washed before and after meals and the teeth brushed or rinsed after each meal. The kitchen should be kept free of cockroaches and flies.
  
• Wholewheat flour chapatis, paratha, bread or porridge are to be preferred to preparations made from refined flour. This is essential for providing our body with essential vitamins, minerals and fibre. Similarly, unpolished rice is better than polished rice.
  
• Scrape vegetables, including potatoes, instead of peeling them. Use the water in which rice or vegetables have been boiled in cooking. Do not overcook vegetables. Let the child get used to the taste of raw vegetables from a young age. Avoid too much spice, though most children can tolerate a limited amount of spice, used in family cooking.
  
• Avoid chocolates, sweets, cold drinks, sherbats, flavouring agents, tea, coffee, etc. as far as possible. Approach the school authorities to send a circular to all parents not to send sweets to school for distribution on their child’s birthday.
  
• If you are non-vegetarian, remember that fish is to be preferred to other types of non-vegetarian food. Eggs should not be given daily, but on alternate days.
  
• Children whose diets are based on the above principles generally do not need extra vitamins, calcium or iron. However, I do find that some children need these supplements after the age of about 9 months. Let your doctor decide about this.
  
• The menu at each main meal (breakfast, lunch, and dinner) or for snacks given between them can vary from day to day. If time permits, more than one item of food can be given at one sitting. But if the child wants to eat more of one preparation and less of another, do not force her to finish each and every thing. Children should be offered enough of protein-rich foods like pulses, grain, peanuts, peas, beans, egg, meat and fish. But vegetarians should note that nonvegetarian food is not essential. Sprouted gram, moong and beans are very nutritious. Green, red, orange and yellow vegetables — cooked or raw — are essential. The cheapest seasonal fruit should be offered in abundance. Many people do not realise that guavas are more nutritious than other more expensive fruits.
  
• Too much sugar, jaggery or salt should not be added to a young child’s food. A sweet tooth attracts more dental decay and can lead to obesity. Children used to more salty food from an early age may continue to take more salt than desired when they grow up. This is not good for our cardiovascular system. I would suggest that no salt be kept on the dining table. If a dish does need additional salt, let it be brought from the kitchen.
  
• Avoid sending the child to school on an empty stomach. In a study from Jerusalem, 11 to 13-year-old children were given tests for cognitive functioning. Those given breakfast 30 minutes before the tests scored significantly better than children who ate at home 1½ to 2 hours before testing, and children who did not eat breakfast that day.

Wholewheat flour paratha is to be preferred to white bread

11 February, 2013