Tuesday, December 23, 2008

Five To Six Months

Your baby will enjoy the best of health on a diet formed exclusively of breast milk until she is 4 months old. Once past this age, she will have increased needs for certain nutrients that can no longer be met solely through mother's milk. During the first 4 months, the mother's stores of iron will be used up and so there is a need to supplement iron from external sources. Hence, supplementary feeding (feeding in addition to breast milk) will need to be introduced as a part of baby's diet. This is a transitional stage where your baby's diet gradually changes from one of breast milk alone to one based on what you and your family eats. This is called WEANING.

As your baby grows older, you may worry about the correct time to introduce your little one to weaning foods. Your baby is the best person to help you out of this dilemma. She will show telltale signs like putting a toy in the mouth or demanding feeds at shorter intervals or be restless during the night. She may also show some interest in other kinds of foods apart from milk

Most pediatrician recommend weaning foods by the end of 4 months. However, let your baby guide you as to when she is ready for these supplementary feeds

The apt age for weaning and introducing such supplementary foods to your baby's diet is end of the 4th month or beginning of the 5th month. About this age, your baby will begin to show signs of learning new feeding skills. This, may then become the ideal time to acquaint your baby with newer textures and tastes too. Prior to this age, your baby's delicate digestive system may find it difficult to cope with anything other than milk. Hence, most pediatricians are not in favor of early weaning.

Weaning is not about charts or time. Weaning is about readiness. So, a gradual shift from breast milk to supplementary feeds is always advised.

We have divided weaning into 3 stages, each of which has progressive changes in the diet that will vary with each baby depending on personal preferences, growth and development (teething) and the baby's ability to adapt.

What To Start With?

Weaning is a period of experiments, both for you and your baby. It is really a matter of trial and error to find out what is best for your baby. Most pediatrician advice to wean gradually over a period of time beginning with home cooked foods using fresh ingredients as these are healthy and easily digestible for your baby.

Introduce your baby to weaning gradually and lovingly, making it a pleasurable experience both for you and your precious one. Never force your baby to eat foods she does not want to eat. It is not unusual for babies to react badly or be allergic to some foods, so watch your baby's reactions closely when you introduce a new food to your baby

The best time to introduce supplementary foods is during the daytime, when your baby is fresh and hungry. If she is not hungry, she will not accept any food and may even become cranky. So, feeding during the day will save both you and your little one an uncomfortable night as digestion is easier earlier during the day than in the latter half of the day.

Start by offering one food at a time and continue this for a couple of days before trying something new. In this way, if your baby does have an adverse reaction, you will know the likely culprit.

It is recommended that you feed your baby yourself till she is one year old. This will give you exclusive personal time with your little one and strengthen the maternal bond of love. This is the most important time for nurturing your precious one. You will soon be adept at feeding your baby and this time spent together will be precious for both of you.

When you initiate your baby to weaning, the question uppermost in your mind will be - "What and how much to start with?" Well, the answer to this one is simple.

Start with anything that is healthy and easily digestible and let your baby guide you about the quantity she is ready for. It is usual to start with half to one teaspoon of a mashed cereal like rice or even fruit or vegetable juice initially. Both liquid and semi-solid supplements can be introduced to your baby's diet at 5 months. Start with one or two additional feeds each day, during the first month of weaning. Gradually, as the number of supplementary feeds increase, the interval between breast feeds will also increase.

Your little one may really enjoy this treat and begin to show signs of savoring the first taste of real food. However, it is also possible that she may take some time getting used to newer foods. Some babies adapt to weaning quicker while others maybe fussy for a while before they adjust. You will have to be patient during this period.

Weaning Foods

There are varying opinions about the sequence of weaning foods. Most babies are accustomed to a diet composed entirely of milk till the fourth month. So initially, it will be a good idea to introduce weaning with liquid supplements like soup, juices, and dal water starting from the fifth month. These can be followed by semi-solid supplements like mashed cereals, fruits and vegetables. You should begin with 1 to 2 supplementary feeds everyday, preferably in the morning. Consult your pediatrician before you start weaning, as he will be the best person to guide you about the special needs of your baby.

Liquid Supplements

 

Milk

 

It is usually extremely difficult and impractical to continue to exclusively breast feeding your baby beyond 4 to 6 months.

However, if you feel comfortable nursing beyond 1 year, feel free to do so. But do remember to start additional foods at the appropriate time because research shows that babies who are weaned later have a harder time adjusting to weaning. 

By the fourth month, your baby's digestive system will have become stronger and you can safely start on undiluted milk, if you're not breast feeding and your baby is on diluted cow's or buffalo's milk. 

This will also be the right time to reduce the number of breast feeds and substitute them with fresh milk (cow's or buffalo's) gradually. Do remember to boil the milk before giving it to your baby. This will not only destroy the disease causing bacteria but also soften the proteins present in it, making digestion easier. Most mothers prefer to start feeding milk using a training cup or a spoon instead of a bottle. Start with a few teaspoons at a time and slowly increase to about half a cup.

 

Fruit and Vegetable Juices

 

A well-balanced diet is most important, especially during these initial months.

Your little one is growing now and will need vitamins and iron to make her strong. Fresh fruits and vegetable juices of carrots, oranges, sweet limes, muskmelon etc.  Are rich storehouses of vitamins A, B and C as well as iron and are the best foods to supplement a milk diet. However, most pediatrician recommend that fruits like custard apple, pineapple, grapes, watermelon and guavas should be avoided till your baby is one year old.

To begin with, introduce your baby to a single fruit or vegetable juice at a time. This will help you to identify your baby's likes, dislikes and allergies, if any. Follow this with a combination of 2 to 3 fruits or vegetables, once baby has adjusted to a single fruit. Try Papaya and Muskmelon Juice after the baby is six months old and has adjusted to both the fruits individually.

Start with a few teaspoons and gradually increase the amount to about half a cup per day.  

Sometimes, your baby will screw her face and spit out some juice. It is possible that she may not like the tangy taste of citrus fruit juices. Try juices or purées of non-acidic fruits like muskmelon, banana, chickoo etc. Straining these juices is essential to make digestion easier. It is better to avoid mushy vegetable juices like tomatoes as they may contain some indigestible shreds even after you strain them as these may be difficult for your baby to digest, especially till she is 6 months old. 

Stay away from myths and superstitions. A prevalent notion that fruit juices must be warmed before feeding to prevent your baby from catching a cold is completely erroneous. Warming or heating will destroy the volatile vitamin C present in them. Before you start preparing your baby's meal, do remember to wash and sterilise all the utensils and pots you use.

 

Vegetable Soups and Dal Water

 

Strained dal water is the best one to begin with, especially moong dal as it is easier to digest. Start with Moong Dal Water. Later, you can start on a combination of green leafy vegetable soups and dal water. Begin with thin soups such as carrot, pumpkin, bottle gourd etc. Begin with strained soups and dal water initially. As your baby grows older and is about 7 months old, you can start on unstrained soups and dals. Later on, you can add other green vegetables to your baby's diet. These are a good source of iron, calcium and vitamin C.

Begin with one type of vegetable or dal and gradually accustom your baby to a combination of these vegetables and dals. Try vegetable variations like Beet and Carrot Soup. A wide variety of soups and juices will help your baby savour and develop a palate for foods other than milk.


Semi-Solid Supplements

Babies are most likely to take to semi-solid foods with gusto, savoring this addition to their regular diet of milk, soups and juices. It is also quite possible that they may resist these changes, resulting in a messy meal and splattered clothing and furniture. Do not be alarmed by this as your baby may resist new tastes initially.  It is a natural process where she is trying to adapt to new foods and to learn the skill of swallowing foods other than liquids while also adapting to newer flavors.

It is not essential to follow a strict drill or order in which to introduce the supplementary foods. However, the best semi-solid supplement for your baby initially, is a single cereal, pulse or a mashed fruit or vegetable.

Rice is the most common cereal to begin with, as it is nutritious and easiest for babies to digest. Gradually, try a combination of a cereal and pulse, such as rice with moong dal in the form of khichdi. Your baby would best accept a well mashed khichdi thinned down with warm water, which will be easier for her to swallow and digest. Serve Moong Dal Khichdi and see your baby happily gurgle it down. 

Other cereals such as wheat, ragi, bulgur wheat etc can be added as baby starts accepting semi-solid foods. Cook and puree these cereals with milk to form a smooth creamy consistency that is balmy for your baby’s tongue. Add a teaspoon or two of butter or ghee to these foods, as these are a rich source of vitamin A. A great start could be made with the Jowar and Ragi Kanji, which is an unusual and yummy combination to initiate your baby to this diet.  Begin with one to two teaspoons and gradually increase the quantity to about half a cup. Once your baby accepts these changes, it is time to introduce her to mashed fruits and mashed dals as well.  Most babies will love the sweet taste of fruits and welcome this innovation in their regular diet. A mashed banana (diluted with a little milk) makes an excellent meal.  Chickoo, papaya and ripe mango can also be great additions. Introduce stewed fruits like apples a week or two later.

Remember to begin with a single fruit or vegetable and gradually accustom your baby to combinations. 

By the end of the fifth month, most babies readily accept more variety and can be served boiled and completely mashed vegetables like carrots, potatoes etc. Ensure that these vegetables are properly cooked and blended to a semi-solid consistency so that they are easy to swallow. 

To meet the increased demands of calories and protein of your growing baby, you can also start with malted porridges that are made with different grains like wheat, ragi, bajra, jowar etc. The process of malting involves soaking the grain overnight to allow it to germinate, then drying it in the sun and then milling it into flour. This conversion makes thinner porridge and enables your baby to eat more. This process converts the starch present in these grains to amylase due to the increased production of an enzyme called amylase and hence it gets the name Amylase Rich Food (ARF).

Flip the pages and try Malted Magic. These are great to carry with you if you are going to be traveling with your baby as it makes a nutritious and hygienic meal for your little one. You can also add these flours to baby's milk shakes, soups, and dals to make her meals more nutritious.

Food Square


The perfect weaning food for your baby should consist of a combination of staple foods, protein supplements, fruits and vegetables for vitamins and minerals and sugar, fats and oils in moderation.

The Food Square below will help you to understand the basic food groups and their combinations that form a balanced diet that is the basis of supplementary feeding.

All the components of the Food Square are important for the nourishment of your baby. However, it is not necessary to provide for all these either in the same meal or at the same time. Introduce your baby to these foods gradually, letting her adjust to their taste from the fifth month onwards.


 

The Staple 

Cereals (e.g. Wheat, Rice etc.) 
Millets (e.g. Jowar, Bajra etc.) 
Roots and Tubers (Potato, 
Carrot etc.)

 

Protein Supplements 

Legumes (e.g. Matki, Cow pea etc.) 
Dals (e.g. Masoor dal, Toovar dal etc.) 
Nuts (e.g. Walnut, Almond etc.) 
Dairy Products (e.g. milk, cheese, curds,  paneer)


Vitamin and Mineral Supplements

Fruits (e.g. Orange, Banana etc.)
Vegetables (e.g. Spinach, Cauliflower etc.)

 

Energy supplements

Sugar and Jaggerey
Fats and Oils (e.g. butter, oil, vanaspati)

Pointers to Weaning


Weaning is a period of experiments, both for you and your baby. It is really a matter of trial and error to find out what your baby really wants as most babies show strong preferences, even at this early age.

Wean your baby gradually over a period of a few weeks or months. Your little one is less likely to be distressed when weaning happens gradually.

During the initial days of weaning, allow your baby to lick on some foods, preferably liquids, so that she gets accustomed to different kinds of flavours and textures. When you start on semi-solid foods, start with foods that are very thin in consistency like Apple Punch. Add sterilised water or milk to thin down the consistency, if required. As your baby gets accustomed to thinner foods, you can gradually thicken the consistency. Along with this, most babies are ready for a mashed cereal or fruit. Encourage your baby to wean by providing other nourishment like Dal Water or Banana Smoothie in place of breast feeds. Your baby will need plenty of loving attention while you both make the transition from nursing to weaning. She will be your best guide during the initial period of weaning and she is the only person whose opinion on this subject counts.

While introducing any foods for the first time, watch out for any allergic reactions, like cough, cold or skin rashes. If these occur, discontinue that food immediately and consult your pediatrician.

Sometimes she may dislike some foods so much that she may just throw them back at you. At these times, avoid giving the same food a second try immediately. Wait for a few weeks before you try again. However, if your baby continues to dislike that particular food, try and add an accepted food to a rejected one to get your baby used to the taste gradually. In the meantime, you can also offer her another food to accustom her taste buds to new foods.

Feed your baby when she is in an upright position. This will make swallowing easier and prevent her from choking on foods.

Try not to show any sort of dislike towards any food while feeding your baby as she may get influenced. It is always better to be guided by your baby's appetite than to feel pressured into overfeeding her.

Do not urge your baby to eat more than she wants. Instead, try and understand your baby's expression towards food. Learn the pattern of your baby's feeding requirements from her body language. Some babies show signs of hunger by waving their hands or kicking their legs when they see food. When your baby is hungry, she may lean forward and open her mouth or cry loudly. When she is no longer hungry, she will reject food by turning her mouth away or falling asleep.

Most doctors are of the opinion that babies do not have a discerning palate for sugar and salt until the age of 7 months. It is wiser to avoid adding them to your baby's meals as a sweet tooth is usually cultivated rather than inherited. If your baby develops a taste for sugary foods at this age, this in turn may lead to dental problems and obesity later in life. Dry fruits like dates and figs or honey can be used as alternative sweeteners. Be sure to use fresh honey as stocked up honey may contain micro-organisms which can be harmful to your baby.

Avoid adding strong spices like pepper and garlic to your baby's feed at least till she is 6 months old as she may find them unpleasant to taste and may outright reject foods containing these spices.

Babies generally accept lukewarm foods more readily. Avoid serving hot foods to your baby. Always bring the temperature of the food down to lukewarm and check it by feeling it on your palm or wrist.

It may seem tough initially and you're both going to throw your share of tantrums at meal times, but try and be patient and resourceful. A very jovial mood will certainly help you a lot more.

If your little one is sick, consult your pediatrician or nutritionist about changes in her diet.

INFANCY - Five To Six Months

The beginning of5th month is the right age for introducing weaning and supplementary foods (feeding in addition to breast milk) to your baby's diet. Strained soups, juices or mashed rice is the best food to begin with. However remember to introduce only a single fruit or vegetable at the initial stage and gradually accustom your baby to a combination of them.



Banana Smoothie

Bananas are a very baby friendly fruit and one of the very few that babies can eat raw. Bananas when combined with curds and orange juice in this velvety concoction provide your baby with energy, carbohydrates, iron, calcium, vitamin A and vitamin C.

Rice Mash

Rice mash is widely recommended as a great starter to the weaning process. It is easily digestible and is more hygienic than other foods like fruit juices, which are open to chances of contamination due to the several steps involved in preparation. Dilute the rice mash with milk (breast or top) to thin down the consistency so that it easy for your baby to swallow.


Moong Dal Khichdi

This is a good combination of a cereal and a pulse which is suitable for your baby once she has adapted to rice after 1 to 2 weeks of starting weaning. This will add more variety to your baby's meal and also provide plenty of protein for healthy growth.


Moong Dal Water

This is a nourishing food and an ideal one to start with as its texture is similar to that of breast milk. The water has been strained as babies cannot digest whole cereals and pulse before the age of 6 months. It is best to give it unstrained after your little one is 6 months old. To make it tastier, you can add a tadka of ghee, jeera and turmeric powder a couple of weeks after you start this.


Barley Water

Barley is a protein rich cereal and is very good for your baby when weaning begins. Flavour the barley water with jaggery which is a rich source of iron. Also squeeze some lemon juice into it to provide the much needed vitamin C that protects your baby from coughs and colds


Apple Punch

"An apple a day keeps the doctor away". But this is one fruit babies have trouble digesting in its raw from till they are 6 months old. So, apple punch is a wonderful way of introducing apples to your baby's diet. As your little one grows older, apples can be stewed in lesser water to make a puree and served.


Papaya and Muskmelon Juice

This unusual combination is an innovative way of introducing a 2 fruit combination in your baby's diet. 
Rich in vitamin A, vitamin C and fibre, this combination will also help cleanse your baby's digestive system.
Of course, it is always wiser to start off with a single fruit like papaya for a few days and then to introduce the muskmelon for a few days to ensure that your baby is not allergic to either of these fruits.
 


Beetroot and Carrot Soup

This is a brightly colored soup and you're going to have a lot of stained "bibs" initially. 
Carrots provide vitamin A which is good for your baby's skin and the beetroot add sweetness, colour and fibre. Try the other combinations mentioned below as "variety is the spice of life." I have started with a combination of 2 vegetables and then added more vegetables to the soup. Remember to ensure that your baby is not allergic to any of them.
 

Apple and Carrot Soup with Potatoes

This is a slightly more "gourmet" soup.
Rich in energy and vitamin A, this soup is a "solid" meal which will make baby feel satisfied. You will notice that she won't be hungry very quickly after she has "dined" on this one.
As your baby approaches the 6th month, you can start adding ingredients like onions that have a strong flavour to improve the taste. You can add a dash of salt and pepper to this soup after your baby is 6 months old.


Dal Mash

Dal mash is a good supplementary meal to meet your baby's increased demands of energy and proteins. Begin with a simple dal mash and later on add vegetables to it. After 6 months of age, you can add a dash of pepper and a few drops of lemon juice to enhance its flavour.



 



 

 



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