Author: Gauri Kshirsagar

What is Weaning?

Weaning is a process of introducing semi-liquid to semi-solid foods other than breast milk to a baby.

 When is the ideal time to start weaning?

WHO recommends starting complementary feeding, supplementary (in addition) to breast milk at 6 months of age (WHO recommends exclusive breast feeding until 6 months of age)

Why start weaning at 6 months of age?

• Breast milk is sufficient for the growth of the baby only till 6 months of age.
• Breast milk output starts to decline thereafter but baby’s physical & mental development continues at a very fast pace till the end of 2 years.
• Weaning should be started latest by 6 months, failing which will lead to malnutrition.
• The rate of increase in length and weight declines but still the child is growing in size.
• Food contains complex form of nutrients. Child is ready to digest these complex carbohydrates, protein and fats by 6 months of age. Enzymes to digest complex nutrients are fully activated now

 

How to initiate weaning and progress?

• Each month is different till one year of age.
• Transition from liquid to solids should be very gradual.
• Frequency from 10 feeds per day (breast feeding) to 6-7 feeds per day should be gradual
• Amount of food to be offered at a time varies with age, example when the child is small, can manage small amount of feeds each time but frequency will be more.
• Once the critical stage of learning a particular behaviour is over, it is difficult to teach that behaviour at a later stage hence, a proper schedule for food should be maintained and followed strictly.
• Some of the points related to consistency, frequency and volume are noted in the following tables:

Consistency: Introduction of right consistency of food at the right age is important to develop good food behaviours.
Consistency	Age
Breast feeds	0-6 months
Semi-liquid	After 5-6 months	Easy to digest, smooth and gentle on baby’s stomach.
Semi-solid	After 8-9 months	Baby now needs food with taste and texture
Semi-solid	After 10 months	Baby now needs food that satisfy his urge to chew-complex taste and texture
Solid diet	1-1.2 yrs	Includes variety of food items

Frequency: Children have to be fed frequently since they can eat small amount at a time due to their little capacity.
Age	Frequency
Till 5-6 months	Child is given breast feeds on demand i.e. 9-10 times over 24 hours.
From 6- 8 months	As the child grows, his requirements increase and he starts to accept larger volume and thicker consistency at a time – feed the child  7-8 times/day
From 9- 12 months	Child normally eats 6-7 times per day and each time.
By 12 – 15 months	Child eats at least 6 times per day.
By 18 months	Child’s eating schedule of 5-6 times /day gets fixed

In addition to the above frequency the time of the regular meals should be fixed and rest of the additional meals should be scheduled around these three:

1. 3 regular meals – Breakfast, Lunch and dinner and
2. 3 in-between healthy snacks
   1. Midmorning (recess time),
   2. evening at 4:30 – 5 PM
   3. Bedtime

Volume: Children have little capacity due to their smaller surface area. Initially accepts small amount but as he increases in size, accepts larger volume.
Age	Volume
Till 5-6 months	Few spoons to 30ml at a time
From 6- 7 months	50-75 ml/g  at a time
From 7-8 months	75 – 100 ml/g  at a time
From 9- 12 months	100 – 150 ml/g  at a time

What are the nutrient value of cow’s and buffalo’s milk in comparison to breast milk?

Nutrients (gm)	Human Milk	Cow’s Milk	Buffalo’s Milk
Carbohydrates	6.8	5.0	4.5
Protein	1.5	3.5	4.3
Fat	4.0	3.5	7.5
Energy	68	66	103

What are the different types of Indian foods that can be used in weaning?

Food varies from region to region in Indian, homemade food in right consistency can be given.

Age	Food
From 6-7 months	Introduce (along with BF) 1.       Fresh milk à  200-250ml/day 2.       Mashed banana/custard à 1/4 – 1/2 3.       Powdered murmura/riceflakes in milk+sugar+fat à 1/4- 1/2 katori 4.       Khichri (Liquid consistency) Washed moong dal + rice + fat  à1/4 – ½ katori 5.       Biscuit/ bread/Suji in milk+sugar+fat à 1/4 – 1/2 cup 6.       Boiled mashed potato/ halwa
From 8-9 months	Continue breast feeds 1.       Fresh milk (includes curd)à250-400 ml/day 2.       Banana OR any other seasonal fruità3/4 – 1 3.       Suji/sago/Dalia in milk +sugar+fat à1/2 – 1 katori 4.       Khichri (semisolid consistency) dal + rice + fat OR rice-dal à1/2 – 1  katori 5.       Biscuit/ bread in milk +sugar+fat à1/2 – 1cup 6.       Potato+  vegetableà1/2 – 1 cup
From 10 – 12 months	Continue breast feeds 1.       Fresh milk (includes curd)à400 – 500 ml/day 2.       Banana OR any other seasonal fruit à1 or more 3.       Suji/sago/Dalia/sevian in milk +sugar+fat (Thick)à1 katori or more 4.       Khichri (semisolid consistency) dal + rice + fat  OR rice-dal à1katori or more 5.       Biscuit/ bread/chapati/ paratha (by 1 year)à1 cup or more 6.       Potato + any other vegetableà        as desired 7.       Curd/ paneer/ groundnut/Eggàas desired

What are the points to remember during weaning?

1. Develop the baby’s taste buds gradually.
2. Prefer easy to digest & viscostable food
3. Always try to maintain a well-balanced diet
4. Choose food which is easy to prepare & affordable
5. Strictly follow hygienic – boil the katori-spoon before each feed
6. Maintain a lot of patience in feeding
7. In terms of availability of food items, nothing is hard and fast, can try different food items
8. Take in mind Likes and dislikes of the child – nothing is a must. Allow your child to dislike certain foods.
9. No restriction on the volume – nothing is too much for the child, unless the child is full and tries to regurgitates
10. Introduce one food at a time
11. Artificial milk formulas/ commercial formulas – not recommended and to be used only in certain unavoidable circumstances

What are the precautions to be taken before each feed?

1. Wash hands before preparing baby’s feed
2. Boil drinking water for 5 minutes or milk. Leave it till it’s lukewarm.
3. Use only clean boiled utensils
4. Use prepared feed within half an hour
5. Discard unused feed

Always remember: After the initial phase of hard work by the mother, there will be no need of forcing, coaxing, fussing or running after the child to eat food.  It will be very natural for him to eat at all meal times and adequately.

I will be following this post with another article on Weaning & Recipes based on my experiences in weaning by twin daughters.

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