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Policies and Practices Recommended in Feeding Older Infants (More Than 6 Months and Under 1 Year) and Young Children ( 1 to 2 Years) in Indonesia *

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Policies and Practices Recommended in Feeding Older Infants (More Than 6 Months and Under 1 Year) and Young Children ( 1 to 2 Years) in Indonesia * Pa.edtiatri.ca Indonesiana. 14 : 185- 188. Nov.- Dec. 1974. 185 From the Depar.tmewt of ChiZd Health, Medical School University of Indonesia, Jakarta Policies and Practices Recommended in Feeding Older Infants (more than 6 months and under 1 year) and Young Children ( 1 to 2 years) in Indonesia * by R. SUTEDJO In general breast mi!lk production By the age of 4-5 months one time starts biologically to decrease by breast feeding rut 9 o'clock is discar­ the infant's age of approx;imately 5 ded ail1d repaaced by the first sollid months, so thrut supplementary fee­ food, i.e. a pornidge consilstnig of 150 ding becomes necessary by that age. ml cow's miJk, 10 gm rice fllour and In fact, at the ;age of 2 months sup­ 10 gnu of cane sugar. plementation can already be started Thi•s cooked porridge contain 5 gm once or twice dai.ly in the form of a protein (86% anima1l and 14% vege­ h~scuit (20 gm) soaked .in milk or table), 210 IU viitami:n A, v.it B 1 and tea or in the form of fruiits either C but also minerals in. t he form of banana (50 gm), papaya (50 gm) or 136 mg Ca, €4 mg phosphorus and orange juice (50 gm). 0.3 mg iron and. provides approxima­ This supplement provides approxima­ tely 165 calories. tely 3 gm of protein, 150 Calories The time scheduJe at this age -beco­ and smal~ amounts of vitamins A, mes as fo.Mows: B1 and C. 6 o'cJock breast feeding N eXlt to those •additional proteins, 9 milk - flour - sugar calories and vitamins, although small porridge in amounts, the benefdlt of this early 11 bi•scuit or fruits supplementation is that the infant 1 breast feeding starts aJ:ready to be trained in eating. 4 breast feeding Bi!scuh or fruits are given at 11 7 breast feeding o'clock in lthe morning. 10 breast feeding "' Inv.ited Paper Seminar - Prote.~n Calorie Advisory Group United Nations, Singa ­ pore, 25- 26- 27 November 1974. 186 R. SUTEDJO Eventually, a second biscuit or fruits small but suf£icient amounts of v~­ can be added at 5-6 o'clock in the tamin B1 and C, ·and 57 mg CaJcium, afternoon if requdlred by the infant. 165 mg phosporu.s and 3.7 mg of iron Instead of 11k:e, other kinds of flour as minerals. can be used e.g. soyabe8Jn, quake!' At the age of 6-7 months another oats, corn f.lour •as to make the fla­ second "nasi tim" repLaces the I vour every day different so that tthe o'clock breast feeddlng, so tthat the infant does not gett bored. regimen becomes as foLlows: At the age of 5 to 6 months another 6 o'clock breast breast feeding, preferably of the 7 9 porridge o'clock in the evening, can be discar­ 11 fru.iJts or biscuit ded and rep3Jaced by a soMd food 1 nasi tim which at this time is more complex 4 breast than the first one. 7 nasi tim It is made of 50 gm rice grain, vege­ 10 breasrt tables in the form of either 10 gm This reg.1men remains untdll the in­ spinach, 10 gm tomato or 20 gm of fant reaches the age of 9-10 months, carrots. AnimailJ proteins are ooded i.e. the time of totall weaning. At this in the form of either one egg, chicken 8Jge the "nasi tim" needs not to be li'Ver, finely sliced meat, chicken, or meved any more. Properly so:ftt coo­ f,ish. Vegetable protems of high ked rice :is usually :tolerated. quality, e.g. soya bean ourd ("tahu or "taufu") or fermented ,bean cake Total weaning .is then started. We­ ("tempeh") can al:so be used. aming ·actually .starts already step by Once again vadaJti.on of tthe ingredi­ step from the age of 5-6 months when 6 times breast feeding are re­ ents i·s necessary as to make the duced gradual~y to only 3 times. infant not Joose his appetite. Additional ketchup, bouiUon or 01ther At the age . of 10 months the first kinds of sauce can be ooded tto make breast feeding to be discarded and the whole dish as palaJtablle as pos­ rep[aced by milk (150 ml) is that sible. Such a dish is calQed "nasi tim" of 4 o'clock in the· afternoon, follow­ (nasdl =cooked rice, tim= sof.t pre­ ed subsequently by the early morning pared). As a matter of fact, the and £mally by the last night breast proper way of preparation is "au feeding. b8Jin marie". lit should be si-eved prior In doing so :i!t is expected thatt we­ to be given by spoon to the infant. aning procedure can be smoothly It contruitns approximately 8 gm of carried out and unnoticed by the protem, 150 calories, 8960 IU vit. A, l!nfan:t. RECOMMENDED FEEDING 187 Imported instant soillid Want foods mi•lk gradual[y decreases with the pre•pared on the western way are age of the chhld and the ignorant availl:able .in lthe Indonesian market. mother mighit think that her sole However, substitutes of the "nasi breast milk 'is sufficient enoogh to tilm" are not acceptable to the Indo­ rear her child. nesian infarut. On the contrary, sub­ The above mentioned regtimen could stilbute of the 9 o'clock porridge is be maintained tillil the chi[(! reaches very much lliked by infants of poor the age of 1 year and over with the as welJ. as r.~ch people. understanding that the first solid Loca1ly made porridge as a dry pow­ food could then be considered as der in /tins named SNM (S = susu breakfast and could be varied with or skim milk, N = n:asi or rice flour, cake made of peanuts, soya beans or M = minyak or a combination of a other legumes, bread, toa:st etc. The f1pray dried coconut fu"'l:d peanut oil) first and second "nasi tim" wiM then is also avai1!able against much Jower become the l!llnch and dinner respec­ prl•ce and ds aJ:so acceP'table to the tively of which the soft cooked rice Indonesian infant. might be replaced-by plain rice as consumed by the rest of the mem­ Locailly made substitutes of "nasi bers of the family. In fact the child t im" are however not yet ava.Uable. starts to share the menu of the fa­ If the paren1ts can afforo to buy miilk mily wdlth the exception of hot dishes. and provide rt:he infaJ!llt with properly prepared solid foods, total wearuing As meil!tioned before, breakfast could a1t the age of 10 months wi11 not give be ma.de variablle, bu't in most fami­ any hazard. lies ilt consists of cooked rice plus vegetable SOUJ) with a piece of meat, If by occasion production of breast­ fish, egg, Jiver or soya bean cake. milk .is •stiil[ a.dequate enough rut the infant's age of 10 months, prolonged Even the family lunch and dinner breast feeding cam: certainTy be advi­ consist of the same ingredients. sed. The role of the breastmillk must However, it is Uip to the m01ther to then be a supplemenltary one. This change the :ffiavour every day and for poilicy should actually be adopted every occasion. from the moment when 3 times solid After Junch or dinner usually a des­ food are a.lready introduced, 'i.e. from sert is served in the form of fruits the age of 6-7 months on. of the season provtiding additiona.l calories and vitamins. We are not of the opim.ion to encoor­ age breast feedd!ng -as [•ong as possi­ The richer the fa.m:ill,>y the more ble for the followin.g reasons. In amount and varierties of proteins are general the amount of the breast served on the tabl:e. J .J 188 R. SUTEDJO For the ehiad the milk could be con­ loping coUIIlJtries where the buying tumed as .a drink. The times to be power is minima.! and where milk given are not necessarily strict and drf.Jnking is unfamiLiar since centu­ rixed. Half a liter per day given bit ries .. by bit in between the meals is suffJ'­ It is however undeniable that non elient. It ,is certainly undeniable tthat m'[k drinking nations exist which half a iliter . of · millk per day adds are able Ito achieve socio-economicaJ, considerable amount of complete pro­ technologtieaJ and herulth progress as teins to lthe menu of the chii•ld in equal as mink drinking nat,ions. order to obtain optimal growth pro­ It is therefore suggested that in de­ vided that the !Parents couM afford veloping ·countries priority should be to buy every day half a liter milk given to intemslil£ication of producti­ for a length of period. on of fish, meaJt, poultry, legume·s as The ques:tilion remains SltilJl unsolved to meet Jt:he need of proteins for 1the whether supplementary mhlk shou!Jtd poplli.·ation which I think can never be strongly advised to chlldren of be entirely met by milk and it's older lthan 1 year especial~y ,in deve- products. L ' L .
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