Introducing Complementary Foods to Your Breastfed Baby

LLA ECHE L EAGUE 957 North Plum Grove Road • Schaumburg IL 60173 USA INTERNATIONAL 847.519.7730•• Fax 847.969.0460 800-LALECHE

Introducing Complementary Foods to your breastfed baby

According to recommendations Feeding complementary foods to your rash, runny nose, or sore bottom. from the World Health baby before she is ready is typically If you see any of these signs, wait a Organization (WHO), the Indian messy and inefficient as she will week and try the food again. If you Academy of Pediatrics (IAP), naturally push the food out with her get the same reaction, hold off until National Institute of Nutrition tongue as long as the tongue-trust your baby is a year old and try again. (NIN), and the Breastfeeding reflex is functioning. By waiting for her • If your baby does not seem to like a Promotion Network of India to be developmentally ready, she new food, offer it again at another (BPNI), human milk is the only becomes an active participant in time. It may take a few times before food that healthy, full-term eating, rather than merely a passive he learns to enjoy a new flavor. babies need for about the first six recipient. This helps to put her in months of life. charge of how much she eats, teaching • As with your milk, allow baby to control the amount he eats, and stop The composition of human milk her important fullness cues. when he is done. Offering “finger changes in response to a variety of Starting solid foods before your baby is foods” allows your baby to do this. cues, so that each mother provides ready will not increase his sleep at milk that meets her own baby's night, is not necessary for larger babies, • Remember that playing with food is unique needs. Human milk and does not initially increase calories. part of learning. Your baby may make a mess and enjoy it thoroughly! provides immunity factors for as Introducing Complementary long as the baby nurses, and many Foods • Do not leave your baby alone while of the health benefits of breast he is eating. Do not offer him solid Learning to eat solid foods is a new skill feeding continue well into food while he is lying on his back. for babies. It will be awhile before your childhood and beyond. baby needs significant calories or Ideal Foods to Offer Signs of Readiness nutrients from foods other than your The Womanly Art of Breastfeeding, a La As your baby will signal that she is ready milk, so consider these first “meals” as Leche League International book, to nurse or is feeling full, she will also sensory experiments. Try to keep the suggests offering complementary signal her readiness for ingesting “lessons” pleasant and relaxed for you foods in the following order, waiting a complementary foods. and your baby. week between the introductions of any Indications include: • Your milk is still the most nutritious new foods: • Baby is about six months old. food your baby will need, so • Soft, seasonal, mild-tasting fruits: breastfeed him first and then offer ripe banana, chickoo, papaya, • Baby is able to sit, with minimal solid food. He will have received the stewed or boiled apple. These can be support. benefit of his mother's milk, and grated, mashed or chopped so that • Baby has lost his tongue-thrust will be ready to learn a new skill. the baby can feed himself safely. reflex, meaning that he does not Hungry babies may not be eager to Citrus fruits can also be offered push foods out of his mouth with his cooperate in new ventures. peeled and chopped. (These are tongue when they are offered. • Offer small amounts of food. Your excellent sources of Vitamin C. • Baby can pick things up between baby is learning to eat and enjoy new However, consider avoiding if there is his finger and thumb. textures, rather than having a full a family history of allergies). You The Benefits of Waiting Until You meal. could give your baby tender coconut meat / pulp (malai). See the Signs • Offer food when the baby is in Most solid foods are lower in calories the mood to learn. This could be • Soft, mild-tasting cooked vegetables: than human milk, of lower nutritional during a quiet time, or it could be at a Sweet potato or carrot cooked, value, and can be difficult for young social time when the rest of the grated, and mashed. babies to digest. Many foods can cause family is also eating. • Whole grain breads and cereals: roti unpleasant reactions and even trigger • Introduce new foods a week apart. or chapatti (wheat, raagi/nachani, allergies in babies with a predisposition This way, a reaction to a p articular jowar, or brown rice flour), khichdi to them if introduced before food can be tracked. Some signs of a cooked with brown rice, semolina completion of six months of age (Greer possible allergic reaction include a (sooji/rawa), bulgar wheat, or laapsi et al. 2008). with moongdal (lentils).

© October 2009, La Leche League International This informational sheet may not be reproduced in any manner for more information: Adapted and translated by Kavita Mukhi, Manisha Gogri, Sonali Shivlani, without written permission from La Leche League International. www.llli.org Anna Coelho and Effath Yasmin from the LLLI pamphlet # 10156-HI-IN LLA ECHE L EAGUE 957 North Plum Grove Road • Schaumburg IL 60173 USA INTERNATIONAL 847.519.7730•• Fax 847.969.0460 800-LALECHE

Adding solid foods is the first step toward weaning, though breastfeeding may continue for months or years after introducing solids. Adding solid foods to your baby's diet: • Replaces your milk with another food. • Impacts your milk supply. • May hasten the return of your menstrual cycle and fertility.

You can use ghee or expressed breast example, stay away from adding salt new. As long as your baby is offered milk to soften khichdi/roti for desired or sugar to baby food for the first nourishing whole foods, her appetite consistency. Porridge with semolina year, however, mild spices can be can be the guide as to what she wants (sooji/rawa) can be offered to your used as there provide essential to eat and when she wants to eat it. baby for breastfast. micronutrients). Avoid force feeding. • Protein-rich foods (meat or beans) Baby food need not be prepared cooked until tender and offered in separately simply remove fully cooked small pieces when your baby is nine ingredients before seasoning when or ten months of age. You can also making soups, stews, and similar introduce egg yolk of a hard-boiled dishes. Foods can and should be egg (boiled for 20 to 25 minutes). appropriate to your home and culture • Oils: Indian Clarified butter (Ghee) or such as idlis, dhoklas, iddiyappam, other cold pressed oils can be added appam and the like made from brown in small quantities during rice or par-boiled rice. Offer semi-solids preparation of khichdi or roti. (mashed) and well cooked food to your Amixture of rice bran oil and baby. groundnut oil is a good example. Sweeteners of any kind are not • Yogurt, natural cheese, and cottage necessary for a healthy diet, and most cheese can all be offered when the are highly processed. Avoid baby is nine or ten months of age introducing them for as long as possible. Jaggery, rich in iron content (consider avoiding if there is a family Resources history of dairy allergies). can be used instead of sugar. When the baby is one year of age, rock salt could • Whole milk can be offered after one be added to food instead of salt. AAP statement, 2005: www.aap.org year of age. However, breast milk is re APHA Statement, 2007: www.apha.org commended until at least two years Good nutrition means eating a well- balanced and varied diet of foods in as Greer, F.R., Sicherer, S.H., Burks, A. W.; American of age. Also whole milk should not Academy of Pediatrics Committee on Nutrition; close to their natural state as possible. replace semi-solid food. American Academy of Pediatrics Section on Allergy This is as true for infants as it is for • Honey is not recommended until and Immunology. Effects of early nutritional inter- anyone else. your baby is at least one to two years ventions on the development of atopic disease in of age because of the risk of botulism Many commercial baby foods have infants and children: the role of maternal dietary added sweeteners, spices, thickeners, restriction, breastfeeding, timing of introduction of poisoning caused by spores of complementary foods, and hydrolyzed formulas. Clostridium botulinum that can be and even artificial colors. If commercial Pediatrics 2008 Jan; 121(1):183-91. found in honey. foods are offered, read ingredient lists carefully. This is also a good time to WHO policy statement, 2003: www.who.int • Traditionally, many pediatricians consider wholesome family food and The Womanly Art of Breastfeeding. Schaumburg, IL: have recommended not giving keep away from refined ingredients La Leche League International, 2004. infants eggs (Egg white), fish, such as refined flour and white rice. Promoting Complementary Feeding Practices; peanuts, or any nuts in the first year Organic food could be considered for Compiled and additional research provided, by Gopi N of life. However, these can be Ghosh, Shavika Gupta & Meghendra Banerjee - Cross the whole family. included in the baby's diet during posted with MC Health Community; 2005 first year of life if no family history of The process of starting complementary Child Care, Dr Prashant Gangal, Mother Support allergy such as asthma or eczema is foods may take 3 to 6 months starting Group Co-ordinator, BPNI, Maharastra; 2007 known. Ensure nuts are offered from when baby has completed six pounded and fish free of bones months until the baby turns one year. La Leche League Leaders are accredited before offering the baby. Once your baby is eating a variety of volunteers who are available to help with Allow your baby to explore the taste foods without any signs of allergy or breastfeeding questions in person, over the of new foods without added spices, distress, there is less concern about phone, or online. Locate an LLL Leader near flavorings, or enhancements (for mixing foods or introducing something you at www.llli.org.