Overall and supporting messages
Facts
Background
 
Overall message -detail 6 months
6-24 months
 
Hygiene
 
Communication summary
 
Further reading
 
20 Questions and Answers
 
References

Questions and Answers for National Nutrition Week 2011

Feeding Smart from the Start.
20 Questions and Answers document.

print full media information           print Questions and Answers

this

Background

This document provides information on Questions and Answers that could be raised during media interviews for NNW 2011. This document may be used in conjunction with the Key Messages document.

The answers can be adapted to suit the target audience; but the overall content should remain consistent with the messages in the documents provided.

Overall message and supporting messages

From six months of age your baby needs breastmilk and solid foods; to promote health, support growth and enhance development. This is called complementary feeding.

General Information

The target group for National Nutrition Week 2011 is parents, grandparents, caregivers and future parents of infants and young children, reached via commercial media.

Messages for health workers, in particular nurses, will be communicated via the Department of Health, and through profession specific publications.

1.     How did National Nutrition Week originate?
2.     What is the theme of Nutrition Week 2011?
3.     What does complementary feeding mean?
4.     How old should a baby be when complementary feeding is started?
5.     Which nutrients are of importance during complementary feeding?
6.     What should mothers and caregivers do to ensure their baby has enough               energy?
7.    
Why is iron critical at this age and what foods should be used to provide               iron?
8.     Why is six months given as the age when complementary feeding should               be started?
9.     What aspects of complementary feeding have an impact on health, growth               and development?
10.   Why is continued breastfeeding emphasised?
11.   When should the consistency of foods be changed from soft to lumpy to               solid?
12.   What could happen to a baby who does not receive enough meals a day?
13.   Should foods for babies have a bland taste?
14.   What drinks can be given to babies during this feeding phase?
15.   What can families do to protect the quality and safety of food for babies?
16.   When can a baby start to drink cow’s milk?
17.   Are there foods that should not be given to babies?
18.   What tips do you have for feeding babies who do not seem interested in               meal times?
19.   What factors guide the recommendations of foods that are included as               suitable for complementary feeding?
20.   Where can we get more information on complementary feeding?   

 

1.     How did National Nutrition Week originate?

National Nutrition Week started in the 1990s when the Department of Health was approached by the Association for Dietetics in South Africa (ADSA). It was agreed that it was important for nutrition messages to be included in the Department of Health Calendar. World Food Day is recognised on the 16th October, and Nutrition Week in the week preceding this.

back to list

2.     What is the theme of Nutrition Week 2011?

The theme for National Nutrition Week 2011 is ‘Feeding smart from the start’. The messages that are being emphasised provide more information on this topic. They are:

From six months of age your baby needs breastmilk and solid foods; to promote          health, support growth and enhance development.
This is called complementary feeding.

back to list

3.      What does complementary feeding mean?

Complementary feeding is the time when babies start to receive soft and then solid foods, in addition to receiving continued feeding with breastmilk. The nutrients in the foods that are recommended complement the nutrients in breastmilk. Together they supply the nutrients needed for the continued growth and development of the baby.

back to list

4.     How old should a baby be when complementary feeding is started?

Complementary feeding is started when a baby is six months old; at this time frequent breastfeeding is continued and foods are introduced. During the next few months the number of foods used, and the amounts are increased, and breast milk feeding continues. When a baby is about 12 months old many of their food requirements can come from family meals, and continued breast milk feeding is recommended. Thus the period of complementary feeding stretches from 6 months to about 24 months, when a child stops breastfeeding and their food intake is based largely on family foods.  However, in a food insecure family breast milk is still a good source of nutrients for the baby.

back to list

5.     Which nutrients are of importance during complementary feeding?

The answer to that is in two parts:

The overall answer is that all nutrients are important. Babies have relatively high metabolic rates and are growing rapidly, so during this time they have proportionately higher needs for nutrients.

The second part of the answer is to highlight the nutrients that are of concern, because babies in South Africa do not always get enough of them. These nutrients are energy and iron.

back to list

6.     What should mothers and caregivers do to ensure their baby has enough         energy?

There are a number of easy to implement actions to achieve the intake goal for energy. Babies have small tummies so cannot take a lot of food at one time. So to achieve energy intake the following actions are important:

back to list

7.     Why is iron critical at this age and what foods should be used to provide         iron?

During pregnancy iron stores are built up in the baby from the mother’s stores and her diet. During breastfeeding some iron is supplied from breastmilk, but the baby also draws from his / her own stores of iron. At six months of age these stores are used up, so the iron must come from breast milk and animal foods.

Some good food sources of iron are liver, meat, egg yolk and mopane worms. Many mothers do not use these foods early in complementary feeding, but they are good choices to supply iron and other important nutrients. They should be well cooked and pureed or minced, and if possible given every day. They can be introduced from the age of six months together with fortified cereals and vegetables.

back to list

8.     Why is six months given as the age when complementary feeding should         be started?

At this age babies have doubled their birth weight, and become more active. Babies who are exclusively breastfed have a lower risk on taking in harmful organisms that may be found in foods. Therefore maximising exclusive breastfeeding prolongs this protection; when the baby is older the immune system is better developed and better able to cope with inadvertent contamination. The age should not be later than this as at this age breastmilk does not supply all the nutrients needed. Developmentally this age is also identified as suitable as infants are able to take semi-solid foods from a spoon and swallow them. The digestive system is mature enough to digest the starch, protein and fat from the solid foods.

back to list

9.     What aspects of complementary feeding have an impact on health, growth         and development?

There are several – one of them is the continued role of breastfeeding. Breastfed babies, in developed and developing countries have less sickness due to respiratory and gastrointestinal illness than do babies who are breastfed only for a short time, or who are not initially exclusively breastfed. Breastfeeding continues to supply health protective substances to the baby from the mother; the baby will not get this protection is he / she does not receive breastmilk.

Another important aspect of complementary feeding is the way in which food is given to the baby, how, when, where and by whom. A child should have his or her own plate or bowl so that you can see how much they have eaten. The utensil used for feeding should be the correct size. The person who is feeding the baby should be able to concentrate on that task, and should interact with the baby during feeding times.

back to list

10.     Why is continued breastfeeding emphasised?

Breast milk continues to supply a large proportion of nutrients to the baby. In addition breastmilk continues to supply protective factors from the mother that help protect against and fight common infectious diseases. This is important as the baby’s immune system is still not fully mature.

back to list

11.      When should the consistency of foods be changed from soft to lumpy to            solid?

Foods that have some lumps can be introduced at about eight months, at this age the baby has developed enough tongue mobility to enable them to chew and swallow these foods. From nine to twelve months babies can start to hold finger foods, and have the manual skills to feed themselves and to drink from a cup.

There is a critical window for introducing lumpy and then solid foods. If they are not introduced at this age it may increase the risk of feeding difficulties later on.

back to list

12.     What could happen to a baby who does not receive enough meals a day?

A baby who is not given enough meals a day, or when the size of meals is too small will have a lower intake of nutrients than needed. This can result as undernutrition which will be seen as a slower increase in growth as indicated on the growth chart, a levelling of growth, or in severe cases a loss of weight. All of these examples are potentially dangerous, and feeding patterns should be corrected as quickly as possible.  It is therefore important that the baby regularly be taken to the clinic to have his/her growth monitored and for other services such as immunisation and vitamin A supplementation.

back to list

13.      Should foods for babies have a bland taste?

There is no need for bland foods. Babies start to learn about different tastes when in the womb, based on foods that their mother is eating. The flavour of breastmilk also changes based on the mothers diet. This gives the baby a chance to learn about flavour, and to enjoy different flavours. These preferences may even track into childhood and adolescence.

It is beneficial to expose babies to different foods tastes during complementary feeding, including many different kinds of vegetables, flavours commonly used in their culture and those eaten by their mother during pregnancy and breastfeeding. Repeated exposure to any foods initially disliked will break down resistance to that food.

There is no need to add sugar or salt as this can set the infant’s threshold for sweet and salty tastes in later life.

back to list

14.     What drinks can be given to babies during this feeding phase?

Breastmilk will supply much of the fluid needed. Other fluids that can be given are clean water (after or between meals) or fruit juice. If fruit juice is used it should be diluted with water, and should only be used occasionally. It must not replace fruit in the diet, as the baby should learn the different textures of different fruits. Drinks should be given from a cup – there is no need for a baby to have a bottle at any stage. 

back to list

15.     What can families do to protect the quality and safety of food for babies?

Contamination of foods is a major cause of diarrhoea, which is very common in babies who are 6 – 12 months old. Safe preparation and use of foods can prevent this.

The people who prepare food for babies, and who feed babies should wash their hands well, with soap and water, before starting with the preparation. This washing should reach all parts of the hand; between the fingers, under the nails and around the thumbs.  Dry the hands with a clean cloth.

All utensils used for cooking and feeding should be very clean. When children are given finger foods to eat their hands should also be thoroughly cleaned.

Bacteria multiply quickly on warm food, and in hot weather. So small amounts of bacteria can multiply to dangerous levels if food is left to stand after it is cooked.

back to list

16.     When can a baby start to drink cow’s milk?

Breastmilk should remain the main source of milk until the baby is at least twelve months old. Pasteurised cow’s milk can be used from six months as part of mixed dishes such as with soft porridge or as a white sauce on pasta. Recommendations on the age of introduction of full cream cow’s milk as the main milk source are given on an individual basis taking into account the normal feeding practices and food availability.

back to list

17.     Are there foods that should not be given to babies?

Babies have a high nutrient need, but if they are given foods with a low nutrient content they will not have space to eat the foods with the nutrients they need. Babies and young children should not be given foods like sweets, sugary drinks, chips, cakes, ice cream, non dairy creamers and artificial sweeteners.

Foods should be clean and freshly prepared. Meat products must be well cooked, so that there is no blood remaining.

It is not a good practice to use leftover foods, or foods that have been cooked and left standing for a long time. These foods have a high risk of having dangerous levels of harmful microorganisms.

Babies should not be given honey, as this may have spores that cause botulism.

back to list

18.     What tips do you have for feeding babies who do not seem interested in           meal times?

Ensure that the baby is being fed in a place free from distractions. The person feeding the baby should concentrate on the baby and interact with him / her during the feeding time.

Whether breastmilk or complementary feeds are given first at a meal has not been shown to matter, the mother can decide based on her convenience and her child’s preference.

If a baby does not accept a new food the mother can mix a bit of a familiar food with it, such as mixing breastmilk into mashed butternut; or butternut into mince meat puree.

Remember that a baby may reject a food the first time they taste it, or may reject the feeling of a food with new texture. But the food should be offered again, as it is usually subsequently accepted.

back to list

19.     What factors guide the recommendations of foods that are included as           suitable for complementary feeding?

The foods that a baby is given at this time must match their stage of development. Their gastrointestinal tract is not fully mature and their muscular co-ordination is developing which influences ability to chew and swallow. Their immune system is also still immature, which means they are more likely to become sick if they eat foods that are contaminated with germs than older children are.

back to list

20.     Where can we get more information on complementary feeding?

Ask a health worker at your clinic, or visit www.nutritionweek.co.za