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Malnutrition - Healthy Food options for Weaning

By Fisayomi Aturamu.

This article on 'Addressing Malnutrition' looks at healthy food options for weaning babies.

Anna is the mother of a beautiful 7-month old girl, Ada.

She resumed work a month ago, after 6 months of maternity leave.

She had started weaning Ada, at about the same time.

However, she’s been worried sick because Ada has not really been interested in some of the baby foods she had used on the recommendation of her friends and seemed to prefer breast milk mainly.

She also worried that Ada was not gaining weight despite the reassurance she got from her last visit to the pediatrician.

The doctor had told her it was normal for babies to reject new foods at times and advised her to be patient.

A lot of mothers are in Anna’s shoes and a common question that they have is how to make their babies interested in the new foods during weaning.

Weaning is a very significant period in the growth and development of an infant because if not done right, it may result in malnutrition.


What is Malnutrition?

Malnutrition literally means ‘bad nutrition’ and can refer to undernutrition – not enough nutrients; or overnutrition – excess nutrients. [1]

It usually occurs due to an imbalance in the quality or quantity of nutrient intake, absorption or utilization. [2]  

About 45% of deaths in children below the age of 5 is due to malnutrition from insufficient protein, energy and micronutrients.

This causes stunted growth and deprivation of essential vitamins and minerals eventually making them more susceptible to diseases. [3]

Although undernutrition is the most common form of malnutrition, overnutrition (obesity) is on the rise globally.

According to UNICEF, in 2016, about 41 million children were overweight or obese while 155 million children were chronically undernourished.

Many developing countries including Nigeria now face a rise in childhood obesity. [3], [4]

To learn more about global activities in managing Nutrition, visit the Scaling Up Nutrition platform.


What is Weaning?

The WHO recommends breastfeed exclusively for at least 6 months [5] after which complementary foods may be introduced to the infant.

Weaning is the transitional process from exclusive milk feeding either breast or formula to the consumption of family food.[SK2] 

The process of weaning is very crucial and if the complementary foods are not adequate in terms of nutrients it may result in malnutrition.

This is because, at six months, infants have greater nutritional needs e.g. iron, that cannot be satisfied by breast milk alone. [7]

Next, at six months, infants have better control over their heads and neck making it easier for them to swallow foods.

At this stage, the digestive tract is better developed and able to tolerate solid food. [7]


Tips to Ensure a Smooth Weaning Process

Your baby’s first foods should be simple and easily digested like smooth purees.

They can be mixed with breast milk or formula milk at first and gradually thickened overtime to resemble small lumps as the transition to adult food is made. [5]

Ideally, you should start with purees and mashed food, and gradually proceed to minced and chopped food.

At 8 months, finger foods can be added and by 12 months, your infant’s menu should contain a variety of family meals. [7]

Bear in mind that this process requires patience and persistence as a new meal can be initially refused; but repeated attempts increases the likelihood of consumption.

This is especially seen when introducing vegetables. A study showed that a new vegetable may be refused up to 8 times. [6]  

Remember to make sure that the texture of the meal is such that it cannot be inhaled or choked on. [7]

To achieve a desired texture, you could mash the meals with a fork, blend in a food processor.


Examples of Healthy Baby Food Options

There are various infant baby cereals available for sale that can be easily prepared by mixing with either breastmilk or infant formula.

However, they can be expensive, therefore the following options can be considered as alternatives:

Oatmeal porridge – this can be prepared by blending the oats into powdered form first, heat some water and prepare. Allow it to cool down before serving. You can add some infant milk or breastmilk as well as mashed bananas.

Mashed yams/potatoes/rice/pasta/plantain served with pureed fish, meat or chicken

Mashed yams/potatoes/rice/pasta/plantain served with mashed lentils, green peas or beans. Soak the lentils or beans for a while and cook until very soft

Mashed Avocadoes or natural peanut butter with tiny bits of bread. Remove the crust and chewy edges of the bread.

Cook vegetables like carrots or pumpkin allowed to cool for a while and puree. Serve with very soft pasta/rice/plantain and pureed fish, meat or chicken.

Mashed potatoes/yams and scrambled eggs/cooked eggs.

Semolina/cornmeal porridge served with infant formula and soft fruits like mangos, pawpaw or bananas.

Apple and couscous porridge.

Cook the apples till tender. Add the couscous and stir the mixture. Turn off heat and leave for about 10 minutes. Blend in a food processor. You can serve with mashed bananas and infant formula or breastmilk. [8] You can always tweak the recipe by replacing the apples with vegetables of your choice or use rice instead of couscous.

Pureed potatoes and vegetables. Dice the potatoes and vegetables of your choice. Cook and mash together or blend afterwards. [9] You can also use plantain, or yams.

Nigerian swallow foods (semolina, garri, pounded yam, plantain flour, wheatflour, etc.) can be made into tiny lumps and taken with local soups like ogbono and ewedu soups as long as they are not spicy or contain large bits of meat or fish that can be easily choked on.

You can make porridge with the regular millet/corn usually used to make pap but fortified with soya beans, natural peanut butter, pureed fish/cray fish, etc. Some people maybe prefer to mill the ingredients to have a readily available flour to make preparation less tedious.

Yoghurt meals – you can blend apples, puree carrots, or other vegetables and add yoghurt. You can include cooked oatmeal, rice, or couscous. [10]


It is important that the complimentary meals contain essential nutrients, as this is the whole point of weaning: to supplement breast milk.

As much as there are lots of readily available packaged weaning foods in supermarket nationwide, be cautious of what you serve your babies.

A study by the University of Glasgow revealed that most commercially available weaning foods contain less nutrients than homemade foods. [11]

Another study done in Plateau State in Nigeria has shown that locally made fortified cereals can be used for complementary feeding if they are hygienically prepared. [12]


Conclusion

Malnutrition is preventable.

Many households may be poor but knowing what is locally available for nutritious diet for breastfeeding mothers would keep mothers in good health while practicing exclusively breastfeeding for the first 6 months of your baby’s life.

The benefits of exclusive breastfeeding last into later childhood and adulthood.

It gives your child the best start in life and a chance to overcome the impact of household poverty and to transition your baby into solid food that may be locally available.

Do not look too far off into packaged food that may not have enough nutrients and that you may not be able to afford.

Do not try to compare yourself to other households. Remember that it is all about what is best for your own child.

Very often, you can afford the best for your child if you look around you or in your backyard.

Do not let your child get malnourished.

Need some more recipe ideas quickly? Check out our healthy weaning foods infogram.


More Reading

 
References
 
1 Malnutrition in Sub – Saharan Africa: burden, causes and prospects. The PanAfrican Medical Journal, [e-journal] 15(120).       
2 London School of Hygiene and Tropical Medicine, 2009.  
3 UNICEF, 2016. The Faces of Nutrition.  
4 WHO, 2017. The Double Burden of Malnutrition.  
5 WHO, 2019. Breastfeeding.  
6 The Lasting Influences of Early Food-Related Variety Experience
7 National Health and Medical Research Council, 2012. Infant Feeding Guidelines. Canberra: National Health and Medical Research Council. 
8 Deepika, 2016. Apple with couscous. 
9 Baby puree with potato, carrots and courgette. 
10 Top 10 Baby Food Recipes for 8- to 10-Month-Olds. 
11 The Guardian, 2013. 
12 Nutrient Analysis of Indigenous Fortified Baby Weaning Foods from Nigerian Cereals. Nigerian Journal of Biotechenology.   
 13 Prevalence of picky eaters among,Infants and toddlers and their caregivers' decisions about offering a new food. 

Editing By AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practicing Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org


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