When breast is not enough, the right complementary foods are important

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Global food price hikes threaten child health.(Photo: Freepik)


Global food price hikes may push parents to introduce cheaper meal options like maize meal, but they might incur longer costs, such as stunting because of poor nutrient intake. 

South Africa is not immune: recent reports from the Eastern Cape report more than 100 cases of acute malnutrition this year, with even a report of a mother feeding her child cool drink powder due to a lack of food in the household. 

Malnutrition is widespread. Reports indicate that malnutrition of children aged six to 18 months is growing in many countries and the shortcomings in this age range are difficult to replace later during childhood. The South African Demographic and Health survey reports that only 23% of toddlers aged 6-23 months are fed a diet considered adequate for infants and young children..

Stunting – a result of long-term inadequate nutrition – affects 27%  of infants, particularly between 18 and 23 months. Stunted children are short compared to children in their age. If not addressed in childhood, stunting may result in poor brain development and fewer chances of finishing high school. Stunted children struggle in learning and may drop out at the primary school level and struggle to get formal employment later in life.

It is not just the quantity of food at issue but also the quality

International recommendations are to start introducing complementary feeding at six months. Around that age, breastmilk no longer provides enough nutrition for child growth and development. Therefore, we must ensure that the right food is served. 

From six months,  children need additional energy, vitamin A and iron.  Iron is important for the formation of blood and vitamin A for building the immune system. As breast milk may not be sufficient, the gap can be closed with complementary foods. 

These complementary foods should include cereals, roots and tubers, legumes, nuts and seeds, dairy, meats, eggs, vegetables, and fruits rich in vitamin A. Cereals are made of grains, for example, maize meal, cornflakes, and rice. Roots and tubers refer to sweet potatoes, potatoes. Legumes include the likes beans, peas, and lentils. Nuts such as peanuts, peanuts, macadamia nuts and sunflower seeds. 

Complementary feeding should be started with 2 or 3 teaspoons and be increased gradually. The transition should be made from pureed foods, lumpy foods, finger foods and then chopped family foods until infants are 12 months old. 

The World Health Organization (WHO) recommends that 6-8-month-olds are fed 2 or 3 times a day, and 9-11-months-old fed 3 or 4 times a day, and parents should pay attention to hunger and satiety signals such as eating fingers, getting excited when seeing food, opens mouth when seeing a spoon

 Choosing the right foods is critical

Infants are often fed maizemeal porridge, potatoes and teas, but these foods alone lack Vitamin A, iron, and zinc, which are necessary for growth and strengthening the immune system. Vitamin A can be obtained from carrots, pumpkins and orange sweet potatoes, and iron from green leafy vegetables like spinach, beet leaves, Mopani worms and animal liver. Sources of zinc include seafood, lean meats and eggs, legumes (beans and peas), nuts, seeds, and soy products.  Mopani worms are high in protein.

Yes, it is true that many people are struggling to put food on the table. However, healthy food does not have to be expensive. Many good foods can be grown and bought locally.

If we don’t choose our foods wisely for our children, we’ll pay a high price in future. It is time we recognise the value of complementary feeding and ensure our children grow up strong and healthy. – Health-e News

Solomon Makwela is a dietitian and a lecturer for community nutrition at the University of Limpopo. His research interest is infant feeding and a national assessor for mother-baby-friendly initiatives. He holds a master’s in public health and is currently enrolled for PhD in Public health nutrition.


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