Weaning, more scientifically known as complementary feeding, implies to process where solid foods and other liquids, in addition to milk, are introduced to infants in order to meet their growing nutritional requirements. The incorporation of complementary feeding is the first major proactive step in the infant’s life towards “growing up”. It requires a series of neurodevelopmental achievements and it becomes a way of socialisation. While the original World Health Organization (WHO) definition of complementary feeding included infant formula as a complementary food or weaning food, the term now refers to all solid foods and liquids other than breastmilk or infant formula and follow-on formula.
The European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) reviewed the literature on complementary feeding for healthy term infants and recommended that:
• Exclusive breastfeeding for around six months is a desirable goal;
• Complementary feeding should not be introduced before 17 weeks (four months) and not later than 26 weeks (six months);
• Breastfeeding should continue throughout weaning, particularly during the early stages;
• Introducing gluten between four and seven months while breastfeeding may reduce the risk of coeliac disease, type 1 diabetes and wheat allergy.
While it is recommended to avoid high-allergen foods like egg and fish until six months of age, the ESPGHAN review claims that there is no evidence that this delay will reduce the likelihood of allergies. However, WHO recommended that each infant must be managed individually since they grow at different rates.
The weaning food offered to infants must have the following characteristics:
• The food should be rich in calories and adequate in good-quality protein, vitamins, and minerals;
• The food, when stirred with cold or warm water or milk, should form a slurry or semisolid mass of soft consistency, enabling the child to swallow it easily;
• The prepared food should have low dietary bulk;
• The food should be pre-cooked/pre-digested or processed in such a way that it needs minimum preparation prior to feeding and is easily digested by the child;
• The food should be low in indigestible fibre content;
• It is advisable not to add artificial colours and flavours to weaning foods, and the composition of the food must follow the guidelines and standards recommended by competent agencies, like the Bureau of Indian Standards.
According to the guidelines of the Protein Advisory Group, weaning foods should have a protein content of at least 20 percent (on a dry weight basis), a fat content of 10 percent, a moisture content of 5 to 10 percent, and a total ash content of not more than 5 percent.
Changing Nutritional and Developmental Needs
The nutritional needs of infants are highly different from adults. Their weights double in the first six months and triple at the end of the first year, thus exhibiting higher vitamin, mineral and energy requirements. Infants need to consume nutrient-rich and energy-rich foods; therefore, their diet should be high in fat (to provide sufficient energy) and low in fibre (to avoid filling them up at the expense of other nutrients).
During the initial six months, infants fulfil all of their nutritional and energy requirements from breast milk, infant formula and from the birth stores of certain nutrients the infants are born with. After six months of age, these stores can no longer meet the nutritional/energy needs. E.g. iron stores from birth are used up by six months and their iron needs can no longer be met by milk alone. Therefore, introduction of weaning foods alongwith breast milk should be commenced at six months in order to provide extra energy and nutrients to sustain normal growth and optimal health and development; and to give infants the opportunity to learn to like new tastes and textures, based on family foods, at a time when they are receptive to them.
Stages of Introduction of Foods
Breast milk or formula milk continues to be an important part of the infant’s nutritional intake for the first 12 months of life. However, these milk feeds should decrease as the quantity of solid food increases. Complementary feeding usually begins with 1–2 teaspoons of a smooth purée or mashed (first stage – 6 months but not before 4 months) food being offered once a day. Infants who are six months old will progress more rapidly from this stage or bypass it completely, moving on to soft lumps and soft finger foods (second stage – 6 to 9 months). As the infant learns to manage complementary food, tries different textures and begins to take a larger quantity, a second and third meal can be introduced containing hard finger foods (third stage – 9 to 12 months).
Types of Food and Drinks
First Stage Weaning Foods: It includes: puréed foods from vegetables like carrot, potato and parsnip, fruits like banana, cooked apple and pear; lentils; and rice mixed with breast or formula milk.
Second Stage Weaning Foods: It includes: minced meat; fish; and poultry (all three properly cooked and given once a week); mashed lentils; milk products; and pasteurized cow’s milk apart from those counted under the first stage.
Third Stage Weaning Foods: It includes: servings of fruits and vegetables; well-cooked eggs; smooth nut butters; and starchy foods like pasta, bread and breakfast cereals.
From the age of six months, water and diluted fruit juices (one part of juice to 10 parts of water) can be given as part of a meal and offered in a cup. This should be lidded if necessary but free-flowing, to help the infant learn to sip and to reduce the risk of causing dental caries. Drinks between meals should be confined to water or breast or formula milk. Cow’s milk should not be used as a main drink before 12 months but small amounts can be added to foods after six months of age.
For healthy babies and young children, a good mixed diet that includes a variety of foods will provide nearly all the vitamins and minerals they require. These include iron, vitamin C, omega-3 fats and calcium. Vitamin D3 supplement should be given every day until they are one year old. Low-fat milk should not be given to children under two years. Skimmed milk should not be given before five years of age. While variety in your baby’s diet is really important, there is a chance they may be allergic to certain foods. That’s why it’s important to introduce cow’s milk, eggs, wheat, gluten, nuts, peanuts, peanut products, seeds, fish, and shellfish one at a time and not before six months. There is no evidence that waiting until your child is older will prevent them from developing a food allergy. Salt (>1g), sugar (including honey), whole nuts and shellfish should be avoided during complementary feeding to reduce the risks of toxins, food poisoning and tooth decay. The drinks which are not suitable for children under one year of age include: cow’s milk; sheep’s milk; rice milk; tea or coffee, even decaffeinated varieties; fruit juice drinks or fizzy drinks; sports or energy drinks; or dilutable squashes.
Current Trends in Weaning Foods
Both home-made and processed baby foods are suitable as complementary foods. Using home-made foods can introduce more varied tastes and textures and seems to provide an easier transition to family foods. Homemade foods can be cheaper and the parent knows what ingredients are used in the food, but parents and caregivers should be cautioned to avoid adding salt and sugar and using adult convenience foods such as: gravy mixes; instant potato; soups; sauces; and ready meals because of their high salt content.
Processed baby foods are convenient, easy to prepare, and they have to adhere to strict compositional regulations like nutritional content, etc. However, there are chances that an infant fed a diet of commercial foods may be reluctant to change later to home-prepared foods. Today, about 87 percent of global baby food and 66 percent of baby formula value sales come from North America and Europe, but developing markets are still driving growth. The sales have grown over 4 percent in Africa/Middle East, 3.4 percent in Asia-Pacific and 2.6 percent in Latin America.
Weaning foods are available in cans and jars either as homogenous purées for young infants (4-6 months of age), or preparation with larger particle size for older infants (from about 7 months of age). Types of products available include: baby rice cereal; breakfast recipe; and savoury recipes. Breakfast recipes are composed mainly of fruits and cereals. Savoury varieties are composite dishes containing ingredients such as: meats; fish; vegetables; and cereals. Dessert varieties consist of fruits, dairy products and cereals. Available drinks include: pure fruits juices with added vitamin C; and purified water with a hint of fruit flavour.
Demand is Driving Innovation in Weaning Foods
The drivers for innovations in weaning foods include: the changing lifestyles; and urbanisation. Growth in the market is also driven by a rising number of women working outside their homes. Also, the current consumer is highly aware of the requirements of their babies at every stage of growth. Thus, companies are now focussing on the incorporation of human milk oligosaccharides and probiotics in the weaning foods. Human milk oligosaccharides mimic the human milk and probiotics help to maintain the intestinal microbiota of the infant and thus keep the gut healthy. Within the EU, there is legislation governing the composition and labelling of baby foods. Some companies have their own additional nutritional guidelines for weaning foods to ensure that these foods help mothers to provide a varied and nutritionally balanced diet for their babies. Manufacturers need to highlight the safety records on their packages and educate their consumers about the benefits of going organic. Consumers need to believe that the processed weaning food companies also value their child’s health above everything!
* PhD. Scholar, Food Technology, Punjab Agricultural University, Ludhiana;
MSc. Food Technology, CSIR-Central Food Technological Research Institute, Mysore; B.Tech. Dairy Technology, National Dairy Research Institute, Karnal
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