Starting Solid Food Beyond 6 Months

PRISMA 2015
Workshop:
Exploring Food for Babies
Beyond 6 Months Old
Wong Hui Juan (Jess)
Nutritionist, IBCLC
18/8/2015 Wong Hui Juan, Jess, Starting Solid 1

OUTLINE
• Theory
• Q&A Session
• Food Display
• To have a better understanding about complementary feeding.
• To know why, how and what to do when starting solid.
OBJECTIVE

Off to A Solid Start
• Complementary feeding: What is it?
Feeding your child, foods in addition to milk
• Start at six month or older
• Why complementary feeding should not start before six month?
• What about milk after 6 months?
• Breastfeeding – still great for your baby

What is your baby first solid food?

Possible relationships between intake of energy
from complementary foods and breastmilk

Maintenance of Breastfeeding
• Breastfed children at 12-23 months of age whose intake is similar to
the “average” amount of breast milk consumed at that age (about
550 g/d in developing countries; WHO/UNICEF, 1998) receive 35-40%
of total energy needs from breast milk (Dewey and Brown, 2002).
• Because it has a relatively high fat content compared to most
complementary foods, breast milk is a key source of energy and
essential fatty acids. Its fat content maybe critical for utilization of
pro-vitamin A carotenoids in predominantly plant-based diets.

ENERGY

Energy Requirement According to Age
From 6 months onwards, breastmilk alone cannot provide all the energy baby needs.
9
Age Total energy
requirement
(kcal/day)
Energy from milk
intake
(kcal/day)
Energy from food other
than milk
(kcal/day)
6 to 8 months 615 413 200
9 to 11 months 686 379 300
1 to 3 years old 945 346 500 hingga 600
4 to 6 years old 1315 300 900 hingga 1000
18/8/2015 Wong Hui Juan, Jess, Starting Solid

Iron

Five Golden Rules
• Start from 6 months onward
• Give enough food to meet his energy needs
• Give a variety of nutrient-rich foods for his growth & development
• Increase the frequency of your baby’s feeding according to his age
• Vary food preparation methods as your baby grows older

Signs that your baby is ready
• Can control his tongue and neck movement better.
• Start to make up-and-down munching movements.
• Can sit up with minimal support.
• Likes to put things into his mouth.
• Show interest in what you are eating.

Tips
• Start with just a few teaspoons and increase the amount slowly.
• If your baby is not too keen to try new food, try adding express breast
milk to baby food. This will help baby get used to the taste.
• Can I add salt?
• Can I add sugar?
• Can I add oil?

Food Texture
Baby Led according to their neurology system development
(rooting reflex, tongue thrust reflex, suck-swallow pattern, gag reflex dan bite reflex).
14
Age Food Texture
6 to 8 months Liquid, puree, blended, mashed & soft food.
9 to 11 months Chopped, diced & nutritious finger food.
12 months & above Family Food

Tips to prevent baby from choking
• Always supervise baby when he is enjoying his finger
food.
• Vegetables like carrots, celery can be cooked until soft.
• Remove all bones from fish properly
• Avoid giving :-
• Small, hard food such as candies & nuts
• Soft and sticky foods such as peanut butter

Amount of Food
Increase the amount gradually as your baby grow.
16
Age Amount of food
6 to 8 months ½ cup of porridge.
9 to 11 months 1 cup of porridge.
1 to 3 years old ½ cup of rice.

When to feed?
Feeding and eating should be enjoyable.
Increase the frequency of feeding gradually.
17
Age Breakfast Lunch Dinner
6 months and below Breastfeeding on demand (BF)
6 months and
above (1st week)
Starting solid BF BF
2nd week Starting solid Starting solid BF
3rd week Starting solid Starting solid Starting solid

Tips
• It is common for your baby to eat only a small amount of food (such
as one teaspoon) when you first begin to complementary feed.
• This is normal especially in the first week.
• DON’T Force feed.
• Your baby’s appetite will grow as time pass

When to feed?
19
Age Main meals Snack
6 to 8 months 2 to 3 times
1 to 2 times9 to 11 months 3 to 4 times
1 to 3 years old 4 to 5 times

Nutrients & Food Sources

The Art of Feeding
• As you feed, smile & talk to your baby. He will be encourage to
try out new food by your soothing voice.
• Inculcate healthy eating habits in your baby – Vegetables & Fruits
• Make mealtimes fun. Pretend the spoon is an aeroplane flying to
deliver food to baby’s mouth.
• Use attractive serving plates, bowl and cutlery to stimulate baby’s
interest in food as well as encourage them to self-feed.
• The joy of eating together.

Food Allergy
• If your family has a history of food allergy, introduce new food to your
baby gradually.
• One food at a time.
• Some signs of possible food allergy:-
• Severe skin rash after a meal
• Vomits most of the food recently eaten
• Produce loose and very watery stools
CONSULT YOUR DOCTOR AT ONCE IF YOU HAVE WORRY OR
DOUBT.

Why Won’t Your Baby Eat?
Possible reason What you can do
Your baby is simply not hungry. Avoid giving snacks or milk to your baby
too near to the meal times. Opt for at
least 1 to 2 hours before meals.
Your baby is distracted. Minimise mealtime distractions (e.g:
switching off TV or putting away baby’s
toys).
Your baby is too tired. Perhaps he had a long & tiring day/
missed a nap. Let him have his nap.
Regular nap times can minimise this
problem.
Your baby is feeling unwell. Check for signs of possible illness (e.g:
high temperature) and consult your
doctor.

When your baby is ill
• Keep breastfeeding often.
• Give more water and other fluids.
• Offer his favourite food.
• Choose soft food for easier digestion.
• After baby recover, let him eat more frequently, give a little more food
each time. This will make up for the nutrients and weight he had lost
during his illness.

Is Your Baby Full?
• Since your baby can’t speak, he communicates with you using sounds
and gestures.
• Knowing these cues will help you determine whether your baby has
eaten enough:-
• Closing mouth as spoon approaches
• Show signs of wanting to leave the table or chair.
• Becomes distracted by his surrounding.

Is Your Baby Eating Enough?
• Many parents are worried that their baby may not be eating
enough.
• Every baby eats and grow at his own rate.
• The best way to be sure is to monitor his growth rate.
• You can consult your health care professional if:-
• Baby’s weight is not within the normal range.
• Notice a sudden weight gain or weight loss drastically.
• There is no increase in weight over period of two to three months

Obese
Overweight
Normal
Wasted
Severe wasted
Risk of overweight

Working with caregivers
• With both parents working full time becoming increasingly common,
more babies are cared by:-
• Maids
• Grandparents
• Baby sitters
• Discuss early about how to feed.
• Help them understand your decision better.
• Play your part in ensuring that baby is feeding well by providing the
ingredients needed to prepare baby’s food.
• Let them know if your baby has allergy or special dietary
consideration.

Cooking for Your Baby
• Home-cooked or commercial baby foods?

Home-cooked is better
• Your know exactly what you are feeding your baby.
• You can introduce a wide variety foods with different tastes and
textures to baby.
• You baby gets to taste local and natural flavours of food.
• It is usually cheaper to prepare food at home.
• Home-cooked complementary food makes it easier for him to get
used to eating family food when he grows older.
• You can control the safety and cleanliness.
• No added sugar, preservatives and food additives.

Storing and keeping baby’s food

Storing and keeping baby’s food
• Clean the ice cube tray with warm soapy water.
• Pour the puree into the ice cube tray.
• Cover the tray with plastic wrap.
• Place the tray in freezer.
• If you run out of space in the ice cube tray, pop out the cubes and
keep them in bag.
• To thaw the “baby food cubes” place the required number of cubes in
a small bowl and place this bowl in a bigger bowl containing hot
water. Cubes will be thawed in 10 – 20 minutes.
• Avoid cross contamination with raw food.
• Do not feed directly from the container and discard any left over that
has baby’s saliva.

Accessories

Food Display

18/8/2015 40Wong Hui Juan, Jess, Starting Solid

REFERENCES & ACKNOWLEDGEMENT
• Complementary Feeding of Young Children in Developing Countries: A
Review of Current Scientific Knowledge, WHO/ NUT/ 98.1.
• Baby’s First Bites, Complementary Feeding with Confidence, Nutrition
Society of Malaysia.
• Nutritionists’ Choice Cookbook, Vol.1, Nutrition Society of Malaysia.
• Garis Panduan Perancangan Menu di TASKA, Bahagian Pemakanan,
KKM.
• Panduan Pemakanan Kanak-kanak Berkeperluan Khas (untuk ibu bapa
dan penjaga), Bahagian Pemakanan, KKM.
• Modul Latihan Pemakanan Bayi dan Kanak-kanak, Bahagian
Pemakanan, KKM.

Starting Solid Food Beyond 6 Months

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