A Complementary Feeding Guide

Complementary feeding can help supplement the nutritional requirements of infants when breast milk is no longer enough.

Looking For Milk?

Don't be spoilt for choice!

By Professor Dr Norimah A Karim, Nutritionist

Discovering New Tastes

A quick guide on what and how to introduce complementary foods to your baby.

By Associate Professor Dr Poh Bee Koon, Nutritionist

A Baby’s First Solids

Introducing solids for your baby’s first steps to eating the right foods.

During the first six months of his life, breast milk is exclusively all that your baby needs. Complementary feeding, which means giving other foods in addition to breast milk, is a gradual shift that often begins once your baby has reached six months of age. This is actually a fun learning time for babies as they are highly curious and wish to explore, touch and taste everything. Furthermore, babies are even more excited when they get to use their own utensils to feed themselves!

Is it Time to Start Solid Foods?

Generally, the recommended age to start solid foods is around 6 months old. However, age is just one factor; a baby’s motor skills and stage of development is also important in determining his readiness towards solid foods. Your baby should be able to hold his head up as well as lose the “extrusion reflex”, which causes them to push out anything from their mouths but liquids.

Other signs to look out for to ascertain that your baby is ready for solid foods are:

• Being able to sit in a stable manner.
• Placing objects in his mouth.
• Has begun chewing motions.
• Holding the breast or bottle while feeding.

Eating on His Own...

By the time your baby is around 9 months old, he would usually have developed the coordination needed to take food using his forefinger and thumb – pincer grasp. He should already have been introduced to foods such as rice cereal and mashed vegetables or pureed meat. During this time, you can encourage him further by providing finger foods like small pieces of ripe papaya or banana that he can pick up and eat himself. You may also provide him with a baby spoon so he can get used to holding the spoon although not yet actually using it to feed himself.

Here are some tips, that you can use to successfully introduce and encourage your baby to use his utensils:

• Look out for signs. If your baby can pick up food using his forefinger and thumb, he may be ready to start using a spoon. Many children start to show an interest in self-feeding between the age of 9 and 14 months.
• Sticky, sticky, sticky! Keep to semisticky foods such as mashed sweet potato that will stay on the spoon. This encourages the success of your baby’s self-feeding. Foods that easily fall off the spoon may frustrate the baby.
• Praise your baby’s efforts. Build your baby’s confidence by praising his attempts at using the spoon. Use comments like, “That’s a good job of holding the spoon”, which can help encourage your baby’s progress.
• Do not force it. Don’t pressure your baby if he is not ready. Put away the spoon and try again in a few weeks.
• Be a role model. Babies often watch how you use your utensils. Therefore, you should use them in a proper manner and place appropriate amounts of food on it.
• Do not be distressed if he messes up. It is common for a messy mealtime when your baby learns how to feed himself. Put a floor mat or plastic sheet underneath the baby’s high chair to minimise the mess or if you’re concerned about his clothes, use a bib around his neck.

Letting your baby self-feed takes a lot of patience and time. Using utensils such as plates, spoons and cups is a learning process and as your baby grows, his coordination and motor skills will grow along with him. Also, always ensure that your baby is not left unattended while eating in case he chokes. Do not force him to eat and do introduce new foods and textures in small portions. Be patient, be creative and enjoy every moment throughout this process!

Young children, especially those under the age of four, are especially vulnerable to developing food allergy. In fact, as many as 5-8% of children under the age of three may have a food allergy. Some of the usual causes of allergies in children and babies include milk, eggs (especially egg whites), soy, wheat, groundnuts and tree nuts (ie walnuts, cashewnuts), fish and shellfish. Parents need to keep in mind, be aware and keep a close watch for symptoms when starting with complementary feeding as each new food is introduced to the child.

Symptoms that arise from a food allergy are unpleasant and can occur within minutes to two hours after eating or exposure (touch or smell). These may include rashes, wheezing, lip and tongue swelling, sneezing, vomiting and abdominal pain. In worst cases, an anaphylactic attack may occur and can potentially cause death.

The Food Principle

Whether you opt to buy commercially prepared baby food or cook at home, the principle is variety. A good variety of food, the majority of which should still be fresh and home cooked, ensure that your baby gets all the necessary nutrients, vitamins and minerals he needs to grow and develop.

Minimising the Risks

An allergy is caused by an allergen, which can be inhaled, injected, eaten or touched. This triggers the immune system into releasing antibodies known as immunoglobin E, which plays an important role an adverse food reaction due to an immunological mechanism. There are certain precautions that you can take to reduce the risk of your children developing allergies in the early stages of their lives.

• Exclusive breastfeeding for six months. Exclusively breastfeeding your baby until he is six months old will significantly reduce the risk of atopic dermatitis and milk allergy during the first two years of his life. The exact mechanism of the protective effect of breast milk towards allergy is complex and may involve a tendency of the baby’s immune system profile to be non-allergic, for example the formation of immunoglobulin IgG4, rather than IgE.

• Use of hypoallergenic formulas when not breastfeeding. Hypoallergenic formulas consist of milk proteins that have been broken down into smaller proteins. Studies have revealed that these formulas may prevent the development of allergies, especially in children with a high risk of developing allergic diseases.

• Delayed introduction of solid foods. Complementary feeding should start only when baby is six months old, not before or after. At 6 months, babies’ immune system is becoming more tolerant towards food allergens and his digestive system will be able to digest the food. However, bear in mind that you should not delay the introduction of complementary food to later than six months of age for nutritional reasons.

• Introduce new foods one at a time. One new food each week will enable you to trace the type of food to which your child may have a reaction to. Start with the least allergenic food like rice cereals. Highly allergenic foods such as nuts, shellfish and eggs can be introduced after your child turns one year old.

Managing Allergies - Now and Beyond

If you suspect your child of having a food allergy, keep a record of the food he eats and the reactions that may arise from them. It is crucial to diagnose accurately what food allergies your child may have in order to prevent an unnecessarily restricted diet. Do consult your doctor before taking any steps in treating your child.

As children get older and their immune system develops, it is possible that your child may outgrow the allergies that he once had towards certain foods. You may try again with certain foods at a later age, but keep in mind that in some cases, the allergy can last a lifetime.

Commercially prepared baby food is ready-to-eat food made especially for babies between 6 months and 2 years old. From juices to purees, and in a vast variety of tastes, colours and textures, commercially prepared baby food is designed to suit your baby’s early level of eating ability and experience. This may seem as the perfect solution for busy parents, but try not to overload your child with commercially prepared complementary food.

The Food Principle

Whether you opt to buy commercially prepared baby food or cook at home, the principle is variety. A good variety of food, the majority of which should still be fresh and home cooked, ensure that your baby gets all the necessary nutrients, vitamins and minerals he needs to grow and develop.

Read it Right

Many commercially produced baby food claim to have the full range of nutrients your baby needs. Whatever the claim is, do read everything on the label to have a clear understanding of what you are feeding your child. Here are some tips to help you along:

• Avoid products containing sugar, dextrose, sucrose or salt. Such additives, like salt, can damage your baby’s kidneys, as his kidneys are not matured enough.

• If water tops the ingredients list, it means a large part of the product is made up of water. Therefore, it is not as nutritious.

• Always check the expiry date, especially if buying at a discount.

• Check the storage instructions. After opening, commercially prepared baby foods can generally be stored for 24 hours in the fridge and kept in the freezer for up to a month, if not contaminated with baby’s saliva or leftover.

• See if additional information on minerals and vitamins is highlighted.

• If your baby has allergies, check for common food allergens like milk, eggs, fish, wheat, peanuts or soyabean.

Answers:

1. True. Supplementing your child’s exclusive breastfeeding diet with complementary food is essential when he or she is 6 months of age or older. As your child gets older and bigger, he becomes more active. Additionally, this is also a stage where rapid development occurs. Thus, by this age, breast milk alone is not sufficient to fulfill his or her nutritional needs. Complementary food helps to fill the gap between the total nutrition needed by your child and the nutrients provided by breast milk, ensuring that your child will be able to sustain his growth. Remember to continue breastfeeding your child for up to 2 years of age, even after introducing complementary food.

2. False. Starting your child on complementary food early is not a good thing. Firstly, your child may not be physically ready to accept solid or semi-solid food, which increases their chances of choking. Additionally, the complementary food may displace breast milk, leading to insufficient energy and nutrient intake in your child. Lastly, your child runs the risk of developing diarrhoeal diseases and other illnesses as their digestive system may not be fully matured. The World Health Organisation (WHO) recommends complementary feeding to begin when your baby is 6 months old.

3. True. At the early stages of feeding, it is best to feed your child food that is smooth in texture. For example, pureed or strained food. Rice porridge and ready-to-eat-infant-cereals are perfect examples of food that is suitable for a child starting out on complementary food. On the other hand, solid food like chunky fruits will choke him as his oral-motor skills are not fully matured. Gradually change the texture of your child’s food as he grows older.

4. False. Your child is not a picky eater. He may just be having a hard time adjusting to the new texture or taste as he is used to consuming breast milk. Start small by giving him 1-2 teaspoons twice a day. If your child refuses them, do not give up. Try giving him again later and he will eventually accept the new food. As time goes by, gradually increase the amount of food and the variety of food you offer your child. Most importantly, make eating time enjoyable and you will find your child enjoying his food.

5. False. As much as you want your baby to eat “nice-tasting” food, it is best that you do not add salt to his food. Your child’s kidneys are not fully matured and will not be able to process excess salt from their food. In the long run, this can harm his or her kidneys. Children above the age of 1 year may eat food that are lightly seasoned with salt, but at the same time, try not to include too much salt in your child’s diet, whatever their age.

1. He needs a varied diet. A mixture of good complementary foods can provide him with all the nutrients he needs. Give foods that are rich in energy, protein and micronutrients (particularly iron, zinc, calcium, vitamin A, vitamin C and folate).
2. He needs variety in the form of different tastes, colours, shapes and textures. This will keep him interested in his food.

This is true because even small babies get bored with the same food everyday. Don’t worry if he leaves out something new today, he may try it again tomorrow.

What’s a good mixture?
The key to eating well at this age is to make sure that your baby has a wide variety of these foods:

The staple
It is eaten regularly and in such quantities as to constitute the dominant part of your child’s diet and supply a major proportion of energy and nutrient needs. However, a staple food alone does not meet your child’s total nutritional needs. He requires a variety of other foods.

What’s good: Rice porridge, mashed potatoes, pasta, sweet potatoes.

Pulses and oil seeds
These foods are a good source of protein for your child. Oil seeds and some pulses (groundnuts, soybean, etc.) are rich in fat and high in energy.

What’s good: Chick peas, lentils, dhal.

Foods from animal sources
These foods are good sources of protein, iron, zinc and vitamin A. Foods that contain bones (e.g. small fish, canned fish or anchovies) are good sources of calcium.

What’s good: Fish, lean meat, poultry, yoghurt.

Dark green and orange coloured vegetables and fruits
You should encourage your child to eat these foods from young as they are all rich sources of vitamin A, vitamin C, folate and iron. The darker the leaf or stronger the orange colour, the more vitamin A they contain.

What’s good: Spinach, sawi, broccoli, kailan, carrot, mango, sweet potatoes, papaya, orange.

Safe preparation and storage
Complementary foods should be prepared and served in a safe manner to avoid contamination. Practice good hygiene and proper handling. Always wash your hands before preparing food. Use clean utensils to prepare and serve, store foods safely and serve foods immediately after preparation. Expressed breast milk can be stored in a clean container and refrigerated for 24-48 hours; in our climate, it can also be stored for up to 4 – 8 hours without refrigeration.

Amounts
Start complementary feeding with small amounts of food and increase the quantity as baby grows. You can start off by giving 1 or 2 teaspoons twice a day, and gradually increase the amount and variety. By 9 months, your baby can eat several spoonfuls (or about half a cup) of a mixture of family foods at each meal. Breastfeeding should also be continued until two years of age or beyond.

Food Types
Rice porridge and ready-to-eat infant cereals (rice) are usually baby’s first foods. Include meat, poultry, fish or eggs as well as vitamin A and C-rich fruits and vegetables daily.

Baby can eat sieved, pureed or mashed semi-solid foods at 6 months of age. By 8 months, he can eat finger foods (snacks that can be eaten by kids alone) and by 12 months, most children can eat the same types of food as you (but remember that they need nutrientdense food).

Don’t add sugar or salt to baby’s foods, use onion and vegetables to add flavor, keep it simple and not spicy. Keep in mind that food prepared at home is always best for baby (and you!).

pureed vegetables and fruits. Meat, fish or egg white can be introduced after baby is 6-8 months old. Your baby should also be fed vitamin A and vitamin C-rich fruits and vegetables everyday and be provided a diet with adequate fat content. Limit the amount of fruit juices to avoid displacing more nutrient-rich foods.

2. Timeliness. Complementary feeding typically covers the period from 6 to 18-24 months of age. Baby should start receiving foods in addition to breast milk from 6 months onwards. The World Health Organization (WHO) recommends that infants receiving complementary foods 2-3 times a day between 6-8 months and 3-4 times a day between 9-24 months, with additional snacks provided 1-2 times daily. Baby can start having family foods at 12 months onwards.

3. Adequacy. The adequacy of complementary feeding depends on the availability of a variety of foods in the household and the feeding practices of the parents or caregivers. Feeding young infants requires lots of care and stimulation, and you should always be aware of baby’s hunger pangs and also encourage him to eat.

What to Feed Baby
Good complementary foods must be able to provide sufficient energy and nutrients and are appropriate to baby’s stage of development. Here’s what you can feed the little one:

Rice, other cereals and starchy foods
Rice porridge and ready-to-eat iron fortified infant cereals are usually baby’s first food at six months. Give soft rice and mashed noodles when baby is older (11 months or so).

Fruits and vegetables
Start off with diluted strained fruit juices and pureed veggies. When your baby is between 6-8 months, give mashed or chopped soft fruits, and cooked-and-sieved or mashed peas and green leafy vegetables. Between 8-12 months, cut up soft fruits into bite-sized pieces and chop veggies to allow baby to discover their individual textures.

Protein-rich foods
Try toasted and finely ground ikan bilis or cooked and sieved egg yolk and peas. Then, chopped chicken and fish when baby is 6-8 months, and after that, minced or finelychopped meat or soft cheese.

• Liquid gold: Colostrum
  In baby’s first few days of life, your breasts secrete colostrum, a thick yellowish substance rich in carbohydrates, protein, and antibodies. Colostrum may be low in volume but it is extremely high in nutrients and immune factors which will protect baby against harmful agents.
  
  
• Mature milk
  Mature milk comes in three or four days after birth. It is greater in volume and appears thinner and lighter in colour.
  
  
• During a feed
  The composition of your breast milk even changes during a feed. The amount of fat increases at the end, making baby full so he stops sucking. An early lesson in controlling his appetite!

Protects Baby Against Disease
Research shows that babies who are breastfed exclusively for 6 months experience fewer illnesses in the first 12 months of life. Breast milk contains nutrients and substances that protect baby from infectious diseases, particularly diarrhoea, cold, bronchiolitis and middle ear infections.

Promotes Better Digestion and Absorption of Nutrients
Certain biological compounds in breast milk cause nutrients to be absorbed by baby effectively:

• A fat-digesting enzyme helps in digestion and absorption of fat.
• An iron-binding protein helps baby absorb most of the iron in breast milk.
• A high lactose content increases absorption of calcium, magnesium, phosphorus and other minerals.

Food for Brain Development
Breast milk contains essential fatty acids such as alpha linolenic acid (ALA) and linoleic acid (LA). These are required to produce docosahexaenoic acid (DHA) and arachidonic acid (AA) which are essential for normal foetal and infant growth and development, particularly for brain development and visual acuity. Proper brain development in baby’s first year provides the foundation of his learning ability in the future.

Decreases the Likelihood of Allergies
Most allergic symptoms associated with formula feed are often due to baby’s adverse immune response to cow’s milk protein. With breast milk, baby is less likely to suffer from allergic symptoms such as infantile colic, vomiting, diarrhoea or bloody stools, malabsorption, eczema, allergic rhinitis and bronchial asthma.

No Greater Love
Baby’s need to hear your heartbeat, feel your warmth and have close physical contact with you is just as intense as his need for food. No activity can meet all these needs as wonderfully and completely as breastfeeding.

together times that you can teach your child all about healthy eating as well as appropriate table manners.

Bringing The Family Together
Want to begin incorporating this routine note of these pointers:

• Set the right example - The important thing to remember is that your child models your behaviour. If you rush through mealtimes, or are picky or do not care about what goes on the dinner table, your child is likely to mimic your behaviour.

• Send the right message - Adopting a healthy attitude towards food will instil good eating habits in your child. Don’t constantly announce that you are on a diet and refuse to eat; this is not how you want your child to turn out to be when he or she grows older.

• Teach your child - Eat and serve sensible portion sizes to give your child a good idea on what’s proper eating. Keep a positive attitude will perceive it as something important and necessary in his or her life.

• Remove all distractions - To make sure you benefit from this time together, keep it dynamic and fun. Turn off the television and even your mobile phone if possible.

• Get your child involved - Have your child help you prepare the meal, set the table, serve the dishes, and clear the table later. This way, your child will feel the ownership in the outcome of the meal, and feel proud with his or her involvement.

Picking What’s Right
The real issue lies in picking out what’s right for your child. With so many options out there in the supermarket aisle, it is easy to be confused on the right cereal brand to choose! What more with the different claims made by each brand, you are bound to be confused and possibly misled as well.

One thing to remember when picking out the right cereal is this: don’t let your child be the ultimate decision-maker in this situation. Cereal companies have also become smart advertisers by banking on television or cartoon characters to attract the child’s attention. It is without a doubt that your child will pick what he or she is interested in, as the healthfulness of the cereal is the last thing on their mind. Also, children are most likely to pick cereal brands with the most flavours, which are typically the sweetest as well as the ones with the most sugar. A healthy option is to add fresh fruits such as bananas or apples in your child’s unsweetened cereal to give him or her variety in taste.

Take in mind that sugar content varies greatly among different cereal brands. Just how much sugar is there in your cereal? Keep this measurement in mind: every five grams of sugar amounts to one teaspoon. So in order to pick a healthy cereal, choose one with less than five grams of sugar consisting mainly of whole grains fortified with vitamins and minerals.

Be sceptical of the health claims made by cereal makers. The most important place where you should be getting all the health information is the nutrition label on the box instead. Learn how to read it efficiently to truly understand what it is claiming. Also, do take note of the amount of dietary fibre contained.

Lastly, the thing to remember when picking out the healthier-choice cereal for your child is this: ask yourself if YOU would eat it yourself. If the answer is no, chances are your child won’t want to eat it as well.

SO HOW DID YOU DO?

1 False.
Sugary foods and drinks are high in calories and low in nutrients, and can cause unhealthy weight gain and dental caries. While you may not want to totally prohibit sugary foods (this only makes them more attractive to your child!), do limit his intake.

2 False.
Fat-free or low-fat milk is not encouraged for young children. They need energy to grow and they can get this from full cream milk, which also contains essential fats.

3 True.
Fruit juices are nutritious. However, they are not a must in your child’s diet and cannot replace fresh fruits. When giving fruit juice, limit the amount as too much can lead to excess calories and weight gain. Also, go fresh (no added sugar) as store-bought juices often contain added sugar and other additives.

4 False.
Children have small tummies and can only eat so much. Healthy snacks, when given with nutritious drinks like milk, fruit juice or soya bean milk can boost their nutrient intake. The timing of the snack is important as eating snacks too close to mealtimes can affect their appetites. As a guide, offer snacks at least 1½ hours before meals.

5 False.
Serving your child his favourite foods may make him more likely to eat, but he will not get variety in his diet (especially if he will only eat cookies and nothing else!). The trick is to give him a balanced, varied diet along with his favourite foods in each meal.

6 True.
However, remember what is ‘enough’ to you may be too much for your child’s tiny stomach. Have realistic expectations and continue offering a variety of foods at regular mealtimes and for snacks. You can monitor your child’s weight and height at regular intervals. As long as he is growing, you do not have to be overly concerned.

7 False.
Every child grows at a different rate. As long as your child is growing, gaining weight and active, he is fine. But if he loses weight or is pale and lethargic, do consult your doctor.

8 False.
A balanced diet daily will supply your child with vitamins and minerals in appropriate combination and amounts. Therefore, supplements are not necessary unless prescribed by a nutritionist, dietitian or medical doctor.

• Plain, boiled water
• Fruit juices (diluted)
• Honey or glucose drinks
• Barley water
• Clear soups
• Fluids in the form of oral rehydration solution (ORS), prepared according to instructions.

Try to get your child to drink at least 1.5 litres of fluids a day. You can let him drink using a straw – it is fun for him and prevents spillages, which means less cleaning up for you.

As your child feels better and is no longer vomiting or having diarrhoea, you can encourage him to take more nourishing fluids such as soups or porridge.

Eat up
Children will not eat foods they dislike even when they are well, what more when they are sick! Offer your child familiar and favourite foods on sick days. Do not attempt to introduce new tastes at this time. Serve nutritious foods in small, bitesized portions. Go for foods that are easy to swallow such as:

• Bread
• Biscuits
• Breakfast cereals
• Egg
• Noodle soups
• Porridge

1. Place your baby’s food, a small towel and her baby cup within reach. Preparing everything before you begin helps you focus on the job at hand: getting your baby to eat.
   
   
2. Talk to your baby about what she is about to experience. In fact, once she gets used to the routine, she will look forward to mealtimes when she hears you repeating familiar words about food and eating.
   
   
3. Start off the meal by giving your baby a few spoonfuls of solid food first. Being new to eating, very little food will actually wind up in her tummy. You can top up later by breastfeeding her. However, do not give her any breast milk before feeding her solids as this will make her full and less willing to try the new experience of eating.
   
   
4. Scoop a little food and put it on your baby’s lips so that she can suck it off. Her first reaction to solid food may be a combination of surprise and repulsion. Avoid pushing the spoon into her mouth, as she will instinctively gag to get the food out. After a few attempts, your baby will begin to enjoy the eating process and cooperate by opening her mouth wide during feeds.
   
   
5. Your baby is still getting used to the idea of solids and will not be able to eat very much. After giving her a spoonful or two of food, resume breastfeeding. You can increase the amount as baby gets used to solids.

As often as possible, go for fresh varieties. Start with small quantities and introduce one type at a time. Give baby three to five days to adjust to new tastes before introducing something else. This will also allow you to evaluate tolerance and identify any allergies if it happens.

Fruits and vegetables are part of a healthy diet that includes other food groups as well. To help baby cultivate wellbalanced eating habits and to develop a taste for a variety of foods, give equal emphasis to foods in every food group.

They all provide different vitamins and nutrients and in varying amounts. You cannot have one without the other!

Salt is an important nutrient needed by the human body and it is found in sufficient quantities in breast milk, rice and most, if not all, of the foods commonly fed to babies. So, do not add salt, soya sauce or artificial seasonings to baby’s food as this can endanger his health.

Children above 1 year old can eat food lightly seasoned with salt but only in very small quantities. Try to reduce the amount of salt in your child’s (and the rest of your family’s) food gradually. You will soon find that most foods are tasty enough without added salt. If you find the food bland, use natural flavourings such as lemon juice, herbs and spices.

“My 7-month-old has been on formula since he was 2 months old. I’ve begun giving him cereal on top of his formula. But at 6.5 kg, his weight’s low for his age. Please advise.”

AP Dr Poh: Babies double their birth weight at 5 months. If your baby was 2.5 kg when he was born, 6.5 kg would be normal for his growth rate at 7 months. Every child grows at a different rate and being small does not necessarily mean he is not healthy. Ask your paediatrician about your child’s growth rate.

From the age of 6 months, baby should be fed foods other than breast milk or formula. Begin with baby rice cereal and fruit or vegetable purées on their own. At 7 months, baby can be fed rice porridge cooked with finely chopped vegetables such as carrots or spinach. At 8 months, shredded, cooked boneless fish may be added. Visit a nutritionist, dietitian or paediatrician for more in-depth advice.

“I’ve been breastfeeding my 9-month-old baby exclusively and am now trying to start him on solids.The problem is, he refuses solids and only wants to breastfeed. Is this normal? Is he getting enough nutrients from breast milk, now that he’s almost 1 year old?”

AP Dr Poh: Breast milk is not enough to supply all the nutrients a 9-month-old baby needs. By baby’s 6th month, complementary feeding must be started. Give your 9-month-old a bowl of his own food and let him try to feed himself. You should also spoon-feed him at the same time. Give him foods that are increasingly firm in texture rather than the porridge, cereals and mash. Make sure the foods are not difficult for him to bite, chew and swallow. Try finger foods like small boneless fish, chicken nuggets (without the added salt, flavouring or preservatives) and soft fruits or vegetables cut into baby-friendly sizes.

Always watch him while he eats, even though he may be able to feed himself. Your baby cannot eat very much due to his tiny stomach so do not worry if he stops after two or three spoonfuls. Whenever he is hungry, offer him food first and not the breast. As long as he is growing at a healthy rate and is active, he is doing fine.

Make eating a fun experience for baby. He will be more willing to try new foods if he finds the experience enjoyable. If possible, continue breastfeeding him until his second birthday and beyond.

1. Did you start giving your baby complementary foods at six months?
   
   Failure to start at six months deprives your baby of the extra food she needs to fill her energy and nutrient gaps. Your baby may grow less rapidly or even stop growing. Her risk of becoming undernourished and developing micronutrient deficiencies also increases.
   
2. Are you still breastfeeding after introducing new foods to your baby?
   
   Breast milk is still a crucial part of your baby’s diet. The World Health Organisation (WHO) recommends that you breastfeed while giving other foods for up to two years.
   
3. Are you slowly increasing the amount of complementary foods given to your baby?
   
   Give complementary foods 3 times a day at 6 to 12 months, 5 times a day at 12 to 24 months. This includes nutritious snacks once or twice a day on top of breastfeeding. As you increase the number of times you feed baby in a day, you should also increase the amount of complementary foods given as she grows.
   
4. Do you offer your baby nutrient-rich foods every day?
   
   While your active baby needs energy from ‘staple’ carbohydrate foods like rice, cereals and mashed potatoes, she should also eat nutrient-rich foods like meat, poultry, fish and eggs; beans, peas, lentils and milk products; as well as fruits and vegetables every day.
   
5. Do you give your baby a wide variety of foods?
   
   At six months, introduce new foods in stages (one at a time, with at least four days in between) to give time for baby to get used to them and to help identify allergic responses. The types of foods you give baby should increase in variety as she approaches her first birthday. The more variety she gets, the more she can meet her nutrient needs. If she dislikes certain foods, try cooking them differently. That way, she will not be deprived of the nutrients from that particular food.