Modern ideas about complementary foods. Methods and timing of the introduction of complementary foods

Currently, there are several major trends in complementary feeding. Let's list 4 main directions.

Classic "Soviet complementary foods"
As part of this approach to complementary foods, our relatives, as well as some doctors, usually advise: to introduce complementary foods early, before 6 months (more about the timing), in large quantities - that is, the amount of complementary foods quickly increases to the "norm" that the child simply must eat; breastfeeding replaced meals (i.e. food is given INSTEAD of breastfeeding). The child is introduced to various dairy products - curds, kefir; juices (see about juices) and so on. Complementary foods are introduced only with pureed semi-liquid food, the mother always feeds with a spoon, and the baby sits in a highchair. If the child does not want, the mother is obliged to feed him, so she either distracts the child - shows puppet show, cartoons, etc., either persuades or even pushes food into his mouth.
Eating a child is the most important activity to which adults devote a lot of attention and energy. It's a whole ceremony. The food for the child is always prepared separately.
disadvantages... It happens that children develop normally and eat on this type of complementary food, but it often happens that children refuse to eat so much complementary foods so early, refuse to sit in a chair, refuse to eat anything other than what their parents give me (why do they give me one thing while they themselves eat another? disorder!) and demand food from the common table, pieces, etc. It happens that after such an introduction of complementary foods, children generally cannot chew for a very long time and eat only mashed potatoes, it happens that they eat only for distraction-entertainment. The main danger is to instill in the child a hatred of food and poor appetite.
For some reason, many of us believe that children always eat poorly, but don't you think that this should actually be the exception, not the rule? After all, a child has a natural feeling of hunger, a normal appetite, and self-regulation of these processes. Our "smaller brothers" are not familiar with the problems when their children - being healthy - do not want to eat.
Problems directly related to breastfeeding - the two most common are: 1) the child eats complementary foods very poorly, because he has negative associations with the process of eating, and "hangs" on his chest, 2) the child, on the contrary, with pleasure already in six months eats large portions of complementary foods, and the mother's milk suddenly begins to rapidly decrease and the child switches to IV even before he is one year old ...
So, this method of introducing complementary foods very often leads to problems, therefore it is NOT RECOMMENDED by HV consultants, modern pediatricians and psychologists.
Modern pediatric complementary foods... If you like to feed your baby separately cooked food, adhere to the "norms" and schemes, you will like the feeding scheme, which is advised by many modern pediatricians. Here, a clear scheme is also preserved - in what order the products are introduced, what complementary foods are the first-second-third, the child eats food separate from other family members (determined by the scheme), at the same time everything is reasonable - breastfeeding is not abruptly replaced, but first breastfeeding after complementary feeding; the introduction of complementary foods from 6 months (more about the timing), they give to try from a certain age not only mashed potatoes. The child is not entertained or forced to eat.
There is relaxed version of pediatric complementary foods, which contains fewer restrictions and recommendations. It is close to the complementary foods recommended by WHO () and La Leche League (). The child is given approximately the same foods that the whole family eats, but, for example, without salt, and not everything that the family eats, but something selectively (for example, if the mother eats rice with sausage, only rice is given). Not too much special effort - the food is not mashed or blended, but it may be kneading. Products are not introduced too quickly, one at a time, starts with small doses. There is no limitation, which is obligatory once a day, but you can not a large number of(if there is no tendency to allergies) - like familiarization with food. The child does not necessarily eat the "norm", but while he is small, he must drink with his breast. The innate desire to eat is encouraged. Small pieces of food (very small) are given early to the baby.
And there is a general direction " pedagogical feeding"." Pedagogical means that we first of all teach the child - we teach him to eat, the correct behavior at the table, we teach that food is joy and pleasure, we show new tastes. (grains of food), nothing is mashed or blended, and does not even knead. The child's food is with the family, as much as he eats, he will eat as much. Nothing is specially prepared, the family is encouraged to switch to a healthy diet. "Rozhana" () developed this direction into a methodology that regulates all the behavior of mothers and children, which must be strictly followed so that there are no problems with eating behavior, this is more interesting for supporters of the “only right way.” Other organizations offer more soft options pedagogical complementary foods, where there are not many strict restrictions.

Many counselors recommend a cross between "pediatric" and "pedagogical" complementary foods. Many families use a combination of approaches, so it is very helpful to familiarize yourself with several options (see below) and also with the exchange of experience ()!

Complementary feeding 2 (modern pediatric)

Complementary foods 3 (softened)

Complementary feeding 4 ("pedagogical"). Especially suitable for children who refuse to eat liquid and puréed foods, or who simply do not eat well.

Complementary feeding today is introduced according to one of two techniques, which are fundamentally different from each other. Each of them is based on its own concept.

Pediatric complementary foods. Its basis is the belief that a child older than 4-6 months begins to lack the energy value of breast milk or formula. The introduction of new products into the baby's diet is intended to fill the lack of necessary elements.
Pedagogical complementary feeding is the second type of technique, which involves the continuation of lactation for up to a year or more. Acquaintance with new products is for informational purposes only and is not intended to fill the lack of energy needs. The child, according to this feeding technique, tries absolutely everything that the parents eat, while the food is not crushed or milled in mashed potatoes.

What point of view does the World Health Organization take on this issue? She takes a neutral position, which we will talk about further.

Pediatric complementary feeding involves the introduction into the diet of precisely those products that will make up for the missing nutritional value of breast milk when the baby is growing up.

Research and scientific evidence have made it possible to formulate basic rules for the nutrition of children under 2 years of age. Widespread coverage took the issue of developing a concept of nutrition for children early age, including complementary foods, which was considered at a global conference attended by experts from WHO and UNICEF. A number of provisions were adopted.

Complementary feeding rules

The best food is breast milk. Having a choice between natural and artificial feeding, the first should be preferred. Breastfeeding creates ideal conditions for the harmonious development of the baby.
Complementary feeding according to medical indications. For the first six months of life, the child is exclusively breastfed. The absence of any other medical indications provides for the introduction of complementary foods after 6 months. Until this period, the child does not need additional drinks and food. It is recommended to maintain lactation for up to 2 years or more.
Balanced diet. Food for a baby should be rich in useful minerals and vitamins, and also correspond to the capabilities of the child's body. The amount of food should be weighed against age norms. New foods should be introduced into the diet gradually, in small doses. The growth of a baby implies an increase in the amount of food consumed.
Variety of flavors. According to the approved scheme for the introduction of complementary foods by the WHO, the child's food should be varied. The children's diet must include vegetables, cereals, poultry, meat, eggs and fish. Lack of breast milk can be replenished with mineral and vitamin complexes that could add nutritional value to your daily diet.
Adaptation of food according to age. At the age of 6 months, the child begins to eat pureed or semi-solid food, puree. From the age of 8 months, it is possible to switch to the use of foods that can be eaten by hand (we recommend that you read :). After one year, the child can begin to feed the food that the rest of the family consumes.
Continuation of lactation. The main food is still mother's milk. Complementary feeding, according to WHO, is introduced in order to meet the increasing energy needs, because with age the child becomes more active. The baby should receive breast milk in the required amount. The tandem "mother-baby" and feeding "on demand" lasts up to a year or even two.

Will I feed all ages submissive?

The description of the rules and actions is presented above in accordance with the opinions of a whole council of specialists. Among other things, parents should consider individual characteristics and the readiness of their child to introduce complementary foods. A baby who is lagging behind in weight gain will require earlier dates for starting complementary foods - 4 months of age in this case will be justified. Another child feels great and develops fully, eating only mother's milk. Perhaps, in this case, the introduction of complementary foods should be started closer to 8 months.

All healthy babies, according to WHO recommendations, should start trying complementary foods no earlier than 6 months. More early dates complementary foods will help reduce lactation, which will eventually become impossible for up to one and a half years, as recommended by the main pediatrics in Russia, or up to 2 years, according to the World Health Organization.

Yakov Yakovlev, an AKEV expert, argues that 6 months of age is not a mandatory number, but only the average time to start complementary feeding. It is preferable to start the introduction of new products a little later. Mothers of formula-fed or breastfed babies whose children gain weight well may well listen to this advice(in more detail in the article:). The only indicator for an earlier start of complementary feeding is underweight (we recommend reading :).

Complementary feeding table

Breastfeeding is maintained as much as possible when new products are introduced. Babies on IV should receive 1-2 cups of cow's milk from 8 months. More detailed diagram nutritional information can be found in tables compiled by pediatricians.

The World Health Organization points out the importance of the following points:

It is difficult to strike a balance when switching to new products. Not only does the child's body have a hard time coping with the assimilation of new types of food, but the food itself may not be nutritious enough. Experts from the World Health Organization note that many children under 5 years of age do not receive the required amount of nutritious and energy foods. The child's diet should be balanced and complete, and offered in sufficient quantity.
Product safety. When preparing food, you need to make it as safe as possible for your baby. Properly cooked food will reduce the risk of intestinal infections.
Interest in new things is encouraged. Your baby's interest in new types of food should be maintained and developed by helping him become familiar with new types of foods.

If the child is interested in some product that is not prohibited, you can try to give it unscheduled

Algorithm for the introduction of complementary foods

WHO step-by-step instructions for mothers are as follows:

Patience. The introduction of complementary foods requires maximum sensitivity from the mother. Be prepared for the fact that not everything that you cook will be appreciated by the crumb. Be patient, don't yell, and force you to eat. Talk in a soft voice while eating and make eye contact. Feeding should be done slowly, slowly.
Purity. Do not forget about hygiene of cutlery and plates, as well as thorough washing of food. Teach your baby to eat clean. To do this, always wipe down the soiled table and do not forget to remove traces of food from the child's face and hands.
Gradual introduction of products. Introducing new foods should start with small portions. With a positive reaction of the body, gradually increase the volume.
Adapt your food. The consistency of the food must comply with age standards. An older baby also gets a more varied consistency of products.
Number of feedings by age. Consider age recommendations for feeding babies. Complementary foods for a baby 6 months old are introduced 2-3 times a day (for more details in the article:). This number increases to 4 when the baby grows up a little. When appetite appears between feedings, you can enter an additional 1 or 2 snacks.
Consider your child's preferences. Try to make your child like the food you offer him. Lack of interest in a particular dish can be changed by experimenting with the combination or consistency of the foods.
Increasing the amount of drinking. After a year, when less breast milk is consumed, the child should be given various compotes, sugar-free baby juices or baby teas to drink more often.

Patience and love are the keys to a good appetite

It is strictly forbidden to force the child to eat. The introduction of complementary foods should be voluntary. Violence in this regard will lead to the child's refusal from any type of food. Create an environment conducive to trying new foods so that your child enjoys the process. A positive attitude of parents, affection and attention are the main companions of starting a new activity.

Complementary feeding - important stage in the life and development of the child. Correct motivation and easy mastering will help in the end to get a well-eating baby, and not a stubborn and a little bit. All WHO advice is intended to organize feeding as safely and comfortably as possible. Taking into account the advice of specialists, you guarantee your child a harmonious development based on a healthy and balanced diet.

Today, there are two systems for the introduction of the first complementary foods for babies. These systems have their own characteristics, so parents should distinguish them.

- The essence of pediatric complementary foods is to introduce the required nutrients into the child's body through the use of a number of food products. Pediatricians believe that already from 4-6 months, the baby does not have enough calories in breast milk or formula.

- In pedagogical complementary foods, the use of food is associated with familiarization of food as such. Complementary feeding does not affect breastfeeding and is not associated with replenishing the caloric content of the diet. The kid gradually eats with his parents from the common table. With pedagogical complementary foods, food is not crushed in mashed potatoes.

The World Health Organization is neutral in recommending the concept of complementary feeding.

Pediatric complementary foods are aimed at consuming foods to replenish the diet with nutrients, since breast milk or formula is no longer enough for the baby.

Scientific research in the development of children under two years of age has determined the main provisions of nutrition and the norms of the first complementary foods. At a global conference on infant nutrition, UNICEF and WHO representatives adopted guidelines.

The order of the first feeding

- The ideal food for babies of age is mother's milk. Breastfeeding is a priority for the mother. In addition to good nutrition, the baby develops harmoniously in a comfortable environment.

- Early complementary foods are introduced by medical indications- the basis for early feeding for babies. For the first 6 months after birth, the baby feeds on breast milk. If there are no medical indications, then the first complementary foods should be introduced after six months. As a rule, until this age, the baby does not need any other food. It is ideal to continue lactating for at least 2 years or more.

- Balanced food. The child's nutrition should be nutritious, suitable for the age of the baby, enriched with vitamins and minerals. New Product should be introduced in small portions, according to age. As it grows, the volume of food also increases.

- A variety of foods. The child's diet should include fruits, vegetables, eggs, meat, poultry, fish, cereals. Complexes of minerals and vitamins will help to replenish the energy value of food during breastfeeding.

- Compliance of food with age norms. Starting from six months, the baby can taste pureed, semi-solid and pureed food. From 8-9 months, the child is able to eat food with handles. At the age of 12 months, the mother can offer the child food from the common table.

- Prolonged lactation. The main food is breast milk. Try to feed your baby on demand until 2-3 years old. As the child grows, he becomes active, he needs more calories, and therefore new foods are introduced.

At what age should I enter?

In addition to following the conclusions of a number of experts on the nutrition of young children, parents need to take into account the developmental characteristics and the degree of readiness of the crumbs for new food. In case of underweight, the child should be introduced to complementary foods earlier than 6 months. If the baby is gaining weight well, is active, vigorous, then you can wait with complementary foods and start from 7-8 months.

WHO notes that, on average, a baby's complementary feeding should begin no earlier than 6 months. If, for no apparent reason, you start feeding earlier, then you can disrupt lactation, which WHO recommends to keep as long as possible.

The well-known AKEV expert, Yakov Yakovlev, expresses the opinion that half a year is not a specific date for the start of complementary feeding, but only an average. Take your time to introduce new foods to the baby, he is eating and gaining weight so well. Only insufficient weight gain is the basis for early feeding.

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The rates of introduction of complementary foods in the table

The table contains the practice guidelines, according to WHO, for the introduction of the first complementary foods for young children. Recommendations are calculated for 90 days:

Day		New Product	Gram	Tea spoon	Introduced product	Gram	Tea spoon
Introduce the zucchini in the morning. Then finish breakfast as usual (breast milk, formula) until the baby is full.
1	Squash puree		2-3	0,5
2	Squash puree		6-8	1
3	Squash puree		18-21	2-3
4	Squash puree		35-42	6-8

5	Squash puree	65-72	11-13
6		115-122	19-21
7	Zucchini puree, 1 tsp vegetable oils	165-167	26-28
Cauliflower feeding. Cook 2 purees. Add cauliflower first, then courgette. Breast milk / formula for lunch
8	Cauliflower puree	2-3	0,5	Zucchini puree, 1 tsp vegetable oils	165-167	26-28
9	Cauliflower puree	6-8	1	Zucchini puree, 1 tsp vegetable oils	161-163	25-27
10	Cauliflower puree	18-21	2-3	Zucchini puree, 1 tsp vegetable oils	148-150	23-25
11	Cauliflower puree	35-42	6-8	Zucchini puree, 1 tsp vegetable oils	128-131	20-22
12	Cauliflower puree	65-72	11-13	Zucchini puree, 1 tsp vegetable oils	98-101	15-17
13		115-122	19-21	Zucchini puree, 1 tsp vegetable oils	48-52	7,0-8,1
14	Cauliflower puree, 1 tsp. oils	165-167	26-28
Introduce broccoli. Cook 2 purees. First add broccoli puree, then cauliflower or squash. Breast milk / formula for lunch.
15	Broccoli puree	2-3	0,5	Cauliflower puree, 1 tsp. oils	165-167	26-28
16	Broccoli puree	6-8	1	Zucchini puree, 1 tsp vegetable oils	161-163	25-27
17	Broccoli puree	18-21	2-3	Cauliflower puree, 1 tsp. oils	148-150	23-25
18	Broccoli puree	35-42	6-8	Zucchini puree, 1 tsp vegetable oils	128-131	20-22
19	Broccoli puree	65-72	11-13	Cauliflower puree, 1 tsp. oils	98-101	15-17
20		115-122	19-21	Squash puree	48-52	7,0-8,1
21	Broccoli puree, 1 tsp. oils	165-167	26-28		165-167	26-28
Complementary feeding with buckwheat porridge for breakfast. Then finish breakfast as usual (breast milk, formula) until the baby is full. Give already tested vegetables for lunch - portion 165-167 g
22	Buckwheat	2-3	0,5
23	Buckwheat	6-8	1
24	Buckwheat	18-21	2-3
25		35-42	6-8
26	Buckwheat porridge, 1 tsp drain. oils	65-72	11-13
27	Buckwheat porridge, 1 tsp drain. oils	115-122	19-21
28	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
Complementary feeding of rice porridge for breakfast. Cook 2 porridge. First, introduce rice porridge, then buckwheat. Give already tested vegetables for lunch - portion 165-167 g
29	Rice porrige	2-3	0,5	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
30	Rice porrige	6-8	1	Buckwheat porridge, 1 tsp drain. oils	161-163	25-27
31	Rice porrige	18-21	2-3	Buckwheat porridge, 1 tsp drain. oils	148-150	23-25
32	Rice porrige	35-42	6-8	Buckwheat porridge, 1 tsp drain. oils	128-131	20-22
33	Rice porrige	65-72	11-13	Buckwheat porridge, 1 tsp drain. oils	98-101	15-17
34		115-122	19-21	Buckwheat	48-52	7,0-8,1
35	Rice porridge, 1 tsp drain. oils	165-167	26-28
Complementary feeding of corn porridge for breakfast. Cook 2 porridge. First, introduce corn porridge, then buckwheat or rice. Give already tested vegetables for lunch - portion 165-167 g
36	Corn porridge	2-3	0,5	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
37	Corn porridge	6-8	1	Rice porridge, 1 tsp drain. oils	161-163	25-27
38	Corn porridge	18-21	2-3	Buckwheat porridge, 1 tsp drain. oils	148-150	23-25
39	Corn porridge	35-42	6-8	Rice porridge, 1 tsp drain. oils	128-131	20-22
40	Corn porridge	65-72	11-13	Buckwheat porridge, 1 tsp drain. oils	98-101	15-17
41		115-122	19-21	Rice porrige	48-52	7,0-8,1
42	Corn porridge, 1 tsp drain. oils	165-167	26-28
Complementary feeding with pumpkin. Give already tested cereals for breakfast - portion 165-167 gr
43	Pumpkin puree	2-3	0,5	Cauliflower puree, 1 tsp. oils	165-167	26-28
44	Pumpkin puree	6-8	1	Zucchini puree, 1 tsp vegetable oils	161-163	25-27
45	Pumpkin puree	18-21	2-3	Broccoli puree, 1 tsp. oils	148-150	23-25
46	Pumpkin puree	35-42	6-8	Cauliflower puree, 1 tsp. oils	128-131	20-22
47	Pumpkin puree	65-72	11-13	Zucchini puree, 1 tsp vegetable oils	98-101	15-17
48		115-122	19-21	Broccoli puree, 1 tsp. oils	48-52	7,0-8,1
49	Pumpkin puree, 1 tsp drain. oils	165-167	26-28
An apple for breakfast. Give already tested vegetables for lunch - portion 165-167 g
50	Applesauce	2-3	0,5	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
51	Applesauce	6-8	1	Rice porridge, 1 tsp drain. oils	165-167	26-28
52	Applesauce	14-18	2-4	Corn porridge, 1 tsp drain. oils	165-167	26-28
53	Applesauce	24-26	3-5	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
54	Applesauce	33-36	5-7	Rice porridge, 1 tsp drain. oils	165-167	26-28
55	Applesauce	44-50	7-9	Corn porridge, 1 tsp drain. oils	165-167	26-28
56	Applesauce	55-65	9-11	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
Complementary feeding with millet porridge for breakfast. Give already tested vegetables for lunch - portion 165-167 g
57	Millet porridge	2-3	0,5	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
58	Millet porridge	6-8	1	Rice porridge, 1 tsp drain. oils	161-163	25-27
59	Millet porridge	18-21	2-3	Corn porridge, 1 tsp drain. oils	148-150	23-25
60	Millet porridge	35-42	6-8	Buckwheat porridge, 1 tsp drain. oils	128-131	20-22
61	Millet porridge	65-72	11-13	Rice porridge, 1 tsp drain. oils	98-101	15-17
62		115-122	19-21	Corn porridge	48-52	7,0-8,1
63	Millet porridge, 1 tsp drain. oils	165-167	26-28
Complementary feeding with meat (rabbit), porridge. Give already tested vegetables for lunch - portion 165-167 gr, applesauce 55-65 gr
64	Rabbit meat	2-4	0,5	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
65	Rabbit meat	7-9	0,5-1,5	Rice porridge, 1 tsp drain. oils	165-167	26-28
66	Rabbit meat	15-17	2-4	Corn porridge, 1 tsp drain. oils	165-167	26-28
67	Rabbit meat	21-23	3-5	Millet porridge, 1 tsp drain. oils	165-167	26-28
68	Rabbit meat	27-33	4-6	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
69	Rabbit meat	36-42	6-8	Rice porridge, 1 tsp drain. oils	165-167	26-28
70	Rabbit meat	45-53	7-9	Corn porridge, 1 tsp drain. oils	165-167	26-28
Complementary feeding prunes for breakfast, porridge. Give already tested vegetables for lunch - portion 165-167 gr, applesauce 55-65 gr
71	Fruit puree with prunes	2-3	0,5	Millet porridge, 1 tsp drain. oils	165-167	26-28
72	Fruit puree with prunes	6-8	1	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
73	Fruit puree with prunes	14-18	2-4	Rice porridge, 1 tsp drain. oils	165-167	26-28
74	Fruit puree with prunes	24-26	3-5	Corn porridge, 1 tsp drain. oils	165-167	26-28
75	Fruit puree with prunes	33-36	5-7	Millet porridge, 1 tsp drain. oils	165-167	26-28
76	Fruit puree with prunes	44-50	7-9	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
77	Fruit puree with prunes	55-65	9-11	Rice porridge, 1 tsp drain.	165-167	26-28
Complementary feeding with meat (turkey), porridge. Give already tested vegetables for lunch - portion 165-167 gr, apple or prune puree 55-65 gr
78	Turkey meat	2-4	0,5	Corn porridge, 1 tsp drain. oils	165-167	26-28
79	Turkey meat	7-9	0,5-1,5	Millet porridge, 1 tsp drain. oils	165-167	26-28
80	Turkey meat	15-17	2-4	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
81	Turkey meat	21-23	3-5	Rice porridge, 1 tsp drain.	165-167	26-28
82	Turkey meat	27-33	4-6	Corn porridge, 1 tsp drain. oils	165-167	26-28
83	Turkey meat	36-42	6-8	Millet porridge, 1 tsp drain. oils	165-167	26-28
84	Turkey meat	45-53	7-9	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
Pears for breakfast. Give already tested vegetables for lunch - portion 165-167 g
85	Pear puree	2-3	0,5	Rice porridge, 1 tsp drain.	165-167	26-28
86	Pear puree	6-8	1	Corn porridge, 1 tsp drain. oils	165-167	26-28
87	Pear puree	14-18	2-4	Millet porridge, 1 tsp drain. oils	165-167	26-28
88	Pear puree	24-26	3-5	Buckwheat porridge, 1 tsp drain. oils	165-167	26-28
89	Pear puree	33-36	5-7	Rice porridge, 1 tsp drain.	165-167	26-28
90	Pear puree	44-50	7-9	Corn porridge, 1 tsp drain. oils	165-167	26-28
91	Pear puree	55-65	9-11	Millet porridge, 1 tsp drain. oils	165-167	26-28

When introducing the first complementary food, it is optimal for mothers to maintain lactation. Infants who are bottle-fed can be given cow's milk up to 2 cups a day, starting at 8 months of age. Check with your pediatrician for detailed nutritional diagrams.

WHO notes significant points in the nutrition of young children:

- It is not so easy for a baby's body to cope with the digestion and assimilation of new food products. Also, food itself may be low in nutritional value. From the beginning of complementary feeding, a nutritional balance should be observed. WHO representatives point out that a large number of children under five years of age lack the required amount of nutrients. A balanced, comprehensive diet will provide your child with all the nutrients.

- Food is safe for crumbs. Follow food preparation guidelines to minimize the occurrence of infectious diseases.

- Encourage crumbs to desire unusual food. When your toddler is interested in trying new foods, be sure to encourage aspiration.

Treat a new product out of the scheme if the baby really wants it, except for those that are banned for objective reasons.

How to start complementary feeding?

WHO sequential algorithm for moms:

- Calm. You should not rush, be attentive to the peculiarities of the baby's development. Perhaps the baby will not like everything that mom has prepared for him. Do not swear, shout or force-feed your baby. Talk to your baby patiently and lovingly as you feed, and take eye contact into account. Feed your baby in a comfortable and calm environment.

- Cleanliness. Keep cutlery and plates clean. Wash all vegetables and fruits. Immediately remove leftover food from the table, wash your baby.

- Consistency in complementary foods. It is necessary to introduce the crumbs to new food from small portions. If there is no reaction, then increase the amount of the portion.

- Suitable food. The food must be adapted to the age of the baby. As they grow up, the child will already receive a variety of foods.

- Meals according to age. Feed your baby by age. The first complementary food is given 1-3 times a day for a six-month-old baby. Then it is increased up to 4 times as the child grows. If the child has an appetite in addition to the main meals, it is recommended to introduce 1-2 snacks.

- Cook according to your baby's tastes. Consider foods that your little one likes. If there is no desire for a certain food, then try to combine and change the recipe, the cooking process.

- Adequate drinking volume. Already from 12 months mother's milk is not enough, so do not forget to water the crumbs. Water, compote, weak tea, juice (without sugar) will do.

Love and patience are the basis of appetite

In no case should the baby be forced to take food. It is worth starting complementary foods if the baby himself reaches for new food. Any violent action can cause psychological trauma, followed by refusal to eat. Create a comfortable and welcoming environment that encourages your baby to eat.

There are many controversial opinions around complementary foods today. Several decades ago, complementary foods began to be given as early as three weeks of a baby's life, and now the time for introducing solid food is pushed further and further.

Mothers and grandmothers in particular find themselves in difficulty, and some of the doctors do not have time to refresh their knowledge ... What are modern views about complementary foods?

What is complementary foods?
Complementary feeding approaches try to explain many terms. Mothers who actively communicate on the Internet have probably heard about the so-called pedagogical and pediatric complementary foods, whose practices actively explain the differences between these systems ... In fact, everything is simpler. World Organization Healthcare, after several large studies of infant nutrition around the world, has come up with recommendations for complementary foods that are quite consistent with the views of most experienced mothers.

According to the WHO, the introduction of complementary foods is the feeding of infants with foods and liquids in addition to breast milk or an adapted formula. Babies receive transitional foods first, which are complementary foods specifically designed to meet specific needs. infant; and then it is time to eat from the family table. Children are physically able to consume foods from the family table by the age of one, after which these foods no longer need to be modified to satisfy
special needs of an infant.

When?
Surprisingly, but back in the 30s-40s of the last century, pediatricians called the optimal time to start complementary feeding six months. The early start of complementary feeding in the 50-60s was directly related to the widespread use of artificial feeding and the fact that mothers went to work very early, and the then mixtures did not satisfy the child's need for vitamins.

Over time, when the composition of the mixtures improved and more and more research results were received on the health of children with early complementary foods, the timing of complementary foods was pushed further and further. From three weeks to a month and a half, then to three, to four, and finally to six. A test of time has shown that the pre-war pediatricians were right.

What are the dangers of feeding too early? It turns out that the earlier it is introduced, the greater the threat of dyspeptic diseases and food allergies due to the immaturity of the baby's intestines. Against this background, the risk of malnutrition increases, because an immature child's body does not yet produce enough enzymes to help assimilate "adult" food. Research carried out by WHO on a regular basis (the latest in seven countries around the world, in 2002) has confirmed that introducing complementary foods before six months increases the risk of pneumonia and recurrent otitis media due to a decrease in the overall body resistance of babies. Babies who only breastfed for the first six months of life began to crawl and walk earlier than babies who received complementary foods shortly after four months. For all these reasons, starting complementary foods at six months is the official recommendation of the ministries of health in most countries of the world, including the United States and Russia.

At the same time, the real introduction of complementary foods can begin a little later, if the maturation of the baby is delayed or the baby is sick. It happens that the mother is worried: the child is already seven months old, and he does not show any interest in complementary foods, and signs of readiness to receive complementary foods have not yet appeared - is it really possible to force feed? Of course, you don’t need to do this! WHO in its recommendations indicates that if the mother is well nourished, then the child is guaranteed enough of all the nutrients and trace elements of breast milk up to about 8 months. The global recommendation to start complementary feeding from 6 months was made taking into account the fact that in reality not all mothers eat normally today, especially those who live in the "third world" countries!

How?
The purpose of complementary foods is to provide your baby with extra energy. And since his ventricle is still quite small, when the energy value is lower than that of breast milk, it turns out that the child, on the contrary, loses in energy and nutrients. Therefore, complementary foods must be high in energy and micronutrient densities and given in small amounts and often. Too liquid (10%, as previously advised) porridge, broth and similar products cannot act as complementary foods - for a baby this is a serious loss in the quality of food!

After six months, the substances that the child begins to miss first are iron and zinc. Therefore, porridge or vegetables, in which iron and zinc are in fairly easily digestible forms, are recommended for the child as the first complementary food. If the child is not gaining weight well or has loose stools, it is better to start with cereals, but if the baby is more often strengthened, then it is worth starting with vegetables. The second complementary food, respectively, vegetables or porridge, the third - meat, and only then everything else.

The second complementary food is introduced in parallel with the first one month later. It is necessary to focus primarily on the vegetables and fruits of the seasonal period and our latitude, avoiding the exotic. As a rule, the first vegetables in the diet are zucchini, cauliflower, carrots. It is more convenient for someone to use factory-made puree, although one must be prepared for the fact that for a very long time the mother will eat the jar almost entirely. Someone simply adds vegetables to the diet of the whole family, in which case
it is good to use a double boiler for cooking vegetables: food is cooked quickly, and vitamins are stored in greater quantities. Finished vegetables can be chopped with a blender.

The cereals with which complementary feeding begins should be hypoallergenic: these are rice, buckwheat and corn, which do not contain gluten, a vegetable protein that often causes an allergic reaction. And you should always remember that no single product can provide the body with all nutrients. For example, potatoes provide vitamin C, but not iron, while bread and beans provide iron, but not vitamin C. The value of breast milk and even an adapted formula remains much higher throughout the first year than any other product, so do not rush to exchange a portion of mother's milk for a carrot or apple!

As for drinking, the need for it arises only when the baby already receives significant portions of complementary foods. In most cases, this happens after 8-10 months, or even later. In parallel with the introduction of complementary foods, the mother may offer the baby to drink compote or water from a cup, but if the baby refuses, there is no need to insist.

How?
And yet, in practice, the main problem of complementary feeding is not to feed the baby with certain foods, but to feed him altogether. Why do many children refuse complementary foods? This happens if the mother forgets that complementary foods are just a transitional stage on the path of the baby from breast milk or an adapted formula to an adult meal. And its meaning is that the child over a year old there was a desire and ability to eat food from the family table!

When giving complementary foods, a mother should always keep in mind that well-fed child- this is a momentary goal, and the main goal is for the crumbs to have an appetite and interest in food. Therefore, the child does not need to be fed at any cost when he does not want to! If the mother begins to forcefully and seriously feed the baby, then he gets the impression that the food is a forcibly imposed object, the value of which is small, and begins to avoid attempts to feed.

How do you generate interest in food? Usually babies at the age of about 5-6 months begin to show nutritional interest, that is, demand what their parents eat. At the same time, babies are rather suspicious and conservative, they usually prefer not to stick in their mouths that are completely unfamiliar to them. Therefore, in order to awaken the child's desire to eat something besides mother's milk, it is necessary to put him with you at the table (instead of separate feedings). The child should see how his family members handle food, and what they eat with appetite, they like to eat. Most often, it happens that the baby just watches for a while (you don’t need to offer him anything without his request), and then - sometimes after a couple of meals, sometimes after a few days - he always starts asking for something to him as well. With this in mind, mom simply keeps a clean spoon for the baby next to her and puts on her plate some food that she plans to give as complementary foods (if homemade food, then, of course, set aside at the cooking stage so that it is free of spices, milk, etc. .), and when the baby begins to ask - not even the first time, but when he takes a bright initiative - he gives a little food intended for the child, one or two teaspoons. If the child asks for more, at first it is not worth giving, this may turn out to be an unnecessary burden on digestion. If the child, on the contrary, frowns and spits out, there is no need to insist, let alone scold, this will contribute to the formation of a negative attitude towards food. Just offer another food another time, and after a while you can offer the same. There is an interesting pattern that suggests that in order for a child to have an appetite for some food, he needs to taste it 8-10 times, and a clear increase in the positive perception of food occurs after 12-15 times. Therefore, those products that the child initially refuses are often accepted later.

The often widespread belief that babies later begin to show interest in food from the family table, with the correct introduction of complementary foods, turns out to be erroneous. As practice has shown, with competent and careful introduction of complementary foods, breastfed babies quickly begin to show interest and actively eat from the family table! Researchers have suggested that this is due to the fact that, unlike "artificial" people who receive food from industrial production with the same taste, babies are already accustomed to different shades of taste and smell transmitted with breast milk.

If the baby is already about a year old, and he eats complementary foods in a minimum amount, this should not become a reason for canceling breastfeeding or rejecting adapted formulas. For a very long time, kids do not associate the saturation process with their parent's table! The incentive for him to try solid food is his interest and desire to behave "like adults", and not at all the desire to get enough. And the cancellation of the usual source of satiety very often leads to the fact that the baby does not start eating solid food in large quantities - if the mother did not help create interest in "adult" food, it will not arise from scratch. The right way is to give up the desire to feed the child immediately with a large amount of food, and go through all the stages of complementary feeding anew, although for a grown child, each stage will take not a month or two, but a week or two. So, what are the stages that a baby should go through in developing an interest in food from the family table?

Approximate stages of complementary feeding.

First stage: 6-7 months.

At this stage, the main goal is for the baby to taste other foods and learn to spoon-feed. At this time, the baby is offered a very small amount of complementary foods, only one to two teaspoons at a time and only once or twice a day. In this case, the baby needs time to learn how to remove food from the spoon with his lips and move it inside the mouth, so some of the food can fall out of the mouth - this does not mean that the child does not like the food. The main source of energy is breast milk, and for "artificial" people - an adapted formula. Breastfeeding continues on demand and the formula is given in the same quantities and at the same interval as before!

The food that the baby receives at this stage is mashed foods, consisting of one ingredient, soft consistency, without added sugar, salt or hot seasonings. It can be either mono-component mashed potatoes or factory-made porridge, or food cooked at home: mashed rice, soft thick porridge, vegetable puree... For a softer taste and better absorption, you can add expressed breast milk or formula to your baby's food.

Second stage: 7-8 months.

When the baby can not only sit without support, but also carry objects (for example, a spoon) from one hand to the other, you can give already thicker food and add new flavors. At the same time, breastfeeding continues on demand, but one must remember that often babies at this time begin to ask for breast less often. To ensure that the amount of milk your baby needs does not decrease, experts in young child feeding advise offering complementary foods only after breastfeeding.

Foods at this stage are well-cooked mashed meats (especially liver), legumes, vegetables, fruits and various grains. Sugar and salt are still not welcome! Mom offers food two or three times a day, the baby still eats a little, but from a wider range of foods.

Third stage: 8-10 months.

Now is the time to learn how to deal with small pieces of food. Mom no longer only feeds from a spoon, but also offers the baby food that he can take with his fingers: slices of fruit, unsweetened cookies, pieces of cheese or carrots. Breastfeeding continues on demand, but in parallel with the meal, the mother also offers the baby a drink from a cup: it can be water, compote or fermented milk products. Babies can refuse additional drinks, you should not worry about this: breast milk still satisfies the needs of the baby, provided that it is fed on demand, so it is mother's business to provide an opportunity for choice. Babies who are fed with formula or mainly formula can be given unmodified cow's milk after 9 months.

The food should be varied and contain fruits and vegetables, legumes and small quantities fish, kefir, meat, liver, eggs or cheese. Babies are offered food three to four times a day, and babies who are not breastfeeding should eat at least five times a day.

Fourth stage: 10-12 months.

These are the last months of the introduction of complementary foods, when adults still give the child adapted food and monitor its amount so that the baby does not eat too much or too little. Breast milk continues to be an important part of the diet and should preferably be the main liquid during the second year of life and even longer.

Products at this stage should be chopped or mashed, and the meat should be rolled in a meat grinder. Each meal includes finger-grip foods: small cubes of fruits, vegetables, potatoes, cheese and soft meats to train your toddler to eat independently and determine the consistency of foods. In infants, at this time, three main meals are alternated with two snacks.

By about one year of age, children can eat regular family meals and do not require specially prepared meals. It is still not recommended to add salt, and limiting salt will benefit the whole family. Children eat slowly, so extra care must be taken to give them extra time and attention. It is impossible to scold a baby if he has not coped with something or refuses something, food should be a source of positive emotions!

Common mistakes when introducing complementary foods

complementary foods are not an end in themselves. A mother who gives her baby complementary foods must firmly understand that complementary foods are not basic, but complementary foods. There is no need to try to give the child a certain amount of complementary foods by all means! Circumstances must always be taken into account. Complementary foods are introduced later to premature babies and babies with allergies. New types of complementary foods are not introduced during illness and after vaccinations! During illness or teething, the baby's appetite drops sharply, and this is natural - complementary foods need to be postponed, because the energy necessary for recovery is spent on digesting food unusual for the body.
juice is not a product of the first feeding. It is not even suitable for a second or third feeding. The baby needs a lot of energy, but physically he is able to use very little food. Therefore, the food that he receives must have a certain energy density, otherwise there is a risk of malnutrition. In addition, in the old Soviet books juices were recommended as additives correcting the lack of vitamins in mixtures produced half a century ago. In other words, it was recommended to start complementary foods with juices because it was assumed that the mother was no longer breastfeeding (very early going to work was considered the norm), and the mixtures did not give the child the required amount of vitamins. Today, mothers often breastfeed for up to a year or more, and the adapted formulas have significantly improved their composition! The early introduction of juices does not make sense precisely because this is a direct displacement of food much more useful for the child, while contained in juices fruit acids without the softening effect of the fiber contained in fruits, they are quite aggressive. On average, in every third child, the introduction of juices earlier than 9 months causes allergic reactions and indigestion. Moreover, due to the combination of high acidity and sugars, fruit juices, when actively used, often cause early childhood caries. So it's better to wait with the juices - after a while they can become friends to the baby, but let it happen later.
complementary foods for up to a year should not displace breast milk or an adapted formula. The World Health Organization, and after it the latest recommendations of the Ministry of Health and Social Development of Russia, specifically and repeatedly emphasize that complementary foods are not a substitute for nutrition, but a complementary one. Unfortunately, many pediatricians are still based on outdated nutritional guidelines, which were given in such a way that by one year breastfeeding was over and the baby was completely switched to "adult" food. Today's recommendations, on the contrary, say that breastfeeding is very useful to continue after a year, therefore it is useful to give complementary foods together with breastfeeding, and not instead of breastfeeding. Otherwise, in a year or even earlier, it turns out that mom's milk has run out.

If complementary foods begin to replace breastfeeding, this leads to a decrease in lactation and, accordingly, to the risk of insufficient energy and nutrient intake by the baby. No product in its value can compare with the value of breast milk, therefore, the amount of milk that a baby receives should not be allowed to decrease due to an increase in complementary foods! On the contrary, as the baby grows, it needs more energy, and complementary foods should replace this missing energy with the same amount of breast milk or an adapted formula as before. And in parallel with the introduction of complementary foods, the mother continues breastfeeding on demand.

The same goes for artificial children. Many mothers are tempted by the 8-9 months to completely abandon formulas and switch to complementary foods. Moreover, it is economically more profitable, especially if you prepare complementary foods yourself. But cheaper does not mean better for a child! The most suitable food for a baby under one year old is, of course, breast milk, followed by an adapted formula. All other products lag far behind even the adapted mixture in terms of bioavailability and nutritional value. Take, for example, the very iron that doctors say so much about the need for children: breast milk the level of its availability for a baby is about 50%, and in infant formula - already about 15-20%. It would seem that there is already a big difference, but iron is absorbed from red meat by about 10%, and from vegetables and grain products specially enriched with iron - by only 4-5%! So for artificial people up to a year, complementary foods should also remain exactly complementary nutrition, and the main energy they need should be obtained from an adapted mixture by age.

Appendix 1: foods that should not be given to children for a long time

coffee, black and green tea inhibit the absorption of iron, you need to avoid their use for up to two years. After the onset of this age, it is still recommended not to give tea to children with meals, so as not to interfere with the absorption of iron.
herbal teas: WHO warns that due to small body size and fast pace physical development infants are less protected than adults from the pharmacological effects of certain chemicals found in herbal teas. There is not enough scientific evidence to support the safety of various herbs and herbal teas for infants, but most herbal teas - in particular the popular chamomile tea - have been shown to have the same negative effect on iron absorption as regular tea. and thus contribute to the development of anemia.
milk with a low fat content is not recommended until about two years of age: due to the low nutritional value, the baby does not receive enough energy.
honey often contains clostridia, which cause botulism. There are very few of them, and the acid contained in the gastrointestinal tract of adults destroys Clostridia. But in children under three years of age, there is not enough acid for this, therefore, the development of botulism is possible.
mushrooms are food that is difficult for even some adults to digest. Children are not advised to eat mushrooms under the age of three: protein that is difficult to digest often causes digestive upset.

Appendix 2: signs of readiness to introduce complementary foods

Today, experts also suggest taking into account the following signs:

extinction of the pushing reflex - if the baby gets something in his mouth, he does not seek to immediately push it out with his tongue;
doubling the birth weight (and for premature babies it is proposed to talk about tripling);
the baby may deliberately turn away from the spoon if the proposed product does not like it;
the child increases the frequency of latching on to the breast or does not eat up with the usual portion of the mixture;
finally, the baby is interested in food: he is actively interested in what the parents eat there.

We draw the attention of parents to the fact that one or two signs from this list are still not enough for the introduction of complementary foods: most of them should appear, and better all. In most cases, this happens just in time for about six months of age, although sometimes a little earlier or later.

Coordinator of the "New Level" project